Withdrawn from the market (safety)
Cisapride
PROPULSID
Pronunciation: SIS-a-pride
What it is5-HT4 agonist prokinetic; withdrawn.
Why this oneIt was the most effective prokinetic for gastroparesis and reflux.
What limits itWithdrawn for fatal QT arrhythmias, particularly with CYP3A4 inhibitors — the case that taught the field about drug-induced torsades.
Cisapride prescription history
Animated chart of estimated U.S. prescriptions per year, Meds eventually withdrawn (1950–2026). Cisapride enters in 1994 (estimated).
FDA-approved for
- GERD (1993 — US market withdrawn 2000, limited-access only)
⚠ BOXED WARNING
- Serious cardiac arrhythmias including torsades
Classes and tags
Clinical profile
Legacy pregnancy categoryC
Defining liabilityQT prolongation and potentially fatal ventricular arrhythmia
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Self-check
- Why was cisapride withdrawn?
Fatal QT arrhythmias. - Which inhibitors particularly heightened cisapride risk?
CYP3A4 inhibitors.