# Cisapride: veterinary dose and monograph

> Cisapride is a veterinary gastrointestinal drug. Prokinetic (gut motility stimulant) that promotes coordinated contractions along the whole GI tract — the most effective medical therapy for feline idiopathic megacolon/constipation and a useful agent for gastric stasis, ileus and reflux. Indications include feline idiopathic megacolon / chronic constipation (mainstay); gastric stasis / delayed gastric emptying; post-operative or functional ileus. This monograph lists 5 reference doses for dogs, cats, rabbits, guinea pigs and chinchillas, each with route, frequency and source.

Source: https://vetmasterji.com/drugs/cisapride · Last reviewed: 2026-10-01

## At a glance

- **Drug class:** Gastrointestinal
- **Also known as:** Prepulsid, Propulsid, Cisapride monohydrate
- **Species with doses:** Dogs, Cats, Rabbits, Guinea pigs and Chinchillas
- **General dose range:** 0.1–0.5 mg/kg PO q8–12h — check the species tables for the indication
- **Routes:** PO
- **Last reviewed:** 1 October 2026

## Indications

- Feline idiopathic megacolon / chronic constipation (mainstay)
- Gastric stasis / delayed gastric emptying
- Post-operative or functional ileus
- Gastro-oesophageal reflux (increases lower-oesophageal-sphincter tone and gastric emptying)

## Cisapride dose by species

Doses are per administration unless stated. mg/kg doses scale with body weight; per-animal, per-quarter and infusion-rate doses are shown as the reference writes them.

### Dogs

*Cisapride doses for dogs*

| Indication | Dose | Route | Frequency | Duration |
| --- | --- | --- | --- | --- |
| Gastric stasis / ileus / reflux | 0.1–0.5 mg/kg | PO | q8–12h | — |

- Gastric stasis / ileus / reflux: Papich 5e: 0.1–0.5 mg/kg q8–12h PO (up to 0.5–1 mg/kg). Plumb’s p.278: 0.1–0.5 mg/kg PO two to three times daily 30 min before meals (Twedt 2008); megaoesophagus 0.55 mg/kg once to three times daily; oesophagitis 0.5–0.75 mg/kg three times daily.

### Cats

*Cisapride doses for cats*

| Indication | Dose | Route | Frequency | Duration |
| --- | --- | --- | --- | --- |
| Megacolon / constipation | 2.5–5 mg/cat | PO | q8–12h, 15–30 min before food | — |

- Megacolon / constipation: Papich 5e: 2.5–5 mg per cat q8–12h PO (up to 1 mg/kg q8h). Plumb’s p.278: 2.5 mg (cats up to 10 lb) or 5 mg (over 10 lb) three times daily, 7.5 mg in cats over 16 lb (Tams); 2.5–5 mg q8–12h (Carr). Halve the dose in hepatic insufficiency. Combine with lactulose and fibre. (The previous 0.1–0.5 mg/kg under-dosed most cats.)

### Rabbits

*Cisapride doses for rabbits*

| Indication | Dose | Route | Frequency | Duration |
| --- | --- | --- | --- | --- |
| GI stasis (no obstruction) | 0.5 mg/kg | PO | q6–12h | — |

- GI stasis (no obstruction): Plumb’s p.278: rabbits 0.5 mg/kg PO q6–12h with fluids and high-fibre slurry (Hess 2002; Lichtenberger 2008). Rule out obstruction first.

### Guinea pigs

*Cisapride doses for guinea pigs*

| Indication | Dose | Route | Frequency | Duration |
| --- | --- | --- | --- | --- |
| Ileus (no obstruction) | 0.1–0.5 mg/kg | PO | q8–12h | — |

- Ileus (no obstruction): Plumb’s p.278: 0.1–0.5 mg/kg PO q12h (Adamcak & Otten 2000); guinea pigs and chinchillas 0.5 mg/kg q8–12h (Orcutt 2005).

### Chinchillas

*Cisapride doses for chinchillas*

| Indication | Dose | Route | Frequency | Duration |
| --- | --- | --- | --- | --- |
| Ileus (no obstruction) | 0.1–0.5 mg/kg | PO | q8–12h | — |

- Ileus (no obstruction): Plumb’s p.278: 0.1–0.5 mg/kg PO q12h (Adamcak & Otten 2000); 0.5 mg/kg q8–12h (Orcutt 2005).

## Contraindications

GI obstruction, perforation or haemorrhage (never give a prokinetic into a mechanical obstruction). Pre-existing QT prolongation/serious arrhythmia. Concurrent potent CYP3A4 inhibitors (ketoconazole, itraconazole, erythromycin, clarithromycin) — raise cisapride levels and arrhythmia risk. Known hypersensitivity.

## Species-specific warnings

> **Caution:** Cats: Confirm there is no obstructing colonic mass/foreign body before using a prokinetic; pair with hydration and stool softeners for megacolon.

## Adverse effects

- Abdominal cramping, diarrhoea (excess motility)
- Vomiting
- QT prolongation / arrhythmia (high doses or with interacting drugs)
- Rarely sedation/behavioural change

## Drug interactions

- CYP3A4 inhibitors (azole antifungals, macrolides): raise cisapride levels → QT prolongation/arrhythmia — avoid combination
- Other QT-prolonging drugs (sotalol, some antiarrhythmics): additive arrhythmia risk
- Anticholinergics (atropine): antagonise the prokinetic effect
- Drugs altering gut pH/absorption: cisapride can change their absorption by speeding transit

## Pregnancy and lactation

Limited data; use only if clearly needed. Generally avoided in pregnancy without strong indication.

## Monitoring

- Stool frequency/consistency and colon size (megacolon response)
- GI tolerance (cramping/diarrhoea)
- ECG if high doses, cardiac disease, or interacting drugs are involved
- Review co-medications for CYP3A4 inhibitors

## Toxicity and overdose

At veterinary doses serious toxicity is uncommon; overdose can cause GI cramping/diarrhoea and, importantly, dose- or interaction-dependent QT prolongation with the potential for ventricular arrhythmia (the reason for its human withdrawal). Risk rises sharply with CYP3A4-inhibitor co-administration.

Management: No specific antidote. Decontaminate if a large recent ingestion; provide supportive GI care. Obtain an ECG and monitor for QT prolongation/arrhythmia — treat ventricular arrhythmia conventionally (correct electrolytes, IV magnesium for torsades, antiarrhythmics as indicated). Discontinue any interacting CYP3A4 inhibitor.

## Clinical pearls

- The single most useful drug for feline megacolon — combine with lactulose, fibre/diet, and aggressive hydration
- Works on the colon (unlike metoclopramide), which is exactly why it succeeds in constipation/megacolon
- Give 15–30 minutes before feeding for best prokinetic effect
- Never use into a suspected obstruction, and avoid azole antifungals/macrolides concurrently (QT risk)
- Now a compounded medication — source from a reputable compounding pharmacy

## Mechanism of action

A serotonergic prokinetic: it stimulates 5-HT4 receptors on enteric (myenteric-plexus) neurons, enhancing acetylcholine release and producing coordinated, propulsive smooth-muscle contractions from the oesophagus through the colon. Unlike metoclopramide it works along the entire gut (including the colon — key for megacolon) and has no central antidopaminergic/anti-emetic action. Its hERG/IKr potassium-channel block underlies the QT risk seen in people.

## Formulations and products

- 5 mg tablet (compounded/specialist)
- 10 mg tablet
- Compounded oral suspension (e.g. 5 mg/mL)
- Cisapride (compounded) (Compounding pharmacy) — Custom (e.g. 2.5 / 5 mg capsule or 5 mg/mL suspension), Compounded capsule/suspension
- Prepulsid (withdrawn) — 5 / 10 mg tablet, Tablet (human-label)

## Storage

Compounded tablets/suspension: per compounding pharmacy instructions (often refrigerated suspension); 15–30 °C for tablets, protected from light and moisture.

## Before you use this dose

> **Caution:** Reference doses for veterinary professionals. Confirm the dose against the product label, the patient’s condition, current guidance and local regulations before use; the attending veterinarian remains responsible for every clinical decision.

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- [Cimetidine](https://vetmasterji.com/drugs/cimetidine)
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- [Hyoscine Butylbromide (N-Butylscopolammonium)](https://vetmasterji.com/drugs/butylscopolamine)
- [Lactulose](https://vetmasterji.com/drugs/lactulose)
- [Loperamide](https://vetmasterji.com/drugs/loperamide)

## Frequently asked questions

### What is the dose of Cisapride for dogs?

Reference doses for Cisapride in dogs: 0.1–0.5 mg/kg PO q8–12h (Gastric stasis / ileus / reflux). Confirm against the label and the patient before use.

### What is the dose of Cisapride for cats?

Reference doses for Cisapride in cats: 2.5–5 mg/cat PO q8–12h, 15–30 min before food (Megacolon / constipation). Confirm against the label and the patient before use.

### What is the dose of Cisapride for rabbits?

Reference doses for Cisapride in rabbits: 0.5 mg/kg PO q6–12h (GI stasis (no obstruction)). Confirm against the label and the patient before use.

### When should Cisapride not be used?

GI obstruction, perforation or haemorrhage (never give a prokinetic into a mechanical obstruction). Pre-existing QT prolongation/serious arrhythmia. Concurrent potent CYP3A4 inhibitors (ketoconazole, itraconazole, erythromycin, clarithromycin) — raise cisapride levels and arrhythmia risk. Known hypersensitivity.

### What are the side effects of Cisapride in animals?

Abdominal cramping, diarrhoea (excess motility); Vomiting; QT prolongation / arrhythmia (high doses or with interacting drugs); Rarely sedation/behavioural change.

## Sources

- Plumb's Veterinary Drug Handbook
- Merck Veterinary Manual, 11th edition
- Papich, Papich Handbook of Veterinary Drugs, 5th edition

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VetMasterJi is a clinical decision-support and education platform for veterinary professionals and students. It does not provide veterinary advice, diagnosis or treatment for specific animals. All drug doses, calculators and differentials are references that must be independently verified before clinical use; the attending registered veterinarian remains solely responsible for every clinical decision.