Cisapride

Also indexed as: Propulsid

Illustration

Cisapride is a gastrointestinal stimulant drug used to treat people with nighttime heartburn due to reflux of stomach acid into the esophagus. It is also used to increase movement of gastrointestinal contents in conditions of lack of spontaneous gastrointestinal movement.

Summary of Interactions with Vitamins, Herbs, and Foods
In some cases, an herb or supplement may appear in more than one category, which may seem contradictory. For clarification, read the full article for details about the summarized interactions.

Avoid Avoid: Reduced drug absorption/bioavailability—Avoid these supplements when taking this medication since the supplement may decrease the absorption and/or activity of the medication in the body.

Tobacco
Avoid Avoid: Adverse interaction—Avoid these supplements when taking this medication because taking them together may cause undesirable or dangerous results.

Grapefruit juice

Pomegranate juice*

Red wine
Depletion or interference

None known
Side effect reduction/prevention

None known
Supportive interaction

None known

An asterisk (*) next to an item in the summary indicates that the interaction is supported only by weak, fragmentary, and/or contradictory scientific evidence.

Interactions with Foods and Other Compounds

Alcohol
Alcohol consumption is associated with nighttime heartburn and may interfere with cisapride therapy.1 Alcohol causes sleepiness, and cisapride may intensify this effect,2 increasing the risk of accidental injury. Ingestion of red wine along with cisapride may also increase blood levels of the drug in some individuals, potentially increasing its side effects.3 People taking cisapride should avoid alcohol.

Tobacco
Smoking is associated with nighttime heartburn and may interfere with cisapride therapy.4 Smokers taking cisapride may benefit from reducing or quitting smoking.

Grapefruit juice
In a study of healthy males, ingestion of 250 ml (about one cup) of grapefruit juice along with cisapride increased the peak blood level of the drug by an average of 68%.5 It is not known whether consuming grapefruit juice at a separate time of the day would affect blood levels of cisapride. As this interaction could potentially increase the side effects of cisapride, individuals taking cisapride should avoid grapefruit and its juice.

Pomegranate juice
Pomegranate juice has been shown to inhibit the same enzyme that is inhibited by grapefruit juice.6 7 The degree of inhibition is about the same for each of these juices. Therefore, it would be reasonable to expect that pomegranate juice might interact with cisapride in the same way that grapefruit juice does.

References

1. Threlkeld DS, ed. Gastrointestinal Drugs, GI Stimulants, Cisapride. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, Nov 1998, 308b–8c.

2. Threlkeld DS, ed. Gastrointestinal Drugs, GI Stimulants, Cisapride. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, Nov 1998, 308b–8c.

3. Offman EM, Freeman DJ, Dresser GK, et al. Red wine-cisapride interaction: comparison with grapefruit juice. Clin Pharmacol Ther 2001;70:17–23.

4. Threlkeld DS, ed. Gastrointestinal Drugs, GI Stimulants, Cisapride. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, Nov 1998, 308b–8c.

5. Offman EM, Freeman DJ, Dresser GK, et al. Red wine-cisapride interaction: comparison with grapefruit juice. Clin Pharmacol Ther 2001;70:17–23.

6. Sorokin AV, Duncan B, Panetta R, Thompson PD. Rhabdomyolysis associated with pomegranate juice consumption. Am J Cardiol 2006;98:705–6.

7. Summers KM. Potential drug-food interactions with pomegranate juice. Ann Pharmacother 2006;40:1472–3.