Drug General Information (ID: DDIHBM28OC)
  Drug Name Cisapride Drug Info Hydroflumethiazide Drug Info
  Drug Type Small molecule Small molecule
  Therapeutic Class Gastrointestinal Agents Diuretics
  Structure

 Mechanism of Cisapride-Hydroflumethiazide Interaction (Severity Level: Major)
     Increased risk of ventricular arrhythmias Click to Show/Hide Mechanism Graph
Could Not Find 2D Structure
      Drug Name Cisapride Hydroflumethiazide
      Mechanism 1 Prolong QT interval Hypokalemia
      Key Mechanism Factor 1
Factor Name Ventricular arrhythmias
Factor Description Ventricular arrhythmias are abnormal heart rhythms that cause your heart's lower chambers to pump blood instead of pumping it. This can limit or stop your heart from supplying blood to your body. While some of these arrhythmias are harmless and do not cause symptoms, others can have serious, even fatal, effects on your body.
      Mechanism Description
  • Increased risk of ventricular arrhythmias by the combination of Cisapride and Hydroflumethiazide 
      Mechanism 2 Prolong QT interval Hypomagnesemia
      Key Mechanism Factor 2
Factor Name Ventricular arrhythmias
Factor Description Ventricular arrhythmias are abnormal heart rhythms that cause your heart's lower chambers to pump blood instead of pumping it. This can limit or stop your heart from supplying blood to your body. While some of these arrhythmias are harmless and do not cause symptoms, others can have serious, even fatal, effects on your body.
      Mechanism Description
  • Increased risk of ventricular arrhythmias by the combination of Cisapride and Hydroflumethiazide 

Recommended Action
      Management Cisapride is contraindicated in patients with uncorrected hypokalemia and hypomagnesemia, such as those taking potassium-wasting diuretics.

References
1 Dresser GK, Spence JD, Bailey DG "Pharmacokinetic-pharmacodynamic consequences and clinical relevance of cytochrome P450 3A4 inhibition." Clin Pharmacokinet 38 (2000): 41-57. [PMID: 10668858]
2 Lewin MB, Bryant RM, Fenrich AL, Grifka RG "Cisapride-induced long QT interval." J Pediatr 128 (1996): 279-81. [PMID: 8636830]
3 Product Information. Propulsid (cisapride). Janssen Pharmaceutica, Titusville, NJ.