Cisapride

Source: Wikipedia, the free encyclopedia.
Cisapride
Clinical data
Trade namesPrepulsid, Propulsid
AHFS/Drugs.comFDA Professional Drug Information
MedlinePlusa694006
Pregnancy
category
  • AU: B1
Routes of
administration		By mouth (tablets), suspension
ATC code
Legal status
Legal status
  • AU: S4 (Prescription only)
  • BR: Class C1 (Other controlled substances)[1]
  • UK: POM (Prescription only)
  • US: Withdrawn
Pharmacokinetic data
Bioavailability30-40%
Protein binding97.5%
Metabolismliver CYP3A4, intestinal
Elimination half-life10 hours
Excretionkidney, bile duct
Identifiers
  • (±)-cis-4-amino-5-chloro-N-(1-[3-(4-fluorophenoxy)propyl]-3-methoxypiperidin-4-yl)-2-methoxybenzamide
JSmol)
  • Clc1cc(c(OC)cc1N)C(=O)NC3CCN(CCCOc2ccc(F)cc2)CC3OC
  • InChI=1S/C23H29ClFN3O4/c1-30-21-13-19(26)18(24)12-17(21)23(29)27-20-8-10-28(14-22(20)31-2)9-3-11-32-16-6-4-15(25)5-7-16/h4-7,12-13,20,22H,3,8-11,14,26H2,1-2H3,(H,27,29) checkY
  • Key:DCSUBABJRXZOMT-UHFFFAOYSA-N checkY
 ☒NcheckY (what is this?)  (verify)

Cisapride is a

parasympathomimetic. Stimulation of the serotonin receptors increases acetylcholine release in the enteric nervous system. It has been sold under the trade names Prepulsid (Janssen-Ortho) and Propulsid (in the United States). It was discovered by Janssen Pharmaceuticals in 1980. In many countries, it has been either withdrawn from the market or had its indications limited due to incidence of serious cardiac side-effects.[2] Propulsid was linked to children's deaths.[3]

The commercial preparations of this drug are the

racemic mixture of both enantiomers of the compound. The (+) enantiomer itself has the major pharmacologic effects and does not induce many of the detrimental side-effects of the mixture.[4]

Medical uses

Cisapride has been used for the treatment of gastroesophageal reflux disease (GERD). There is no evidence it is effective for this use in children.[5] It also increases gastric emptying in people with diabetic gastroparesis. Evidence for its use in constipation is not clear.[6]

In many countries, it has been either withdrawn or had its indications limited because of reports of the side-effect

U.S. Food and Drug Administration (FDA) issued a warning letter to doctors,[7] and cisapride was voluntarily removed from the U.S. market on July 14, 2000. Its use in Europe has also been limited.[5] It was banned in India and in the Philippines in 2011.[8]

Veterinary uses

Cisapride is still available in the United States and Canada for use in animals, and is commonly prescribed by veterinarians to treat megacolon in cats.

Cisapride is also commonly used to treat GI stasis in rabbits, sometimes in conjunction with metoclopramide (Reglan).

Kinetics

Oral bioavailability of cisapride is approximately 33%. It is inactivated primarily by hepatic metabolism by CYP3A4 with a half-life of 10 hours. The dose of the drug should be reduced in case of liver diseases.[9]

Pharmacology and mechanism of action

As a

muscarinic receptors
.

See also

References

  1. ^ Anvisa (2023-03-31). "RDC Nº 784 - Listas de Substâncias Entorpecentes, Psicotrópicas, Precursoras e Outras sob Controle Especial" [Collegiate Board Resolution No. 784 - Lists of Narcotic, Psychotropic, Precursor, and Other Substances under Special Control] (in Brazilian Portuguese). Diário Oficial da União (published 2023-04-04). Archived from the original on 2023-08-03. Retrieved 2023-08-16.
  2. ^ "Propulsid To Go Off Market - Warning". MedicineNet. Retrieved 2021-12-25.
  3. ^ "PROPULSID: A Heartburn Drug, Now Linked to Children's Deaths". Los Angeles Times. 2000-12-20. Retrieved 2021-12-25.
  4. ^ US patent 5955478, Gray NM, Young JW, "Methods for treating gastrointestinal motility dysfunction using optically pre (+) cisapride", issued 1999-Sep-21 
  5. ^
    PMID 20393933
    .
  6. PMID 21249695
    .
  7. ^ ""Cardiac contraindications included in new FDA warnings about Propulsid"". medscape.com. January 25, 2000. Retrieved 10 May 2021.
  8. ^ "Drugs banned in India". Central Drugs Standard Control Organization, Dte.GHS, Ministry of Health and Family Welfare, Government of India. Archived from the original on 2015-02-21. Retrieved 2013-09-17.
  9. S2CID 33641651
    .

Further reading

External links

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