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 individual patient is always advised to consult their own physician.

More Propulsid Concerns [posted 11/19/98]
Question: Last fall, I was diagnosed with GERD and H. Pylori infection, and prescribed Propulsid (along with Prilosec) after the initial antibiotic treatment for the latter condition. I took it twice a day for about a month, and did notice an increase in "skipped heartbeats" for a time. These continue to occur infrequently, but without great impact on my daily routine (I continue to run and excercise daily, for example). Given the recent FDA warning on Propulsid, should I be concerned?

Answer: I would try to decrease it to one and see if it is still effective. Bedtime is usually the best time. A good drug,but, interacts with lots of others-are you taking any other drugs?

Propulsid Concerns [posted 10/20/98]
Question: My father has been having stomach problems and was recently prescribed Propulsid. What exactly is this drug used for. They have not diagnosed him with a particular illness.

Answer: Propulsid is a motility agent which acts to speed up movement of food/etc. from the mouth to the anus. It is commonly used in acid reflux disease since speeding up motility will decrease the acid which reluxes (goes the wrong direction) to the esophagus. It is also used for patients who empty their stomach slowly to decrease emptying time. An upper GI or endoscopy is usually necessary to evaluate whether this drug would be useful.

Propulsid Concerns [posted 10/20/98]
Question: I have been diagonosed with bi-polar manic with schyso tendencies, panic disorder, severe reflux, ulcers (non-bacterial) from my esophagus to the bottom of my stomach, high blood pressure, edema, asmatha, angina, fibromalsia, osteo arthritis, ADD, and I am allergic to cats and some chemical compounds. Due to this I take a long list of drugs. What is the scoop on propulsid and could i be at risk?

Answer: Well, propulsid interacts with many other medications in its metabolic degradation pathway. So, one must be careful not to get high levels by interacting with other meds. With the laundry list that you are on, I would check with the company's medical department-Janssen 800-JANSSEN.

Propulsid Use for Infants [posted 10/13/98]
Question: I have an 11 week old baby with reflux. She is on propulsid and zantac. Just recently the Dr. stopped the zantac and started her on prilosec. Is there any research on using prilosec on infants?

Answer: No. But, it is very commonly used by pediatricians without any major adverse reports coming out about the drug.

Propulsid Side Effects [posted 10/9/98]
Question: I have just read the latest reports on the side effects from taking the drug Propulsid for reflux. My daughter started taking the drug at 3 mos and she is now 10 mos. I am very concerned and my doctor does not seem to know very much about the report. Please let me know what I should do. Do I need to take her in for tests? Please advise.

Answer: What side effects are you referring to? In general, fairly minimal. However, never really tested on children although used extensively by pediatricians to avoid reflux.

Neutropenia: A Propulsid Side Effect? [posted 10/9/98]
Question: My very healthy 8 month old is neutropenic. She takes propulsid and carafate for her reflux. Is propulsid known to cause neutropenia? Are there any other causes of neutropenia that we should explore? All her other blood counts appear normal.

Answer: Listed as a potential cause, but, very uncommon. You won't know for certain without stopping the medication. Carafate would not cause the problem.

Propulsid [posted 10/1/98]
Question: My baby is on Propulsid (1.0ml, 4x daily) and zantac(0.7ml, 3x daily). This is to aid with her GERD. She has been on this combination since July 12, 1998 and it seemed to be working. However, lately she has been spitting up more between meals and seems to be experiencing stomach cramps. Could this be due to the medications? Also, Propulsid is known to have some severe side affects, would a switch to Reglan be recommended? I want to help my child and sometimes feel put of by her gastrointerologist.

Answer:This can be due to the propulsid and may necessitate a dosage alteration. I would avoid Reglan unless there is no alternative due to the potential for long term neurologic side effects seen with this drug.

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