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Is rectally administered cisapride an effective prokinetic agent?
1Department of Pharmacy Practice, School of Pharmacy, Southwestern Oklahoma State University, Weatherford, USA.
The Annals of Pharmacotherapy
|November 26, 1999
Summary
Rectal cisapride effectively enhances gastric emptying in some patients but is not recommended due to limited efficacy in critical populations and lack of commercial availability. Further investigational trials are advised.
Area of Science:
- Gastroenterology
- Pharmacology
Background:
- Cisapride is an oral prokinetic agent.
- It enhances lower esophageal sphincter tone, gastric emptying, and small-bowel motility.
Purpose of the Study:
- To summarize published data on the efficacy of rectally administered cisapride.
Main Methods:
- Searched MEDLINE and International Pharmaceutical Abstracts for double-blind, placebo-controlled trials.
- Included studies from January 1966 to December 1998.
Main Results:
- Rectal cisapride enhanced gastric emptying in healthy individuals and those with gastric emptying disorders.
- It was ineffective for antagonizing narcotic effects or promoting bowel activity postoperatively.
- Mixed results were observed for promoting enteral feedings in patients with ileus.
Conclusions:
- Rectal cisapride is not recommended currently.
- It was only effective in patients who could take oral cisapride.
- Efficacy was not demonstrated in patients unable to take oral medication.
- Limited use to investigational trials due to lack of commercial product and varied study designs.