Should cisapride be avoided in patients with diabetic gastroparesis?
The gastrointestinal motility stimulants, cisapride and erythromycin, have been used in the management of diabetic gastroparesis. However, drug interactions may result in prolongation of the electrocardiographic QT interval with the risk of ventricular arrhythmias. These drugs should, therefore, not be used in combination. We report two cases that illustrate inappropriate use of these agents. Moreover, patients with recurrent severe hypoglycemia or renal impairment may be at increased risk from cisapride-related cardiotoxicity. Thus, even as monotherapy, cisapride may pose dangers for high-risk diabetic patients.
Evans
A J
AJ
Southampton General Hospital, Southampton, United Kingdom.
Krentz
A J
AJ
D000328:Adult; D020117:Cisapride; D000075202:Contraindications; D003922:Diabetes Mellitus, Type 1 / Q000150:complications*; D003928:Diabetic Nephropathies; D003930:Diabetic Retinopathy; D004347:Drug Interactions; D004917:Erythromycin / Q000627:therapeutic use*; D005260:Female; D005765:Gastrointestinal Agents; D018589:Gastroparesis / Q000188:drug therapy* / Q000209:etiology; D006801:Humans; D008133:Long QT Syndrome; D008297:Male
D005765:Gastrointestinal Agents; D004917:Erythromycin; D020117:Cisapride