Effects of Cisapride on QTc Interval and QT Dispersion in Preterm Infants

ABSTRACT

PURPOSE: Cisapride, a prokinetic agent, is widely used in preterm infants with feeding intolerance or gastroesophageal reflux. Although cisapride is regarded as a safe drug, increased QTc interval or ventricular arrhythmia has been reported in adults and neonates. So we prospectively examined the effects of cisapride on the QTc interval and QT dispersion in preterm infants. METHODS: QTc interval and QT dispersion were determined just before and 4.9+/-1.7days after the start of the cisapride treatment in 15 preterm infants with cisapride between April 1, 1998 and August 31, 1998. RESULTS: Cisapride significantly increased QTc interval(P<0.05), and this had no correlation with birthweight or gestational age. Three(20%) of the 15 cases were found to have QTc interval above 0.450, but they were clinically asymptomatic. QT dispersion did not increase significantly. CONCLUSION: Cisapride use in preterm infants is associated with an increase in QTc interval. High dose or longterm use of cisapride in preterm infants should be used cautiously, and when used, monitoring the QTc interval should be considered.