Drug interactions
Cisapride + Efavirenz
Severity: Major
Cisapride and Efavirenz: major interaction.
Last updated Sources: US FDA label
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Efavirenz can prolong the QT interval, and cisapride has a serious risk of torsades de pointes. Efavirenz also affects CYP3A4 activity, which may alter cisapride exposure, so combined use raises arrhythmia risk.
What this interaction means in plain words
Cisapride and Efavirenz can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Cisapride belongs to Gastrointestinal Tract; Efavirenz belongs to Anti Virals.
Why it happens
Additive QT prolongation, with efavirenz-related modulation of CYP3A4 that may change cisapride levels.
What to do
Avoid the combination and use an alternative prokinetic. If it cannot be avoided, monitor ECG and electrolytes.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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References
Other interactions of Cisapride
- Apomorphine + Cisapride Contraindicated
- Artemether + Cisapride Contraindicated
- Azithromycin + Cisapride Contraindicated
- Ceritinib + Cisapride Contraindicated
- Chloroquine + Cisapride Contraindicated
- Cisapride + Citalopram Contraindicated
Other interactions of Efavirenz
- Cobimetinib + Efavirenz Contraindicated
- Dienogest / estradiol valerate + Efavirenz Contraindicated
- Dihydroergotamine intranasal + Efavirenz Contraindicated
- Dihydroergotamine + Efavirenz Contraindicated
- Doravirine + Efavirenz Contraindicated
- Efavirenz + Elbasvir / grazoprevir Contraindicated
Frequently asked questions
Can I take Cisapride with Efavirenz?
MediHelp rates the interaction as major. Cisapride and Efavirenz can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Efavirenz can prolong the QT interval, and cisapride has a serious risk of torsades de pointes. Efavirenz also affects CYP3A4 activity, which may alter cisapride exposure, so combined use raises arrhythmia risk.
How serious is the interaction between Cisapride and Efavirenz?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the combination and use an alternative prokinetic. If it cannot be avoided, monitor ECG and electrolytes.
What other medicines interact with Cisapride?
MediHelp also lists interactions of Cisapride with, for example, Apomorphine, Artemether, Azithromycin. The full list is on the Cisapride page.
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