Cisapride

Cisapride for dogs is a prokinetic drug that supports the proper functioning of the digestive tract. This medication is commonly used to treat conditions associated with gastrointestinal motility, such as megaesophagus, stasis, and reflux.

If your dog has been prescribed cisapride, it’s important to know how the drug works and what potential side effects it could have on your dog. Keep reading for more information on the dosage, efficacy, and drug interactions of cisapride for dogs.

Dosage

Cisapride is available as a compounded tablet, capsule, or liquid. When treating gastrointestinal motility function in dogs, a dose of 0.1 to 0.5 mg per kg of body weight, given orally every 8 to 12 hours, is recommended.

Dosage instructions

Cisapride can be given with or without food, but is commonly given 30 minutes before feeding. Make sure to follow your veterinarian’s dosage instructions and measure dosage amounts carefully. If you miss a dose, never give a double dose — simply continue with the regular dosage schedule.

Your veterinarian may lower the normal dosage amount if your pet has liver disease.

Efficacy

A prokinetic drug, cisapride speeds up the passage of food through the digestive tract. It increases the motility of the colon, esophagus, stomach, and small intestine, speeding up the digestive process. As a result, cisapride treats vomiting caused by megaesophagus, as well as a range of other conditions associated with the stomach emptying too slowly.

Studies show that cisapride is more effective than metoclopramide hydrochloride at increasing lower esophageal sphincter resting pressure. Because it promotes colonic motility, it can also successfully treat megacolon in dogs. 

In terms of dosage amount and cisapride toxicosis, severe clinical signs have been reported in acute exposures as low as 18 mg per kg. These signs include diarrhea, muscle tremors, ataxia, and hyperthermia.  

While it was originally developed for use in humans, cisapride has since been withdrawn from the human market in many countries due to the risk of reactions with other drugs causing heart arrhythmias and death. As a result, it’s no longer commercially available and can only be accessed from compounding pharmacies. However, according to the Merck Veterinary Manual, there haven’t been reports of similar adverse reactions to the clinical use of cisapride in veterinary medicine.

Cost

The cost of cisapride for dogs depends on the dosage strength and form prescribed. Compounded liquid forms of the drug range in price from $40 to $115. Chewable tablets cost between $65 and $80 for 60 to 90 chewables with a dosage strength of 2.5 and 5 mg.

Side effects

While side effects of cisapride for dogs are uncommon, they can include:

• Vomiting

• Diarrhea

• Abdominal pain

• Changes in heart rhythm

Consult your veterinarian if you’re concerned about any of the side effects of cisapride. 

In cases of overdose, symptoms may include: 

• Drooling

• Lack of coordination

• Agitation

• Muscle twitches

• Fever

• Aggression

• Disorientation

• Seizures

Considerations

There are a few important factors your veterinarian will need to consider before prescribing cisapride for dogs. Not only can this drug interact with certain other medications, but it may also be unsafe to give to dogs suffering from specific health problems. That’s why it’s important that your vet knows about your pet’s full medical history and any other medications they are taking.

Drug interactions

Cisapride can interact with the following drugs:

• Antacids (such as cimetidine and ranitidine)

• Antibiotics (such as erythromycin and chloramphenicol)

• Antifungal agents (such as ketoconazole and itraconazole)

• Benzodiazepines (such as diazepam and alprazolam)

• Anticholinergic agents (such as antihistamines and some heart medications)

• Tricyclic antidepressants

• Warfarin

This is not a complete list, so make sure your vet is aware of all medications and supplements your dog is currently taking.

Allergic reactions and sensitivity

Do not give cisapride for dogs to pets who are allergic to the drug or have an intestinal obstruction or perforation.

Cisapride’s use in pregnant or lactating animals is only recommended when the benefits outweigh the risks. Use cisapride with caution in pets who have liver disease or abnormal heart rhythms.

Frequently asked questions

Does my dog need a prescription for cisapride?

Yes, you’ll need a prescription from your veterinarian to give cisapride to your dog.

How should cisapride be stored?

Check the medication container for storage instructions. Keep cisapride away from direct sunlight and moisture and out of reach of children.

What should I do if I think my dog has had an overdose of cisapride?

Monitor your dog closely for any clinical signs of an overdose and seek emergency veterinary attention. You can also contact the ASPCA Animal Poison Control Center.