Cisapride Suspension and Sitagliptin and simvastatin

In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.

Cisapride is no longer on the market in the US. Do not take cisapride with any other medication.

MONITOR: The coadministration with simvastatin may increase the plasma concentrations of cisapride due to competitive inhibition of cisapride metabolism via CYP450 3A4 isoenzymes. Conversely, cisapride may reduce the plasma concentrations of the pharmacologically active acid metabolite of simvastatin, possibly due to reduction of its reabsorption during enterohepatic recycling secondary to increased gastrointestinal motility. In 11 healthy volunteers given simvastatin (20 mg orally twice a day) and cisapride (10 mg orally three times a day) concomitantly for 4 days, the cisapride area under the plasma concentration-time curve (AUC) increased by an average of 14%, while that of simvastatin acid decreased by an average of 33%. The clinical significance of this interaction is unknown. However, given the high degree of interpatient variability with respect to CYP450 3A4 metabolism (one subject in the study had a 50% increase in cisapride AUC), some patients may be at increased risk of cisapride toxicity. The potential for diminished therapeutic effect of simvastatin should also be considered.

MANAGEMENT: Due to the potential for serious and life-threatening adverse cardiac events associated with increased plasma levels of cisapride, an HMG-CoA reductase inhibitor that is not metabolized by CYP450 3A4 such as fluvastatin or pravastatin may be preferable in patients receiving concomitant therapy with cisapride. If simvastatin must be used, clinicians should monitor patients for cisapride toxicity as well as reduced cholesterol-lowering effects of simvastatin. Patients should be advised to seek medical attention if they experience fainting, dizziness, an irregular heartbeat or pulse, or other unusual symptoms while using cisapride.

Cisapride Suspension

Generic Name: cisapride

Brand name: Propulsid

Synonyms: Cisapride Tablets

What is Cisapride Suspension?

Sitagliptin and simvastatin

Generic Name: simvastatin / sitagliptin

Brand name: Juvisync

Synonyms: Sitagliptin and simvastatin (Oral)

What is Sitagliptin and simvastatin?