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Cisapride

Also indexed as: Propulsid®

Cisapride is a gastrointestinal stimulant drug used to treat people with nighttime heartburn due to reflux of stomach acid into the esophagus. It is also used to increase movement of gastrointestinal contents in conditions of lack of spontaneous gastrointestinal movement.

Safetychecker Summary for Cisapride
(for details about the summarized interactions, read the full article)

Beneficial May be Beneficial: Depletion or interference—The medication may deplete or interfere with the absorption or function of the nutrient. Taking these nutrients may help replenish them.

Menthol-containing herbs such as peppermint
Avoid Avoid: Reduced drug absorption/bioavailability—Avoid these supplements when taking this medication since the supplement may decrease the absorption and/or activity of the medication in the body.

Tobacco
Avoid Avoid: Adverse interaction—Avoid these supplements when taking this medication because taking them together may cause undesirable or dangerous results.

Grapefruit juice

Red wine
Side effect reduction/prevention

None known
Supportive interaction

None known

An asterisk (*) next to an item in the summary indicates that the interaction is supported only by weak, fragmentary, and/or contradictory scientific evidence.

Interactions with Herbs

Menthol-containing herbs
People with esophageal reflux should avoid use of menthol-containing herbs, such as peppermint; the volatile oils in these plants may decrease the pressure in the lower esophageal sphincter and make the reflux worse.1

Interactions with Foods and Other Compounds

Alcohol
Alcohol consumption is associated with nighttime heartburn and may interfere with cisapride therapy.2 Alcohol causes sleepiness, and cisapride may intensify this effect,3 increasing the risk of accidental injury. Ingestion of red wine along with cisapride may also increase blood levels of the drug in some individuals, potentially increasing its side effects.4 People taking cisapride should avoid alcohol..

Tobacco
Smoking is associated with nighttime heartburn and may interfere with cisapride therapy.5 Smokers taking cisapride may benefit from reducing or quitting smoking.

Grapefruit juice
In a study of healthy males, ingestion of 250 ml (about one cup) of grapefruit juice along with cisapride increased the peak blood level of the drug by an average of 68%.6 It is not known whether consuming grapefruit juice at a separate time of the day would affect blood levels of cisapride. As this interaction could potentially increase the side effects of cisapride, individuals taking cisapride should avoid grapefruit and its juice.>

References:

1. Sigmund CJ, McNally EF. The action of a carminative on the lower esophageal sphincter. Gastroenterol 1969;56:13–8.

2. Threlkeld DS, ed. Gastrointestinal Drugs, GI Stimulants, Cisapride. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, Nov 1998, 308b–8c.

3. Threlkeld DS, ed. Gastrointestinal Drugs, GI Stimulants, Cisapride. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, Nov 1998, 308b–8c.

4. Offman EM, Freeman DJ, Dresser GK, et al. Red wine-cisapride interaction: comparison with grapefruit juice. Clin Pharmacol Ther 2001;70:17–23.

5. Threlkeld DS, ed. Gastrointestinal Drugs, GI Stimulants, Cisapride. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, Nov 1998, 308b–8c.

6. Offman EM, Freeman DJ, Dresser GK, et al. Red wine-cisapride interaction: comparison with grapefruit juice. Clin Pharmacol Ther 2001;70:17–23.