propulsid and heart arrhythmias

I am the mother of a 28 year old with Down

[Cleveland Clinic, MD]

Propulsid (generic cisapride) is generally a well tolerated drug with a very low incidence of side effects.  There were less than 1% of patients taking the drug that reported palpitations.  There have been some rare reports of fatal heart arrhythmias in patients taking cisapride although causality has not been established.    Cisapride is metabolized through the cytochrome P-4503A4 system and therfore certain drugs should be avoided to reduce the risk of a dangerous rhythm.  These drugs are:itraconazole, miconazole, clarithromycin, erythromycin, and troleandomycin.

[Tandy]

Thank you for your prompt reply. It is reassuring to know that serious side effects from Propusid are uncommon. I understand that most arrhythmias have been related to interactions between Propulsid and other drugs such as those you mentioned. I was just hoping there could be a way of knowing in advance who might become one of those in the less than 1% who experience side effects.

[Cleveland Clinic, MD]

Unfortunately not.  There are alternative to propusid and I would discuss these with her doctor if this is a concern.