GENERIC NAME: cisapride
BRAND NAME: Propulsid
IMPORTANT NEWS ALERT - The U.S. Food and Drug Administration (FDA) has issued an urgent warning regarding cisapride (Propulsid) which has been found to cause cardiac arrhythmias (irregular heart rhythms). All patients taking cisapride have been advised to contact their doctors. The manufacturer of cisapride, Janssen Pharmaceutica, will remove cisapride from pharmacies by July of 2000; however, Janssen plans to make the drug available for patients with unusual, debilitating problems for whom there is no alternative therapy.
DRUG CLASS AND MECHANISM: Cisapride is a "prokinetic" agent that increases muscle contractions of the lower esophagus and the lower esophagus sphincter. The lower esophagus sphincter, located between the esophagus and stomach, normally prevents reflux of acid and other stomach contents into the esophagus. In patients with Gastroesophageal Reflux (GERD), a weakened lower esophagus sphincter allows reflux of stomach acid into the esophagus, causing heart burn and acid damage to the esophagus (peptic esophagitis). Cisapride, like metoclopramide (Reglan), decreases stomach acid reflux by strengthening the lower esophagus sphincter, as well as the peristaltic muscle contractions of the lower esophagus. These two medications also hasten the stomach emptying of solid and liquid meals into the intestines. Faster emptying of meals decrease the reflux of stomach acid and other contents into the esophagus.
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