Metabolism is extensive with no active metabolites. The elimination half-life of cisapride is about 10 hours in healthy volunteers and may be prolonged in patients with hepatic impairment or in the elderly. Cisapride pharmacokinetics are not altered in patients with renal impairment or in patients receiving hemodialysis. Cisapride is classified as pregnancy category C. Adequate studies in pregnant women have not been conducted, so cisapride should be used during pregnancy only when clearly needed. Cisapride is excreted into breast milk at a concentration of about one twentieth that found in maternal plasma.
Caution is advised in prescribing cisapride to breast-feeding women.
The use of cisapride in patients in whom increased gastrointestinal motility can be harmful is not recommended. These patients include those with GI bleeding, GI obstruction, or GI perforation. Cisapride is contraindicated in patients with a known sensitivity or intolerance to the drug. A careful patient history should be taken to determine previous cisapride intolerance or sensitivity. Although a causal relationship with cisapride has not been established, rare cases of cardiac arrhythmias have been reported.