The People's Perspective on Medicine

Cisapride

Overview

*** WARNING: THIS DRUG WAS WITHDRAWN FROM THE MARKET BY THE FDA.

Propulsid promotes good muscle tone in the gastrointestinal tract and in so doing facilitates the proper movement of food through the system.

It is prescribed for nighttime heartburn due to acid splashback from the stomach to the esophagus through the ring of muscle known as the lower esophageal sphincter.

Instead of combating the symptoms of heartburn by neutralizing or reducing the acid produced in the stomach, Propulsid tightens the sphincter to help keep the acid in the stomach where it belongs.

Side Effects and Interactions

Reported side effects of Propulsid include headache, diarrhea, stomachache, constipation, flatulence, runny nose and vision disturbances.

Other reactions, such as insomnia or drowsiness, vaginitis, dry mouth, palpitations, tremor and migraine, are less common.

Many other effects were reported rarely during clinical trials, and some potential side effects of this relatively new drug may not yet have been recorded. Report any symptoms to your physician promptly.

Because Propulsid is prescribed for heartburn, other medicines that work to reduce acid secretion may be prescribed at the same time. Both Tagamet and Zantac are absorbed more rapidly when given with Propulsid.

Tagamet also increases the blood levels of Propulsid.

Other stomach medicines such as Donnatal or Pro-Banthine would work against Propulsid and shouldn't be combined with it.

Besides increasing sphincter pressure, Propulsid hastens stomach emptying. This is generally beneficial but it could interfere with proper absorption of other medicines taken together with Propulsid. Blood levels of such medicines may need to be monitored more frequently.

Propulsid increases the action of blood thinners like Coumadin. Blood clotting time should be checked carefully both when patients on anticoagulants start taking Propulsid and when they stop.

Alcohol and sedative drugs like Halcion, Restoril, Ativan or Xanax produce more impairment in a person who is also taking Propulsid.

Because Propulsid is a relatively new medication, there may be other drug interactions that have not yet been identified.

Do not take any other medication without first asking your physician and pharmacist to check on the potential for interaction with Propulsid.

Special Precautions

Propulsid should not be taken when there is gastrointestinal bleeding, obstruction of the bowel or a possible perforation. Increasing digestive tract movement in such cases could be dangerous.

Although Propulsid doesn't slow reflexes or impair judgment on its own, it may increase the impairment experienced by a person taking an anti-anxiety medicine such as Valium or Xanax.

If Propulsid must be taken together with a benzodiazepine, a prudent person will avoid driving or operating dangerous machinery.

Taking the Medicine

Propulsid is taken four times a day, at least 15 minutes before meals and at bedtime.

Store the pills away from moisture at room temperature (between 59 and 86 degrees F).

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About the Author
Joe Graedon is a pharmacologist who has dedicated his career to making drug information understandable to consumers. His best-selling book, The People’s Pharmacy, was published in 1976 and led to a syndicated newspaper column, syndicated public radio show and web site. In 2006, Long Island University awarded him an honorary doctorate as “one of the country's leading drug experts for the consumer.” .
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