Cisapride 101: What You Need to Know if Your Dog or Cat Needs Cisapride

Cisapride is a medication used to enhance neurotransmission. It is typically prescribed by veterinarians to treat gastrointestinal (GI) conditions in dogs and cats. It is also prescribed to relieve constipation and acid reflux in dogs and constipation and megacolon in cats.

Cisapride generally comes in the form of an orally administered capsule. Your veterinarian may prescribe under the brand names Prepulsid® or Propulsid®

Cisapride was originally developed for and used widely in humans. Cisapride is generally safe for pets, but animals with cardiac arrhythmia or conduction disorders may require additional monitoring.

Cisapride is prescribed as a motility enhancement drug by veterinarians to help food pass more quickly through the digestive tract. It is used to treat GI conditions like idiopathic (unknown cause) constipation and reflux.

Cisapride can be used to increase pyloric sphincter pressure in the lower esophagus, which prevents gastric acid secretion in anesthetized dogs.

Cisapride works to enhance neurotransmission. It increases the release of acetylcholine, a chemical in the brain that transmits nerve signals to the body. These signals stimulate the gastrointestinal smooth muscles. Smooth muscle contraction helps pass food more quickly (motility) through the small and large intestines to regulate bowel function.

Side effects are uncommon, but vomiting, diarrhea, hives, or gastrointestinal discomfort may occur. Cardiac arrythmias are seen in humans, but are less common in pets.

More serious side effects include incoordination, excessive drooling, muscle twitches, agitation, abnormal behavior, increased body temperature, and seizures. These are generally signs that doses are too high. Contact your veterinarian immediately if you suspect an adverse reaction.

Cisapride is a short-acting medication that should stop working within 24 hours, although effects can be longer in pets with liver or kidney disease.

• Cisapride may affect the absorption of other oral medications, including Cyclosporine and Tetracyclines.
• Cholinergic drugs such as Bethanechol may increase the effect of Cisapride on the GI system.
• Cisapride may increase the Central Nervous System-depressant effects of Phenothiazine tranquilizers, sedatives, narcotics, barbiturates, antihistamines, and anesthetic agents.
• Extrapyramidal (involuntary movements) effects of Cisapride also may be increased with concurrent use of Phenothiazine tranquilizers, narcotics, and Butyrophenones.
• Acute hypotension may occur with IV use of Cisapride and anesthetic drugs. Hypertension may occur with concurrent use of Cisapride and MAO inhibitors.
• Opiate analgesics, atropine, and other anticholinergic drugs may antagonize any effects on GI motility.

• Prokinetic drugs such as Cisapride should not be used when increased GI motility may be harmful (mechanical obstruction, impaction, potential perforation, or GI hemorrhage).
• The dose of Cisapride should be reduced in animals with decreased liver function. Elimination of Cisapride is not significantly influenced by decreased renal function.
• Animals with cardiac arrhythmia or conduction disorders may require additional monitoring.
• High doses of Cisapride were found to decrease fertility and to increase embryonic losses in laboratory animals.
• Cisapride is excreted in milk. It should be used during pregnancy or lactation only when the benefits clearly outweigh the risks.
• Cisapride has a host of potential drug interactions and should not be used on pets on azole antifungal drugs or erythromycin due to increased risk of cardiac effects.

Cisapride is usually given orally. The starting dose is usually 1 mg, and the most commonly used dosing strengths are 2.5 mg, 5 mg, and 10 mg. Be sure to follow your veterinarian’s dosing instructions carefully.

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If you miss giving your pet a dose, give the next dose as soon as you remember or, if it is close to the next scheduled dose, return to the regular schedule. Do not double dose to catch up. If you are not sure what to do, call your veterinarian about the missed dose and follow their directions.

• It is unlikely that an oral overdose of Cisapride will cause death.
• Overdose will cause similar but more severe clinical signs of the side effects listed above.
• Anticholinergics, such as Diphenhydramine, may be used to decrease the Central Nervous System effect.

If you suspect your pet or another animal has accidentally overdosed or has eaten this medication inadvertently, immediately contact your veterinarian or the A.S.P.C.A.’s Animal Poison Control Center at 888-426-4435.

Remember to take your prescription container with you when you take your pet for treatment. If you or someone else has ingested this medication, call the National Capital Poison Center at 800-222-1222.

Compounded medicines are prepared for the exact strength your veterinarian prescribes. The price of the medication will depend on the dosage and the medication form with certain dosage forms and higher strengths generally being more expensive.

In addition, the cost of a medication will depend upon the price of the other active pharmaceutical ingredients and may increase the cost of the finished drug.

What Is Cisapride and How Does it Work?

Cisapride activates Acetylcholine release, which in turn stimulates the GI smooth-muscle that facilitates the elimination of waste. Cisapride is also a serotonergic agonist, meaning it inhibits the release of serotonin in the brain to reduce pain, nausea, and other symptoms. Anatomic differences between species can affect effectiveness.

Are There Alternatives to Cisapride for Gastrointestinal Issues in Dogs?

While Cisapride is a superior prokinetic drug (a medication that helps control acid reflux), Metoclopramide is also effective and is often prescribed by veterinarians.

Are There Any Pretreatments for Dogs Before the Administration of Cisapride?

No. In fact, Cisapride is a pretreatment for pets about to go under anesthesia because it decreases the chances of gastroesophageal reflux (GOR) in the anesthetized animal.

Which Gastrointestinal Conditions Is Cisapride an Effective Treatment Option for Dogs and Cats?

Cisapride is used widely to treat gastric-emptying disorders, intestinal transit, and other motility disorders in both dogs and cats. It accelerates emptying the stomach and propulsion of food through the intestines by increasing peristalsis.

This article is meant to provide general and not medical advice. We strongly recommend that a veterinarian be consulted for the specific medical needs of your animal.

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