Concerns about cardiac arrhythmias led to restrictions being placed on the prescription of cisapride.1 There are few gastrointestinal conditions which require treatment with cisapride.2 It should only be tried if patients with gastroparesis or severe gastro-oesophageal reflux have not responded to other drugs.

The manufacturer has now decided to withdraw the highest strength of cisapride tablets (20 mg). It has also revised the product information.

All patients now require measurements of renal function and ECGs before and during treatment. They should be followed up at least every three months. As interactions may prolong the QTc interval, patients taking cisapride should be regularly asked if they are taking any other medicines.