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Table 1 Criteria for the appropriate use of Cisapride

From: Effect of drug utilization reviews on the quality of in-hospital prescribing: a quasi-experimental study

1. Indication for use

Criteria

Exception

May be used:

May be used

1.1 For empirical treatment (no investigation): symptoms of dysmotility with or without gastro-oesophagus reflux symptoms

1.1 1) If dysphagia, more than 3 vomiting episodes per week, or gastro-intestinal bleeding not related to another cause

2) If mechanical obstruction or intestinal perforation.

1.2 For non empirical treatment (with investigation): symptoms of dysmotility with or without gastro-oesophagus reflux symptoms AND absence of moderate to severe oesophagitis at endoscopy (Savary-Miller grade III or IV)

1.2 1) For moderate to severe oesophagitis if prescribed with a proton pump inhibitor (lansoprazole, omeprazole, pantoprazole)

2) If mechanical obstruction or intestinal perforation.

1.3 For gastroparesia

1.3 If mechanical obstruction or intestinal perforation.

1.4 For chronic pseudo-obstruction

1.4 If mechanical obstruction or intestinal perforation.

2. Contra-indicated drugs (combination therapy)

Criteria

Exception

Must not be used:

May be used:

2.1 With domperidone or metoclopramide

 

2.2 With proton pump inhibitors

2.2 With proton pump inhibitors when moderate to severe oesophagitis

2.3 With an Anti-H2

 

3. Dosage

Criterion

Exception

3.1 Maximum of 80 mg/day; 20 mg/dose, 4 doses/day

3.1 If > 80 years old or hepatic failure: Maximum of 40 mg/day; 10 mg/dose

4. Drug interactions

Criterion

Exception

Must not be used: 4.1 Concurrently with erythromycin, clarithromycin, fluconazol, ketoconazol, itraconazol, nefazodone, nicoumalone or warfarin

May be used: 4.1 In presence of nicoumalone or warfarin if international normalized ratio obtained 1 week after addition of cisapride and at cessation if stopped