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Cisapride Suspension and Darunavir Tablets

Determining the interaction of Cisapride Suspension and Darunavir Tablets and the possibility of their joint administration.

Check result:
Cisapride Suspension <> Darunavir Tablets
Relevance: 02.09.2023 Reviewer: Shkutko P.M., M.D., in

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.

Consumer:

Using cisapride together with darunavir is not recommended. Combining these medications may significantly increase the blood levels and effects of cisapride. High blood levels of cisapride can occasionally cause an irregular heart rhythm that may be serious. You should seek immediate medical attention if you develop sudden dizziness, lightheadedness, fainting, or fast or pounding heartbeats during treatment with cisapride. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor. **Cisapride (Propulsid) is no longer marketed in the United States. You should only be taking cisapride if you are obtaining the medication from your doctor though a Limited Access Program developed jointly by the manufacturer and the FDA.**

Professional:

CONTRAINDICATED: Coadministration with protease inhibitors (PIs), particularly ritonavir, may significantly increase the plasma concentrations of cisapride. The mechanism is PI inhibition of CYP450 3A4, the isoenzyme responsible for the metabolic clearance of cisapride. The interaction has not been specifically studied with any of the available PIs, but has been reported in patients receiving cisapride with other potent CYP450 3A4 inhibitors such as macrolide antibiotics or azole antifungal agents. Clinically, high plasma levels of cisapride may increase the risk of QT interval prolongation, which has been associated with ventricular arrhythmias including torsade de pointes and sudden death.

MANAGEMENT: Given the potential for serious and life-threatening adverse cardiac events associated with increased plasma levels of cisapride, concomitant use with protease inhibitors is considered contraindicated.

References
  • Dresser GK, Spence JD, Bailey DG "Pharmacokinetic-pharmacodynamic consequences and clinical relevance of cytochrome P450 3A4 inhibition." Clin Pharmacokinet 38 (2000): 41-57
  • Mangum EM, Graham KK "Lopinavir-Ritonavir: a new protease inhibitor." Pharmacotherapy 21 (2001): 1352-63
  • "Product Information. Norvir (ritonavir)." Abbott Pharmaceutical, Abbott Park, IL.
  • Desta Z, Soukhova N, Mahal SK, Flockhart DA "Interaction of cisapride with the human cytochrome P450 system: metabolism and inhibition studies." Drug Metab Dispos 28 (2000): 789-800
  • "Product Information. Crixivan (indinavir)." Merck & Co, Inc, West Point, PA.
  • "Product Information. Incivek (telaprevir)." Vertex Pharmaceuticals, Cambridge, MA.
  • "Product Information. Fortovase (saquinavir)" Roche Laboratories, Nutley, NJ.
  • "Product Information. Lexiva (fosamprenavir)." GlaxoSmithKline, Research Triangle Park, NC.
  • Lewin MB, Bryant RM, Fenrich AL, Grifka RG "Cisapride-induced long QT interval." J Pediatr 128 (1996): 279-81
  • "Product Information. Prezista (darunavir)." Ortho Biotech Inc, Bridgewater, NJ.
  • Michalets EL, Williams CR "Drug interactions with cisapride: clinical implications." Clin Pharmacokinet 39 (2000): 49-75
  • "Product Information. Victrelis (boceprevir)." Schering-Plough Corporation, Kenilworth, NJ.
  • "Product Information. Agenerase (amprenavir)." Glaxo Wellcome, Research Triangle Pk, NC.
  • Hill SL, Evangelista JK, Pizzi AM, Mobassaleh M, Fulton DR, Berul CI "Proarrhythmia associated with cisapride in children." Pediatrics 101 (1998): 1053-6
  • "Product Information. Viracept (nelfinavir)." Agouron Pharma Inc, La Jolla, CA.
  • "Product Information. Propulsid (cisapride)." Janssen Pharmaceutica, Titusville, NJ.
  • Gill J, Feinberg J "Saquinavir soft gelatin capsule - A comparative safety review." Drug Safety 24 (2001): 223-32
  • Malaty LI, Kuper JJ "Drug interactions of HIV protease inhibitors." Drug Safety 20 (1999): 147-69
  • Bran S, Murray WA, Hirsch IB, Palmer JP "Long QT syndrome during high-dose cisapride." Arch Intern Med 155 (1995): 765-8
  • Michalets EL "Update: clinically significant cytochrome P-450 drug interactions." Pharmacotherapy 18 (1998): 84-112
  • Gray VS "Syncopal episodes associated with cisapride and concurrent drugs." Ann Pharmacother 32 (1998): 648-51
  • "Product Information. Reyataz (atazanavir)." Bristol-Myers Squibb, Princeton, NJ.
Cisapride Suspension

Generic Name: cisapride

Brand name: Propulsid

Synonyms: Cisapride Tablets

What is Cisapride Suspension?
Darunavir Tablets

Generic Name: darunavir

Brand name: Prezista

Synonyms: Darunavir

What is Darunavir Tablets?
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In the course of checking the drug compatibility and interactions, data from the following reference sources was used: Drugs.com, Rxlist.com, Webmd.com, Medscape.com.

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