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Description
Nupride
(Cisapride) is an
effective and well-tolerated prokinetic agent that restores
motility throughout the length of gastrointestinal tract.
It is devoid of central depressant or antidopaminergic actions,
thereby is free from any serious side effects like extrapyramidal
symptoms, galactorrhoea or pseudopregnancy in females or gynaecomastia
in males.
Composition
| Each uncoated
tablet contains : |
|
|
| Cisapride (as
Cisapride BP) |
10
|
mg |
Actions
Nupride
(Cisapride) promotes motility of gastrointestinal tract
and also increases antroduodenal coordination by indirectly
facilitating acetylcholine release from the myenteric plexus
mediated by postganglionic nerve endings. This release of
acetylcholine increases oesophageal activity and increases
lower oesophageal sphincter (LES) tone, thereby improving
oesophageal clearence and decreasing reflux of gastric contents
into the oesophagus. Nupride (Cisapride) enhances gastric and duodenal contractility
and antroduodenal coordination which leads to enhanced gastric
and duodenal emptying and reduction in duodenogastric reflux.
Studies carried out further suggested Cisapride (Nupride)
to act both as antagonist of serotonin (5HT3) receptors
as well as an agonist of 5HT4 receptors. However stimulation
of 5HT4 receptors is the key factor than blockade of 5HT3
receptors for prokinetic action. Nupride
(Cisapride) is rapidly absorbed following single oral
administration of 5-20 mg giving rise to peak plasma level
of 45-65 mcg/L in 1/2 to 2 hours with absolute bio-availability
of 40%-50%. Absorption is enhanced in presence of food.
Elimination half life is 7-10 hours, not altered in patients
with renal insufficiency, though may be increased in presence
of hepatic diseases. Elimination is mainly through stool
& urine. The drug is extensively metabolised and the
major metabolite is norcisapride; plasma protein binding
is 98%.
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Indications
Nupride
(Cisapride)
is effective in the management of a variety of gastrointestinal
motility disorders like gastro-oesophageal reflux, reflux
oesophagitis, nonulcer dyspepsia, nausea & vomiting, gastroparesis,
constipation.
Contraindications
Nupride
(Cisapride) should not be used in patients in whom an increase
in gastrointestinal motility could be harmful, e.g., in the
presence of gastrointestinal haemorrhage, mechanical obstruction
or perforation. Nupride
is
also contraindicated in patients with known sensitivity or
intolerence to the drug.
Adverse Reactions
With Nupride
(Cisapride) diarrhoea is the most frequent gastrointestinal
side effects reportedÑusually transient and discontinuation
of the drug is rarely needed. Other side effects, rarely observed
are headache, nervousness, extrapyramidal symptoms, rash.
Precautions
Nupride
(Cisapride) should be used in pregnancy only if the potential
benefit outweigh the risk to the foetus. Caution should be
taken while using in nursing mothers. Safety and efficacy
of Cisapride (Nupride)
are not established in children. Caution is needed in impaired
hepatic function and in renal failure. Concomitant use of
Nupride
(Cisapride) with imidazole derivatives or macrolide antibiotics
should be avoided.
Drug Interactions
Anticholinergic
drugs-compromise beneficial effects of Cisapride. Coadministration
of H2 antagonists lead to their increased absorption and serum
concentration. Imidazole class (Ketoconazole, fluconazole,
itraconazole and metronidazole) or macrolide antibiotics (erythromycin
and clarithromycin) have been found to inhibit the cytochrome
P-450 enzyme system that affects Cisapride metabolism and
results in increased serum Cisapride levels.
Dosage
1 tablet to be given thrice daily 15-30 minutes
before meals.
Packing
Strips
of 10 tablets
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