Cisapride Use 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.