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Doctors' Answers to "Frequently Asked Questions" - Propulsid

These comments are made for the purpose of discussion and should NOT be used as recommendations for or against therapies or other treatments. An indi vidual patient is always advised to consult their own physician.

[posted 01/18/2000]
Question: are you aware of any studies demonstrating the effect of propulsid on neurological development in children?

Answer: No, but you can get these from the companies scientific department. Or if they won't send them to you, they will to your doctor. Janssen 800-JANSSEN

[posted 12/1/1999]
Question: I have been on Wellbutrin SR and noticed some diminished libido. After being prescribed Levsin, Propulsid, and Prilosec to treat
delayed gastric emptying and Irritable Bowel Syn., my sex drive seemed to decrease even more. I just recently got married and this is
causing me a lot of distress. I went back to my doctor and was prescribed Serzone in place of the Wellbutrin. I researched this on the internet
beforehand and found Propulsid and Serzone should not be combined, but my doctor said it wasn't really dangerous when I brought this up. I'm very leery
about doing so and want to know if this is a dangerous combination and, if so, ist here another option to Serzone that won't adversely affect libido

Answer: The problem is building up levels of propulsid which can cause cardiac irregularites. If you have no history of cardiac irregularities and reduce the dosage, you would probably be ok. Celebrex is another alternative in place of Serzone. I am not aware of Propulsid interactions,but this is pretty new. I'd check with the manufacturer of Propulsid, Janssen 800-Janssen.

[posted 11/3/1999]
Question: I am taking currently norvasc 2.5 mg every day. This is prescribed for my scleroderma as it's supposed to help the circulation to the extremities. I am also taking tenolin (atenolol) 25 mg. every 2nd day as I had a mild heart attack 3 years ago. My first query is: Is there a potential problem here, (taking into account the low dosages) as I have recently heard there can be a potential danger, when mixing a beta blocker with a calcium channel blocker? My 2nd question relates to prepolsid (5 mg twice a day)? A recent news story mentioned a potential risk with prepolsid. My 2nd question is: Is there an effective substitute you can name to treat the gastroesophagul reflux that I'm taking the prepolid for? thank you.

Answer: There is no risk of mixing the two unless your pulse rate or blood pressure is too low. Propulsid can cause irregular heart rhythms and should be used with extreme caution in cardiac patients. Reglan would be ok, but has it's own toxicity(neurologic facial tics). The H2 blockers or Prevacid/Prilosec would be ok.

[posted 11/14/1999]
Question: I have taken Prevacid (30 mg./day) on an empty stomach every morning for the past 18 months for treatment of chronic esophagitis/gastritis. I also take Atenolol, Zestril, and HCTZ for treatment of essential hypertension. Since August of this year I have experienced significant problems in swallowing some foods and my daily medications, although a barium UGI series and esophageal manometry have both indicated normal conditions in my esophagus and stomach. In the event of regurgitation of my Prevacid capsule should a second capsule be taken, or can I take my capsule with food to assist in fully swallowing my capsule? I have been concerned because I never experienced such upper esophageal problems until recently, although my mother has a ten-year history of comparable esophageal reflux difficulties. My gastroenterologist offers little guidance on this subject based upon the radiologically normal diagnostic findings seen to date.

Answer: I assume they have tried you on Propulsid or Reglan? These are motility agents and increase movement from top to bottom. Propulsid is to be avoided if you have any cardiac problems, especially heart rhythm problems. Reglan has potential irreversible neurologic side effects, which is a unique risk. Secondly, if this doesn't work try switching the atenolol to a calcium channel blocker. The calcium channel blockers have effect on smooth muscle and might be of some help here.

[posted 08/6/1999]
Question: My son has been diagnosed with a severe case of reflux. This was confirmed by an Upper GI. He was initially put on Zantac, 0.5 cc, 2 times per day and Propulsid 0.5 cc, 4 times per day. I recently switched pediatricians. The new doctor kept the Zantac dose the same, but switched Tyler to Reglan, 0.5 cc, 3 times per day. This new doctor has not used Propulsid for a year. My question is which medication is better for GERD? Are there any harmful side effects with either medication? Are these really needed to treat GERD? Thank you so much for your assistance. Laurel Bernard

Answer: Reglan is usually better but, more risky. Some patients develop an irreversible facial tic called tardive dyskinesia. Reglan is consequently used only if propulsid is not working and should be a second line drug. It should be used with caution in younger patients since they face a lifetime of this facial tic. I would not be in favor of this in a young person. Surgical correction would probably be better than Reglan if the propulsid is not working. Has he seen a GI specialist?

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