Propulsid review

Propulsid is a drug used to treat nocturnal heartburn as a result of gastroesophageal reflux disease (GERD) with generic name cisapride and manufactured by Janssen Pharmaceuticals. It works by promoting muscle movement of the esophagus, stomach and the intestines. It also strengthens the lower esophageal sphincter to prevent acid reflux. Once a popular acid reflux medication, Propulsid has been pulled out of the US market since July 14, 2000 due its links to cases arrhythmia or irregular heartbeat. It was available as 10mg and 20 mg tablets as well as in 1mg/ml suspension form.

Initial dosages were given at 10mg for 4 times each day and at least 15 minutes prior to meals and before bedtime. The dose may be increased to 20mg for better effect on some patients. If nocturnal heartburn does not occur then medication should be stopped. Also, it is strongly advised not to exceed recommended doses of this drug, and if liver conditions are present, then dose may be reduced in half. Always take each dose with a glass of water. If you are using the liquid suspension, shake the bottle well and use a special measuring cup rather than a household spoon to get the correct dose.

Do not take Propulsid if you have or have a family history of heart conditions such as QT prolongation, ventricular arrhythmia, ischemic or vascular heart disease or other structural heart condition. Do not take it if you also have history of conditions that may lead to respiratory failure or to electrolyte imbalance (such as potassium or magnesium imbalance). This puts you at a higher risk to suffer from QT prolongation, heart attacks and even death.

It has been recommended that prior to administering Propulsid the patient must undergo a 12-lead ECG test to determine fitness. If QT interval is longer than 4½ seconds then Propulsid should not be administered. Propulsid is now only recommended to be administered to patients where antacids, lifestyle changes and other conventional treatment to GERD do not yield results.

Some drugs may also increase the risk of arrhythmia when taken with Propulsid. These include certain antibiotics such as clarithromycin, troleandomycin and erythromycin, certain antifungals (fluconazole, itraconazole), and some anti-arrhythmia drugs (quinidine, procainamide, and sotalol). Diuretics may also increase this risk by causing an electrolyte imbalance in the body. Grapefruit juice should also be avoided as it may increases concentration of cisapride in the body.

Dizziness, headache, diarrhea, and constipation may be initially experienced upon taking of Propulsid, but these should generally disappear as treatment goes on. If not, then consult your doctor. Also watch out for rashes, itching, swelling and difficulty in breathing as these may be symptoms of an allergic reaction to Propulsid. Immediately consult your doctor if you experience vision problems, fainting, irregular heartbeat, chest or abdominal pain, or mood swings. Some side effects may not be indicative of any serious disorder but some may be warning signs that may lead to complications as a result of the increased risk for arrhythmia, so it is best to consult your doctor if any symptoms do appear.

Propulsid has the following structural formula:

Chemical structure of propulsid

• Molecular formula of propulsid is C23H29ClFN3O4
• Chemical IUPAC Name is 4-amino-5-chloro-N-[1-[3-(4-fluorophenoxy)propyl]-3- methoxypiperidin-4-yl]-2-methoxybenzamide
• Molecular weight is 465.9455 g/mol
Propulsid available : 5mg tablets, 10mg tablets

Generic name: Cisapride

Brand name(s): Acenalin, Alimix, Cipril, Enteropride, Kinestase, Prepulsid, Pridesia, Propulsin, Risamal, Syspride

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