Cisapride is a substituted
benzamide compound that stimulates motor activity in all segments of the gastrointestinal tract by enhancing the release of
acetylcholine from the enteric nervous system.
Cisapride is administered orally in the treatment of
gastro-oesophageal reflux disease, functional
dyspepsia,
gastroparesis, chronic
intestinal pseudo-obstruction syndromes and chronic
constipation. In
gastro-oesophageal reflux disease in both adults and children,
cisapride provides symptomatic improvement and mucosal healing. Long term treatment with
cisapride is effective in the prevention of relapse of oesophagitis.
Cisapride improves gastric emptying rates and improves symptoms in patients with
gastroparesis of various origins. Unlike
domperidone and
metoclopramide, long term administration of
cisapride seems to result in persistently enhanced gastric emptying.
Cisapride is also effective in improving symptoms in patients with functional
dyspepsia. In comparative studies in patients with functional
dyspepsia,
cisapride was at least as effective as
metoclopramide,
domperidone,
clebopride,
ranitidine and
cimetidine.
Cisapride increases stool frequency and reduces
laxative consumption in patients with idiopathic
constipation. Severe cases of slow transit
constipation seem refractory to
cisapride. Clinical studies also indicate that
cisapride might be effective in the treatment of chronic
intestinal pseudo-obstruction, postoperative
ileus,
peptic ulcer and
irritable bowel syndrome. Further clinical studies are warranted to define the role of
cisapride in these conditions. The dosage of
cisapride ranges from 5mg 3 times daily to 20mg twice daily.
Cisapride is generally well tolerated, both during short and long term treatment. In children,
cisapride is also well tolerated in doses of 0.2 to 0.3 mg/kg, 3 to 4 times daily.(ABSTRACT TRUNCATED AT 250 WORDS)