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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