Effect of cisapride on acid gastro-oesophageal reflux during treatment with caffeine

About 50% of preterm infants and neonates receiving methylxanthines for res piratory stimulation will develop a pathological gastro-oesophageal reflux (GOR) pattern. In the face of potential GOR-related complications the effec t of a concomitant treatment with a prokinetic agent, such as cisapride, sh ould be evaluated, In this study 32 formerly preterm infants were studied s imultaneously by 24-hour oesophageal pH monitoring and cardio-respirogram b efore the presumed end of caffeine treatment. In 14 of these infants a refl ux index (RI; percentage of recording time) of more than 4% could be detect ed (pH <4). Ten of them were treated orally with cisapride (0.2 mg/kg t.i.d .), Data of pH monitoring, cardio-respirogram and caffeine serum concentrat ions were obtained before and 5 days after introducing cisapride. The Ri an d the frequency of GOR decreased significantly with cisapride. The steady-s tate serum concentrations of caffeine were not influenced by cisapride and the extent of periodic breathing remained unchanged. In conclusion, cisapri de has a positive influence on GOR parameters during caffeine treatment wit hout impairing the oral bioavailability or therapeutic effect of caffeine. Copyright (C) 2000 S. Karger AG, Basel.