Basic Information:

• Mechanism: Cisapride stimulates GI smooth muscle activity by acting as a serotonergic agonist and promoting acetylcholine release. This increases peristalsis throughout the GI tract.
• Absorption: It is generally better absorbed with food and should be administered orally 15 minutes before feeding in small animals.

Dogs and Cats:

• Applications: Widely used for treating gastric-emptying disorders and other related motility issues. In cats, particularly effective for chronic constipation and megacolon.
• Horses: Use in POI: Used to manage post-operative ileus following abdominal surgeries. Its overall effectiveness is under study due to species-specific responses to the medication.

Administration:

Multiple routes have been studied, but oral and intravenous administrations are commonly used, while rectal absorption is minimal.

Side Effects:

Common GI symptoms include abdominal pain and diarrhea. May cause esophageal irritation if not administered with food.

Precautions:

Not suitable for use where increased GI motility could be harmful, such as in cases of mechanical obstruction or GI hemorrhage. Dosage should be adjusted in animals with liver function impairment. Use with caution in animals with cardiac arrhythmias or conduction disorders.

Drug Interactions:

Avoid use with certain antifungal agents and antibiotics like ketoconazole, erythromycin, and fluconazole due to risks of severe cardiac arrhythmias. May interact with anticoagulants, increasing their effect and necessitating close monitoring.

Overdose:

Generally, has a wide safety margin; however, high doses can cause significant GI distress and central nervous system symptoms. Treatment includes GI emptying, activated charcoal, supportive care, and cardiac monitoring.