Cisapride Use in Cats

Cisapride is useful in treating may gastrointestinal problems in cats

In July 1993 a drug called cisapride was approved in human medicine for treating gastroesophageal reflux in humans. In January of 2000, cisapride was removed from the United States market by the FDA after reports of cardiac side effects such as rapid and irregular heart rate. In veterinary medicine there were never any such cardiovascular effects seen. The drug was extremely helpful in treating many gastrointestinal disorders so it continued to be used, primarily in cats.

Cisapride is very effective in treating certain types of constipation in cats, such as constipation due to hairballs and constipation in cats with a condition called megacolon. Megacolon is a condition where a certain part of the intestine gets dilated causing its regular motion (called peristalsis) to become somewhat paralyzed. Cisapride is also used for gastrointestinal reflux as well as a condition called postoperative ileus.

The positive effects seen from cisapride in cats include accelerated gastric emptying of both liquids and solids, and a decrease in transit time. Although there is another drug called metoclopramide that can be used for similar conditions, cisapride is more potent and has a broader range of activity for many conditions. Cisapride also has much less of an effect on the central nervous system because it does not so readily cross the blood-brain barrier. The blood-brain barrier is one of those very important and regularly studied terms in pharmacy school that signifies whether a certain drug has any effect on the central nervous system or it does not.

Since cisapride has been discontinued in human medicine, the pharmaceutical company that used to market it under the trade name “Propulsid” has decided to stop making it available. For a while this medication was not available in any form. After the realization that this drug was extremely useful in veterinary medicine, certain compound pharmacies were fortunately able to make cisapride available to the millions of suffering pets that have benefited from using it. Cisapride has been considered a ‘miracle drug’ for many pet owners who have continuously watched their pets suffer from certain gastrointestinal conditions.

It is extremely important to watch the dose of cisapride and to make sure the pet does not get a higher dose than that prescribed by the veterinarian. Animals with liver disease may also need to have their dose reduced in order to reduce the chances of bad side effects. Cisapride also has many drug interactions because for one it accelerates the time that certain other drugs pass through the intestines therefore possibly affecting absorption. Other drug interactions include many of the anti-fungal drugs such as ketoconazole, itraconazole, and miconazole. Using this medication along with these anti-fungals has the potential of causing very dangerous ventricular arrhythmias. Cisapride may increase the rate of absorption of cimetidine, ranitidine, and may increase the effects of certain anticoagulants. Other possible adverse reactions and interactions have occurred.

It is important to stay in close contact with your veterinarian and discuss any medications your pets may be taking along with any observed adverse effects seen after administering the drug. A close relationship with the veterinarian is one of the best ways to get the most benefit of any treatment while still managing the dangerous bad effects. Your 1800PetMeds pharmacist is also available to answer any of your medication related questions. When dealing with medication such as cisapride it is so important not to leave any of the questions you have unanswered.

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37 Comments

  1. My 16 yr old maincoon was diagnosed with gastric immobility complete bloodwork normal done 2x in a yr. cisipride 2x daily with Pepcid ac 5mg 2x daily. She stopped vomiting for 5months than started a few times a week again. Everything else is normal. This week she has vomited almost everyday 1x. Vet said next step ultrasound or endoscopy. I have reservations about anesthesia at 16 & endoscopy can make things worse. What is your opinion.

  2. Dr. Michael Dym, VMD veterinarianMarch 24, 2015 at 12:14 am

    I would go for ultrasound first over endoscopy and anesthesia, and based on ultrasound, incorporate some form of presumptive treatment. I would only use endoscopy and biopsy as last resort

  3. I have a cat that I’m having trouble with being constipated and vomiting. I took him to the vet and he said no dry food and to give him a dulcolax pill everyday and he wrote me prescriptions for cisapride and lactulouse. My question is will these cause a runny stool because we are having problems with him using the litter box because of these issues?

  4. Do you know of or could you help find any cisapride suppliers in Asia? Because it is very difficult to find in Malaysia and stock is limited. My cat is taking it and has improved drastically. Poops daily. thank you very much

  5. Cisapride was a godsend for my cat with hypertrophic cardiomyopathy. He was having semi-annual enemas until the vet recommended cisapride several years ago. Though it sometimes causes diarrhea when he can’t always get to one of our multiple litter boxes, the occasional clean-up is a lot easier to deal with than a trip to the vet for another enema. He used to really struggle to eliminate, now it comes easy (even if occasionally too easy!). Yes, it’s expensive, but to see our HCM cat enjoying his now senior years instead of suffering with constipation, I would say it’s worth it.

  6. can someone help me? can prednisolone and cisapride be given together to a cat

  7. Is it still save to give cisapride to a cat? Is it better to give mosapride instead of cisapride?

  8. Stella and Chewy’s is what aggravates the constipation. My cat became seriously blocked when I fed Natures Variety canned and Stella and Chewy’s freeze-dried rehydrated. It’s concrete in the bowel. There is too much bone in these products.

    My cat is doing much better on high moisture canned food. I’ve been feeding him Tikki cat beef and chicken, grain free, and adding Miralax and more water. Also drink’s organic goat’s milk. He does not drink water at all.

    I switched him to raw at one point and he blocked up again.

  9. My 15 year old femaie cat named Xena has been on cisapride mg tablet and 1ml ratio-lactulose every 12 hours for the last 2months. She has severe constipation and 90% kidney failure — no vomiting. She was taken off Royal Canin fibre response which helped her for many years — now she is just on vet renal support canned wet food. She is loosing weight and is still forcing on the litter box. I am afraid if something doesnt change that she will suffer too much and i will have to put her down. Can you help please. thank you

  10. Sharman, Kidney failute is irreversible in every animal. 🙁 dialysis is an option but…that won’t save them. 🙁 I’m really sorry to hear that.

  11. My little Houtan is on Cisapride 5mg, 0.5ml 2x a day for Mega colon and constipation. Last check up also showed some Renal Failure so we have altered his diet, and have him on 0.2ml of Benazepril 2x a day. With this we give him 2 small scoops of Aventi in his food. Both Meds are liquid and mix into his food too. We add different Meds at different times through out the day. We used to use Mirilax for last few years with good results, until it stopped working. BMs were getting further apart. The new Meds are working fine, until he started becoming Fecal incontinent, (much to his mortification) We don’t make a big deal of it. So question is, could he be on too high a does of Cisapride. It for motility after all. I also worry that with food passing through faster is he getting enough Nutrition? Can I safely lower the dose 0.1 ml.? Thank you

  12. Mama Lucy was diagnosed with a broken/shattered femur (severe) two weeks after the incident (unknown how it happened-cat was let out accidentally). At first the vet said she had three puncture wounds, but when she still was not weight bearing after 2 weeks, so I brought her back. She was operated on with a plate and pin. After the second week, I noticed she was not having enough bowel movements and were very small and hard. I brought her back to the vet, and xray showed she was backed up, got an enema, was prescrobed Royal Canine prescription and 1ml of lactulose q12h. The 1st 2 days, she did go ( I am assuming because of the enema), but after that she did not go for another week. I brought her back, another xray and enema, and he put her on lactulose 1ml q12hr along with cisapride 1ml q12h. He said it is possible that she could have nerve damage that is not letting the colon have peristalisis. He does not know if this would be a permanent condition. It has been day 2, she did go yesterday, but not today. She is still on the Royal Canine prescription diet, which she really is not fond of.
    My questions are this:
    1. Is there a way to tell if it is actually nerve damage?
    2. Is there any other medicines/alternatives if the cisparide/lactulose and the special diet?
    3. The vet tells me she cannot have an enema every week if this does not work? Why not?
    4. Is there any other food (moist) I can give her along with the dry since she is not eating enough? Would adding water to food help her?
    The cisparide costs $80.00, the food 50.00, not to mention all the vet visits. Just want to know possible options and future costs for my cat.

    Thank you!
    Dolores

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