Cisapride Compounded Oral Suspension for Cats (Veterinary Only)

Oral Suspension Formulation

Cisapride made into a flavored, custom strength liquid for cats, on a veterinarian's order. Not for people. Chino, CA.

Reviewed by Linda Pungpravat, Compounding Pharmacist, RPh Mixwell Compounding Pharmacy, Chino, CA

USP <795> compliant
USP <800> hazardous drug lab
PCCA member

At a Glance

Preparation details for Cisapride Compounded Oral Suspension for Cats (Veterinary Only)
Dosage form	Oral suspension
Route	Oral
Active ingredients	Cisapride
Technology	Oral Suspension Formulation
Strengths in literature	Oral suspension 5 to 10 mg/mL for cats, per FDA's office stock list. Tablets or capsules 2.5 and 5 mg.
Commercial product	Commercial product discontinued
Strength and directions	Per prescriber
Dispensing	Valid prescription

Speak with our pharmacist Send a prescription

Phone (909) 378-7301. Fax (909) 378-7071

Clinical Advantages

Liquid dose measured by volume
Strength set by the veterinarian
Flavor options chosen for cats
Option for cats that refuse capsules
Non sterile preparation

How It Works

What is cisapride?

Cisapride was sold in the U.S. as Propulsid, approved for adults with nighttime heartburn from GERD [4]. The label shows a 20 mg tablet and a 1 mg/mL suspension [4]. It was later removed from the market for safety reasons [2].

No FDA approved cisapride product is marketed for people or animals. The FDA lists cisapride as a bulk drug substance that may be used for office stock in cats [1]. A compounded suspension is not FDA approved, and the FDA has not reviewed it.

What is an oral suspension?

It's a liquid that is swallowed. The medicine is spread through a liquid base, so the bottle gets shaken before each dose. The pharmacy makes it to the veterinarian's order, and the dose is measured in milliliters with an oral syringe.

What a liquid gives a veterinarian

A strength in mg per mL chosen to fit a cat's weight, including small or older cats
A form for cats that won't take a capsule
A choice of base, flavor, and dye made with the pharmacist

A water based liquid has a short shelf life. The USP 795 default is 35 days if it's preserved and 14 days if it isn't [5]. The pharmacist sets the date for each bottle.

For veterinarians

Small animal, feline, and veterinary internal medicine practices
Send the species, weight, strength in mg per mL, the total volume, and flavor needs. Call (909) 378-7301 to talk with our pharmacist
FDA guidance expects a patient specific prescription within a veterinarian client patient relationship [3]
Our pharmacist confirms the source of the cisapride used. Compounded animal drugs are not made from bulk drug substances

For cat owners

Shake the bottle well, and measure each dose with the syringe we give you
This medicine is for your cat only. Keep it away from children, and wash your hands after dosing
Tell your veterinarian about every medicine and supplement your cat gets

Clinical Details

What does the evidence show?

The FDA lists cisapride among bulk drug substances for compounding office stock drugs for cats, as tablets or capsules of 2.5 and 5 mg and an oral suspension of 5 to 10 mg/mL. The FDA notes that no approved cisapride product is marketed [1].
Cisapride appears on the FDA list of drug products withdrawn or removed from the market for safety or effectiveness reasons [2].
No FDA approved labeling describes cisapride use in cats.

Findings come from the cited studies and do not promise any individual outcome.

Why is it compounded, and how is it typically used?

Why it is compounded

No cisapride product is currently marketed for people or animals [1]. A veterinarian who prescribes it for a cat relies on a compounding pharmacy. Mixwell prepares cisapride for veterinary patients only and does not compound it for people [2].

Dosage forms and strengths

Oral suspension at the strength the veterinarian specifies, measured by syringe
Flavors chosen for cats, such as fish or poultry
Capsules when the veterinarian prefers a solid form
Dye free versions on request

Dosing, monitoring, and duration are the veterinarian's decision.

How Mixwell prepares it

Mixwell compounds this suspension in Chino, California under USP 795 rules for non sterile preparations [5]. Each prescription is checked for species, weight, and strength before compounding. The label identifies the preparation as for veterinary use. We ship across California, including Chino Hills, Ontario, Pomona, Diamond Bar, and Rancho Cucamonga.

Paying for it

Mixwell doesn't accept insurance. Veterinary prescriptions can't be charged to an HSA or FSA account. Call (909) 378-7301 for pricing.

Safety information

The Propulsid Medication Guide says the drug may cause serious irregular heartbeats that may cause death. It lists medicines that must not be combined with it, including erythromycin, clarithromycin, fluconazole, itraconazole, oral ketoconazole, and certain antidepressants, antipsychotics, and heart rhythm drugs. It also advises against grapefruit juice, and lists heart disease, kidney disease, and low potassium, calcium, or magnesium as reasons not to take it [4]. These warnings are for people.

Cisapride must never be given to people. Keep it away from children, and wash hands after dosing a cat. Compounded animal drugs are not FDA approved, and the FDA has not evaluated their safety or effectiveness.

Patient selection, dosing, monitoring, and duration are the veterinarian's responsibility. Pet owners should talk with their own veterinarian before giving any medication.

References

U.S. Food and Drug Administration. List of bulk drug substances for compounding office stock drugs for use in nonfood producing animals. FDA Center for Veterinary Medicine
Drug products withdrawn or removed from the market for reasons of safety or effectiveness. 21 CFR 216.24. eCFR
U.S. Food and Drug Administration. CVM GFI #256, compounding animal drugs from bulk drug substances. Final guidance, 2022. FDA guidance
Propulsid (cisapride) tablets and suspension. Label and Medication Guide. FDA Drugs@FDA
United States Pharmacopeia. General Chapter 795, Pharmaceutical Compounding: Nonsterile Preparations. USP NF. Official November 1, 2023.

What to include on the prescription

APIs and strengths
Base or vehicle
Quantity
Directions for use
Refills
Allergies or dye free needs

Call (909) 378-7301 Fax (909) 378-7071

Compounded in Chino, CA. Delivered across California.

Chino
Chino Hills
Ontario
Pomona
Diamond Bar
Rancho Cucamonga
Eastvale

Mixwell Compounding Pharmacy 13788 Roswell Ave, Ste 158, Chino, CA 91710
(909) 378-7301

Compounded medications are not reviewed or approved by the FDA. Dispensed only with a valid prescription. Mixwell is a non sterile pharmacy and does not prepare sterile products or injectables. Compounded preparations are not presented as superior to commercially available products, and nothing here promises a specific result. Mixwell does not accept insurance. Call for pricing.

Call pharmacist Send Rx