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[Cisapride treatment for children with gastro-esophageal reflux]
C M Kneepkens1, J H Hoekstra, Y Vandenplas
1Academisch Ziekenhuis Vrije Universiteit, afd. Kindergeneeskunde, Amsterdam.
Insights
Cisapride effectively treats pediatric gastro-oesophageal reflux but lacks official registration in the Netherlands, leading to information gaps for doctors. Key recommendations include strict dosage limits, avoiding specific drug interactions, and monitoring QTc intervals in at-risk children.
Area of Science:
- Pharmacology
- Pediatric Gastroenterology
Context:
- Cisapride is a prokinetic drug used for pediatric gastro-oesophageal reflux.
- Lack of official registration in the Netherlands complicates cisapride's use in children.
- Prescribers face challenges in accessing comprehensive information on cisapride's pediatric application.
Purpose:
- To provide essential guidance for the safe and effective use of cisapride in pediatric patients.
- To address the information deficit regarding cisapride's off-label use in Dutch pediatric practice.
Summary:
- Recommends a maximum cisapride dose of 0.2 mg/kg, four times daily.
- Advises against co-medication with imidazole antifungals and macrolide antibiotics.
- Emphasizes QTc interval monitoring for pediatric patients with risk factors for QTc prolongation.
Impact:
- Aims to improve prescribing practices and patient safety for cisapride in pediatric populations.
- Facilitates informed clinical decision-making for managing pediatric gastro-oesophageal reflux with cisapride.
Abstract:
The prokinetic drug cisapride is widely used for treating gastro-oesophageal reflux in infants and children. As in the Netherlands it is not officially registered for use in these age groups, prescribing doctors have problems obtaining adequate information on proper use and side effects. In the treatment of pediatric gastro-oesophageal reflux with cisapride the major recommendations include not to exceed the maximum dose of 0.2 mg/kg four times daily, to avoid comedication with imidazoles and macrolides and to check the QTc interval in patients with known risk factors for QTc prolongation.