CISAPRIDE
What is in this leaflet
This leaflet answers some of the common questions about Cisapride Tablets and Suspension. It does not contain all of the available information. It does not take the place of talking to your doctor or pharmacist.
If you have any concerns about using Cisapride, ask your doctor or pharmacist.
Your doctor and pharmacist have more information.
What Cisapride is used for
Cisapride is used to treat:
- Severe reflux oesophagitis - The burning indigestion pain caused when the acidic stomach contents flow the wrong way back up the gullet. Your doctor can only prescribe Cisapride for this condition after other treatments, including medicines called "proton pump inhibitors", have failed to bring relief.
- Gastroparesis - The discomfort caused by a slow working stomach. For example, the inability to finish a meal, a feeling of being "too full" or bloated after a meal, a loss of appetite, feeling sick and maybe vomiting, or belching without relief.
- Severe gastro-oesophageal reflux in children - The discomfort caused to babies and children when they continually bring up their stomach contents after feeding. A specialist physician or surgeon will have confirmed that you, or your child, have one of these conditions.
Cisapride works by strengthening the muscle contractions of the digestive system. Food then moves through the stomach more easily.
Cisapride has been approved for the uses listed above. However, your doctor may prescribe this medicine for another use. If you would like more information ask your doctor.
Before you use Cisapride
When you must not use it
Do not use Cisapride if you know you are allergic to any of the ingredients. Signs of allergy include a skin rash, itching, shortness of breath and/or a swollen face.
Do not use Cisapride:
- if you know you have a rare heart disorder known as a QT-prolongation. Sometimes this runs in the family
- if you know you have a very slow heart beat
- in babies born 6 weeks or more prematurely, for the first three months after delivery
Your doctor will not prescribe Cisapride if an increase in muscle contractions of the digestive system could harm you. For example, if you have had bleeding, a blockage or puncture in your stomach or bowel.
Do not use Cisapride with any of the following when either taken by mouth or given by injection:
- certain medicines called azoles, used to treat fungal infections, eg. ketoconazole, itraconazole, miconazole and fluconazole
- certain antibiotics called macrolides, eg.erythromycin, clarithromycin and troleandomycin
- certain antidepressants, such as nefazodone, amitriptylline and maprotiline
- certain medicines used to treat mental illness, such as chlorpromazine, pimozide and sertindole
- certain medicines that act on the heart, eg. quinidine, disopyramide, procainamide, amiodarone, sotalol and bepridil
- certain antihistamines, eg. astemizole and terfenadine
- certain medicines used to treat AIDS eg. ritonavir and indinavir
- the antimalarial halofantrine
- the antibacterial sparfloxacin
All of these medicines are known by a variety of brand names which are not included here. Please check with your doctor or pharmacist if you think you might be taking one of these medicines.
You should NOT take Cisapride with grapefruit juice.
Before you start to use it
Certain people must use Cisapride with caution. Ask your doctor for advice.
Elderly
If you are elderly, you may need less Cisapride. Your doctor will advise you on the correct dose.
Driving and Operating Machinery
There is no problem if you take only Cisapride because it does not slow down your reactions. However, you should be careful if you are taking Cisapride with alcohol or tranquillisers or other medicines which make you sleepy.
You must tell your doctor if:
- you have or have ever had a heart disease
- a member of your family has died unexpectedly from heart related problems
- you are taking medicines or have medical conditions which cause an imbalance of potassium and magnesium levels in your blood
- you have persistent vomiting or diarrhoea
- you have or have ever had liver or kidney disease
- you have a lung disease or breathing problems
- you are pregnant or planning to become pregnant
- you are breast feeding or wish to breastfeed
It is important to ensure that your doctor knows about your personal and family medical history. If you have not told your doctor or pharmacist about any of the above, tell them before you start taking or are given Cisapride.
Your doctor will advise you whether or not to take Cisapride or if you need to adjust the dose, or adapt your treatment.
Other medicines and alcohol
Tell your doctor if you are taking any medicines that slow down blood clotting (anticoagulants) because Cisapride may increase their effect.
Cisapride can speed up and increase the sedative effects of alcohol and sleeping tablets. Be careful and tell your doctor if you are taking any of these products with Cisapride.
Tell your doctor if you are taking any medicines to slow down the stomach or bowel as they may reduce or cancel the effect of Cisapride.
There are also some other drugs that may cause problems if used together with Cisapride. So, make a point of telling your doctor or pharmacist if you are taking any other medicines , including medicines you can buy without a prescription from a pharmacy, supermarket or health food shop. They will tell you which drugs should not be taken or what other measures (e.g. a change of dose) are necessary. Also, while you are taking Cisapride, do not start taking a new medicine without first informing your doctor or pharmacist.
Using Cisapride
How to use it
Cisapride is best taken 15 minutes before meals and if necessary, before going to bed. Swallow the tablets with some water or drink but NOT grapefruit juice.
The following are the most often used doses, but your doctor may adjust them to suit your needs. Do not take more than the dose prescribed by your doctor.
Adults
The usual dosage is one 5 mg or 10 mg tablet, two to four times daily, 15 minutes before meals and at bedtime; or two 10 mg tablets before breakfast and at bedtime.
Persons with kidney or liver diseases
It is best to take half the dose prescribed for other adults. Your doctor will tell you how many tablets or how much solution is appropriate to your particular situation.
Babies and Children
It is best to use the liquid suspension for babies and children.
Less than 6 years of age (Up to 25 kg in weight):
The usual dose is 0.2 mL (equal to 0.2 mg) of suspension per kilogram of body weight, given not more than three to four times daily, 15 minutes before meals and at bedtime.
6-12 years of age (Between 25 - 50 kg in weight):
The usual dose is 2.5 mL to 5.0 mL (equal to 2.5 mg to 5.0 mg) of suspension, given three to four times daily, 15 minutes before meals and at bedtime.
Important Note:
The dose for children should not be more than 5 mL (equal to 5 mg) of suspension of Cisapride at a time.
5mL of suspension is equal to a full measuring cap provided with the 200 mL bottle or a full pipette provided with the 100 mL bottle.
How to use the liquid suspension
Before each use, shake the bottle well. The bottle comes with a child-proof cap and should be opened by pushing the plastic screw cap down and turning it anti-clockwise.
Directions for using the pipette provided with the 100 mL bottle of liquid suspension:
- Pull the white plastic cover off the pipette with a firm tug so that the blue markings can be seen.
- Insert the pipette into the bottle
- While holding the grey bottom ring, pull the white top ring up to the blue line which corresponds to the child's weight in kilograms. For example, pull the white plunger up to the 5 kg mark for a child weighing 5 kg
- Hold the grey bottom ring and take the pipette out of the bottle
- Empty the liquid from the pipette into some drink other than grapefruit juice by pressing the white top ring down. Give the drink to the child
- Rinse and dry the pipette after use and store it in its case. Close the bottle
Directions for using the measuring cap provided with the 200 mL bottle of liquid suspension:
- A measuring cap is supplied with graduation marks at 2.5 mL (equal to 2.5 mg) and 5 mL (equal to 5 mg)
- Fill the measuring cap up to the required amount
- Give the dose to the child. Alternatively, the measured amount of liquid suspension can be poured into a drink (NOT grapefruit juice) and given to the child
- Rinse and dry the measuring cap after use. Close the bottle
If you forget to take a dose
Take it as soon as you remember, and then continue taking it as you would normally.
If it is almost time for your next dose, skip the dose you missed and take your next dose when you are meant to.
Do not take a double dose to make up for the one you missed.
Overdose
Telephone your doctor, or the Poisons Information Centre, or go to the Accident & Emergency Department at your nearest hospital immediately if you think you or anybody else has taken too much Cisapride.
If you have taken too much you may get stomach cramps and diarrhoea or irregular heart beat. Very young children can become listless and weak.
Your doctor may give charcoal to stop any Cisapride remaining in the stomach from entering the bloodstream. You or your child will also need to be watched closely.
The doctor may want to do an ECG test for a rare condition known as QT-prolongation, and may check for a slow heart beat and take a blood sample to measure changes in substances called electrolytes (especially for a low potassium or magnesium level).
While you are using Cisapride
Things you must do
Always follow your doctor's instructions carefully.
You must tell your doctor immediately if you suffer from persistent or severe attacks of vomiting or diarrhoea.
You must avoid alcohol when you are taking Cisapride Tablets and Suspension. The combined effect of alcohol and Cisapride may cause drowsiness.
Always inform your doctor or pharmacist that you are using Cisapride before you commence taking any new medicines.
Things you must NOT do
Do not use a medicine for any purpose other than the purpose it has been recommended for you.
Do not take more than the recommended amount.
Never allow others to take medicines recommended for you, and never use medicines prescribed for others.
Things to be careful of
Ask your doctor before taking any other medicines.
Cisapride can increase the effect of medicines which slow down the ability to react. These medicines include "tranquillisers", sleeping pills, some antihistamines, and some medicines used to treat depression.
Side Effects
Tell your doctor as soon as possible if you do not feel well while you are using Cisapride.
All medicines have side effects. Often they are not serious but sometimes they can be. You may need medical treatment if you get some side effects.
Tell your doctor if you notice any of the following and they worry you:
- diarrhoea
- stomach cramps
- rumbling in your stomach (this actually shows that Cisapride is working)
- light headedness
- mild headache
- slight blurred vision
These are all mild side effects of Cisapride and will usually disappear within a few days on their own. Tell your doctor if they continue.
Tell your doctor if you notice any of the following:
- diarrhoea in babies or children
- muscle stiffness or cramps
- you have to pass urine more often
These side effects are rare. Tell your doctor about them because medical attention might be necessary.
STOP taking Cisapride and tell your doctor immediately if any of the following happen:
- you have an allergic reaction to Cisapride (allergy can be recognised, for instance, by skin rash, itching, shortness of breath and/or a swollen face)
- dark brown urine, pale stools or yellowing of the skin
- you feel faint, become dizzy or have irregular heartbeats
These side effects are rare. You should tell your doctor about them because you may need urgent medical attention.
Do not hesitate to report any other side effects to your doctor or pharmacist.
After using Cisapride
Storage
- Keep Cisapride tablets in the blister pack until it is time to take them
- Keep your Cisapride tablets below 30ºC and store them in a dry place
- Keep your Cisapride suspension stored below 25ºC
- Check the suspension bottle is properly sealed. Keep it where young children cannot reach it. A locked cupboard at least one-and-a-half metres (1.5m) above the ground is a good place to store medicines
- Do not store Cisapride, or any medicine in the bathroom or near a sink. Heat and dampness can destroy some medicines
- Do not use Cisapride Tablets and Suspension beyond the date (month and year) printed on the pack after the letters 'EXP', even if it has been stored properly.
- Medicines cannot be stored indefinitely
Disposal
Once you have finished using Cisapride Tablets or Suspension, or your medicine has passed its expiry date, ask your pharmacist what to do with any that is left.
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