Injuries Resulting From Propulsid
Propulsid, which contains cisapride, has been associated with serious cardiac arythmias. Ventricula tachycardia, ventricular fibrillation, torsades de pointes, and QT prolongation have been reported in patients taking cisapride. Many of these patients also took drugs expected to increase cisapride blood levels by inhibiting the cytochrome P450 3A4 enzymes that metabolize cisapride. These drugs include clarithromycin, erythromycin, troleandomycin, nefazodone, fluconazole, itraconazole, ketoconazole, indinavir, and ritonavir. Some of these events have been fatal. Cisapride is contraindicated in patients taking any of these drugs.
QT prolongation, torsades de pointes (sometimes with syncope), cardiac arrest, and sudden death have been reported in patients taking cisapride without the above-mentioned contraindicated drugs. Many patients had disorders that may have predisposed them to arrhythmias with cisapride. Cisapride is contraindicated for those patients with: history of prolonged electrocardiographic QT intervals or known family history of congenital long QT syndrome; renal failure; history of ventricular arrhythmias, ischemic heart disease, and congestive heart failure; clinically significant bradycardia; uncorrected electrolyte disorders (hypokalemia, hypomagnesemia); respiratory failure; and concomitant medications known to prolong the QT interval and increase the risk of arrhythmia, such as certain antiarrhythmics, including those of Class 1A (such as quinidine and procainamide) and Class III (such as sotalol); tricyclic antidepressants (such as amitriptyline); certain tetracyclic antidepressants (such as maprotiline); certain antipsychotic medications (such as certain phenothiazines and sertindole); astemizole, bepridil, sparfloxacin, and terodiline.
Propulsid was marketed by Janssen Pharmaceutical to treat heartburn in patients with gastroesophogeal reflux disease. Because of the problems discussed above, Janssen removed Propulsid from the market in 2000.
Jim Szaller has served as Treasurer of the Association of Trial Lawyers of America (ATLA) Propulsid Litigation Group from 2000 to the present. The Propulsid Litigation Group has developed, assembled and distributed a vast amount of material to lawyers representing individuals injured by Propulsid. In addition, the Group has lectured extensively and provided advice on a variety of issues related to Propulsid litigation.