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May 22, 2019  
EDUCATION CENTER: Treatments
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  • Promotility Agents

    Overview
    Reviewed by Dr. Rich Alweis

    Promotility agents speed digestion, which prevents acid from staying in the stomach too long. They are sometimes used to treat gastroesophageal reflux disease (GERD) if proton pump inhibitors and H2 blockers don’t work. They are also used to treat critically ill patients.

    Detailed Description
    Promotility agents reduce the amount of food that stays in your stomach. Since more food in your stomach increases likelihood of reflux, promotility agents are sometimes used to treat reflux. Both promotility agents, however, have negative side effects, and are usually used as a method of last resort for treating GERD. Sometimes, these medications are used to help digestion in critically ill patients.

    Cisapride (Propulsid is the brand name) can cause serious heart-related side effects and has effectively been removed from the market. It is still available on a very limited basis, but should be a treatment of last resort. Patients who do take cisapride must be monitored for heart problems. You should have an electrocardiogram before beginning your regimen and your doctor should monitor the levels of potassium and magnesium in your blood while you are taking the medication.

    Metoclopramide is the other main promotility agent. While it is much less likely to cause a life-threatening side effect, it can cause muscle spasms and other discomfort. It is generally used as a short-term adjunct to H2 blockers and proton pump inhibitors, or long-term for patients with gastric motility problems (for example, diabetic gastroparesis).

    Generic versions of metoclopramide are available, but Propulsid is the only form of cisapride available.

    In addition to their side effects, both cisapride and metoclopramide need to be taken four times a day, which makes them more difficult for the average person to take a full course of the medication.

    Last updated: 25-Jun-03

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