Cisapride: Cardiological Considerations About its Proper Utilization

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Abstract

Cisapride isa benzamidic derivative frequently used in children and adults for the treatment of gastroesophageal reflux. Since its FDA approval in1993 there have been numerous reports of sudden deaths attributed to the use of this drug. Cisapride is a potent blocker of the delayed potassium current (particularly of its rapid component, lKr) and prolongs the QT interval in the ECG of susceptible patients. The consequences are lethal ventricular arrhythmias, like torsade des pointes, and sudden death. Because of this dangerous side effect Janssen Pharmaceuticals, Inc., cisapride manufacturer, has recently announced the withdrawal of the drug from the Unites States market next July. The dis-continuation of the drug in the rest of the world has not been yet announced, but it will probably happen as in the Unites States. Meanwhile, we should be aware of its dangerous side effect and have to be very cautious when we prescribe it. We should perform a careful follow up of the FDA and local guidelines regarding the evaluation and follow-up of patients treated with this particular drug.