Is cisapride useful in patients with high GRVs?

• A. Yes
• B. No, it was withdrawn from US market in 2000 due to cardiac dysrhythmias
• C. Only in pediatric patients
• D. It is a first-line prokinetic

Answer: (B)

Cisapride acts as a prokinetic by activating 5-HT4 receptors to boost gastric motility, which could help with high gastric residuals. But it carried a serious safety risk: it prolongs the QT interval and can cause life‑threatening cardiac arrhythmias like torsades de pointes. Because of this danger, cisapride was withdrawn from the US market in 2000, so it is no longer used for this purpose. Other prokinetics with safer profiles are preferred.