Should cisapride be avoided in patients with diabetic gastroparesis?

The gastrointestinal motility stimulants, cisapride and erythromycin, have been used in the management of diabetic gastroparesis. However, drug intera ctions may result in prolongation of the electrocardiographic QT interval w ith the risk of ventricular arrhythmias. These drugs should, therefore, not be used in combination. We report two cases that illustrate inappropriate use of these agents. Moreover, patients with recurrent severe hypoglycemia or renal impairment may be at increased risk from cisapride-related cardiot oxicity. Thus, even as monotherapy, cisapride may pose dangers for high-ris k diabetic patients. (C) 2000 Elsevier Science Inc.