Effect of cisapride on acid gastro-oesophageal reflux during treatment with caffeine.
About 50% of preterm infants and neonates receiving methylxanthines for respiratory stimulation will develop a pathological gastro-oesophageal reflux (GOR) pattern. In the face of potential GOR-related complications the effect of a concomitant treatment with a prokinetic agent, such as cisapride, should be evaluated. In this study 32 formerly preterm infants were studied simultaneously by 24-hour oesophageal pH monitoring and cardio-respirogram before the presumed end of caffeine treatment. In 14 of these infants a reflux index (RI; percentage of recording time) of more than 4% could be detected (pH <4). Ten of them were treated orally with cisapride (0. 2 mg/kg t.i.d.). Data of pH monitoring, cardio-respirogram and caffeine serum concentrations were obtained before and 5 days after introducing cisapride. The RI and the frequency of GOR decreased significantly with cisapride. The steady-state serum concentrations of caffeine were not influenced by cisapride and the extent of periodic breathing remained unchanged. In conclusion, cisapride has a positive influence on GOR parameters during caffeine treatment without impairing the oral bioavailability or therapeutic effect of caffeine.
Kentrup
H
H
Department of Paediatrics, University Hospital, RWTH Aachen, Germany.
Baisch
H J
HJ
Kusenbach
G
G
Heimann
G
G
Skopnik
H
H
D002110:Caffeine / Q000097:blood / Q000627:therapeutic use*; D020117:Cisapride / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D005764:Gastroesophageal Reflux / Q000188:drug therapy*; D005765:Gastrointestinal Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000188:drug therapy*
D005765:Gastrointestinal Agents; D002110:Caffeine; D020117:Cisapride