Gastro-oesophageal reflux and cisapride

Cisapride was more effective than placebo in diminishing symptoms and endoscopically-visible lesions associated with reflux oesophagitis.

Cisapride and cimetidine seemed to offer an additive benefit.

Maintenance doses halve the relapse rate of mild reflux compared to placebo.

The recommended doses of cisapride for reflux were:

• for symptoms and mucosal lesions, 10mg tds or qds; or 20mg bd PO
• for maintenance treatment, 20mg nocte or 10mg bd

A twelve week course was recommended.

This drug was withdrawn from marketing in the UK from 28th July 2000 until further notice. This is because cisapride can prolong the QT interval, which may lead to rare but life-threatening ventricular arrythmias. The committee on Safety of Medicines has advised that all treatment with cisapride should be stopped and patients should be changed to an alternative treatment as necessary.

Reference:

• 1) Committee on Safety of Medicines (July 2000).Suspension of cisapride (Prepulsid): Product withdrawal.