Cisapride: an alternative to other prokinetic and antisecretory agents in gastrointestinal motility disorders

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IN BRIEFCisapride is a prokinetic agent that appears to be effective and well tolerated in a variety of gastrointestinal motility disorders.The evaluation of cisapride is impeded by a lack of comparative data. The need for such data is particularly keen with regard to omeprazole, which currently appears to be the dominant therapy for gastro-oesophageal reflux disease (GORD). Nonetheless, cisapride represents a well tolerated alternative as both a primary treatment for GORD and as prophylaxis of recurrence. The drug appears to be as effective as H2-antagonists in treating GORD.Cisapride also appears to be a useful therapy in paediatric patients with GORD.In functional dyspepsia and idiopathic or diabetic gastroparesis, cisapride is generally more effective than placebo and appears to have similar efficacy to comparator drugs. Compared with metoclopramide and domperidone, the lack of antidopaminergic adverse effects (prolactinaemia and extrapyramidal effects) with cisapride may be considered an advantage.

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