Vet Guide to Cisapride in 2025 🐾

Hi, I’m Dr Duncan Houston, BVSc—founder of Ask A Vet. In this 2025 guide, we explore cisapride, a potent prokinetic agent used in dogs and cats to support digestive health. It aids conditions like reflux, constipation, megacolon, and postoperative GI stasis. Learn how it works, when to use it, proper dosing, precautions, monitoring advice, and how to keep your pet's gut happy. 🐾😊

📘 What Is Cisapride?

Cisapride is a powerful **gastrointestinal motility stimulant** that enhances smooth muscle contractions in the stomach and intestines by increasing **acetylcholine** release via serotonin (5‑HT₄) receptor activation :contentReference[oaicite:3]{index=3}. Originally developed for humans (brand name Propulsid®), it was withdrawn due to cardiac arrhythmia risk. However, it remains used—off-label—in veterinary care for pets :contentReference[oaicite:4]{index=4}.

✅ When & Why Vets Prescribe Cisapride

• Reflux and esophagitis—speeds gastric emptying to reduce GERD :contentReference[oaicite:5]{index=5}.
• Constipation or megacolon in cats—improves colon motility when standard treatments fail :contentReference[oaicite:6]{index=6}.
• Postoperative or ileus in dogs and cats—prevents GI stasis and aspiration pneumonia :contentReference[oaicite:7]{index=7}.
• Other off-label uses: small mammals, reptiles, urinary retention and hairball support :contentReference[oaicite:8]{index=8}.

📐 Dosing & Administration

Only available via veterinary compounding—capsule, tablet, or liquid:

• **Dogs**: ~0.1–0.5 mg/kg orally every 8–12 hours, typically 30 min before meals :contentReference[oaicite:9]{index=9}.
• **Cats**: ~2.5 mg per cat orally every 12 hours; may vary based on weight and GI motility needs :contentReference[oaicite:10]{index=10}.

Onset begins within 1–2 hours; dosing frequency maintains consistent gut stimulation :contentReference[oaicite:11]{index=11}.

⚠️ Side Effects & Safety Considerations

Generally well tolerated in pets:

• Mild GI signs—vomiting, diarrhea, abdominal cramping :contentReference[oaicite:12]{index=12}.
• Rarely more severe: incoordination, tremors, excessive drooling, agitation, abnormal behavior, fever, or seizures—more likely with overdose :contentReference[oaicite:13]{index=13}.
• No documented arrhythmia risk in pets, but use caution in those with heart or liver disease :contentReference[oaicite:14]{index=14}.
• Contraindicated in GI obstruction, perforation, bleeding—can worsen these conditions :contentReference[oaicite:15]{index=15}.

🔗 Drug Interactions & Precautions

• Many drug interactions—anticholinergics, benzodiazepines, cyclosporine, furosemide, ondansetron, opioids, narrow-therapeutic drugs (warfarin, macrolides, fluoroquinolones), antacids like cimetidine :contentReference[oaicite:16]{index=16}.
• Adjust dosage or monitor when combined; always inform your vet of every medication or supplement :contentReference[oaicite:17]{index=17}.

🩺 Monitoring & Follow-up

• Watch for improvement in vomiting, straining, stool passage, appetite.
• If no progress within 2–3 days, re-evaluate GI obstruction or need for further diagnostics.
• In long-term use, monitor general health and adjust dose as needed.

⏳ Missed Dose & Overdose

• **Missed dose**? Administer unless it's near the next dose—never double up :contentReference[oaicite:18]{index=18}.
• **Overdose signs**: worsening GI signs, tremors, abnormal behavior—seek emergency vet care or poison control :contentReference[oaicite:19]{index=19}.

🏡 Real-Life Scenarios

🐶 Postoperative Dog with Ileus

• Give 0.2 mg/kg cisapride every 8 hours, 30 min before feeding.
• Expect bowel movement in 24–48 hours; if not, reevaluate.

🐱 Cat with Megacolon

• Start 2.5 mg cisapride every 12 hours alongside fiber, hydration, and stool softeners.
• Monitor daily stool consistency and frequency; continue as long-term under vet guidance.

❓ FAQs

Why can’t I buy cisapride off-the-shelf?

It’s FDA‑withdrawn for human use due to heart risks but still legal off-label in pets via compounding pharmacies :contentReference[oaicite:20]{index=20}.

Is it safe long-term?

Yes, for chronic cases like megacolon or reflux—monitored regularly to ensure continued efficacy and minimize side effects.

Can I give it with food?

Yes—food may improve absorption and reduce GI upset; follow your vet’s advice on timing.

Will it affect my pet's heart?

No cardiac side effects seen in veterinary patients—but if your pet has heart disease, your vet may recommend periodic screenings :contentReference[oaicite:21]{index=21}.

📌 Final Takeaways

• Cisapride is an effective prokinetic used off-label in dogs and cats for digestive issues like reflux, constipation, and megacolon.
• Dosage: Dogs 0.1–0.5 mg/kg q8–12h; cats ~2.5 mg per cat q12h—typically 30 min before meals.
• Generally safe—mild GI upset possible; serious side effects rare when used properly.
• Many drug interactions—share all medications with your vet.
• Monitor response closely; reevaluate if signs persist or worsen.

Curious if cisapride might help your pet's digestion—and want a tailored plan for use and monitoring? Download the Ask A Vet app for personalized dosing tools, drug reminders, and 24/7 veterinary guidance. Let’s support your pet’s gut health—together! 🐾❤️