Combined therapy with cisapride and cimetidine in severe reflux oesophagitis: a double blind controlled trial.

Abstract

SUMMARY Combined treatment with cimetidine 1 g daily and cisapride 40 mg daily in patients with endoscopically diagnosed severe reflux oesophagitis was compared with single drug therapy (cimetidine and placebo). At the end of the six to 12 weeks treatment, 11 (46%) of the 24 patients under single drug therapy were endoscopically healed and three were improved. In contrast, 16 (70%) of the 23 patients under combined therapy were healed and all of the remainder were improved (p= 0.25). The severity of diurnal and nocturnal heartburn, decreased significantly more (p<005) on cimetidine+cisapride than on cimetidine+placebo. The combined treatment was well tolerated. These results suggest that combined therapy with cisapride and cimetidine may be useful in patients with severe reflux oesophagitis.

Updated Guidelines for the Diagnosis and Treatment of Gastroesophageal Reflux Disease

“…have appropriately decreased the regular use of these medications (90). Cisapride (91,92) and domperidone (93) have been demonstrated to produce relief of symptoms. There have been reports of fatal cardiac dysrhythmias associated with the combination of cisapride and several agents that are metabolized by the cytochrome P-450 system (94).…”

Updated guidelines for the diagnosis and treatment of gastroesophageal reflux disease

“…(75) or cisapride (10 mg q.i.d.) (76) have been shown to result in improved healing of esophagitis, compared with cimetidine alone. Cisapride may also be an effective maintenance therapy for GERD (77,78).…”

Rationale and efficacy of medical therapy for gastroesophageal reflux disease

“…In clinical practice the most frequently used combinations include a prokinetic and an antisecretive agent, but discordant results have been achieved : overall, the available data would appear to show that cimetidine, when combined with metoclopramide or cisapride [48], has proved more effective than when used alone. Insufficient data exist on combinations of the above prokinetics with ranitidine or other newer H2-antagonists.…”

“…In combination with cimetidine it has been shown to increase the efficacy of the latter [48], even in cases of severe oesophagitis. Finally, cisapride has revealed good prophylactic properties (see maintenance therapy).…”