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2D Structure
Also known as: Prepulsid, Propulsid, 81098-60-4, 104860-73-3, 4-amino-5-chloro-n-[1-[3-(4-fluorophenoxy)propyl]-3-methoxypiperidin-4-yl]-2-methoxybenzamide, Risamal
Molecular Formula
C23H29ClFN3O4
Molecular Weight
465.9  g/mol
InChI Key
DCSUBABJRXZOMT-UHFFFAOYSA-N

A substituted benzamide used for its prokinetic properties. It is used in the management of gastroesophageal reflux disease, functional dyspepsia, and other disorders associated with impaired gastrointestinal motility. (Martindale The Extra Pharmacopoeia, 31st ed)
1 2D Structure

2D Structure

2 Identification
2.1 Computed Descriptors
2.1.1 IUPAC Name
4-amino-5-chloro-N-[1-[3-(4-fluorophenoxy)propyl]-3-methoxypiperidin-4-yl]-2-methoxybenzamide
2.1.2 InChI
InChI=1S/C23H29ClFN3O4/c1-30-21-13-19(26)18(24)12-17(21)23(29)27-20-8-10-28(14-22(20)31-2)9-3-11-32-16-6-4-15(25)5-7-16/h4-7,12-13,20,22H,3,8-11,14,26H2,1-2H3,(H,27,29)
2.1.3 InChI Key
DCSUBABJRXZOMT-UHFFFAOYSA-N
2.1.4 Canonical SMILES
COC1CN(CCC1NC(=O)C2=CC(=C(C=C2OC)N)Cl)CCCOC3=CC=C(C=C3)F
2.2 Synonyms
2.2.1 MeSH Synonyms

1. Propulsid

2. R 51619

3. R-51619

4. R51619

2.2.2 Depositor-Supplied Synonyms

1. Prepulsid

2. Propulsid

3. 81098-60-4

4. 104860-73-3

5. 4-amino-5-chloro-n-[1-[3-(4-fluorophenoxy)propyl]-3-methoxypiperidin-4-yl]-2-methoxybenzamide

6. Risamal

7. 4-amino-5-chloro-n-{1-[3-(4-fluorophenoxy)propyl]-3-methoxy-4-piperidyl}-2-methoxybenzamide

8. T 1341

9. Dsstox_cid_2825

10. 4-amino-5-chloro-n-{1-[3-(4-fluorophenoxy)propyl]-3-methoxypiperidin-4-yl}-2-methoxybenzamide

11. Dsstox_rid_76746

12. Dsstox_gsid_22825

13. Ncgc00016944-01

14. 4-amino-5-chloro-n-(1-(3-(4-fluorophenoxy)propyl)-3-methoxypiperidin-4-yl)-2-methoxybenzamide

15. Benzamide, 4-amino-5-chloro-n-(1-(3-(4-fluorophenoxy)propyl)-3-methoxy-4-piperidinyl)-2-methoxy-, Cis-

16. Benzamide, 4-amino-5-chloro-n-[1-[3-(4-fluorophenoxy)propyl]-3-methoxy-4-piperidinyl]-2-methoxy-, Cis-

17. Prestwick_786

18. Cas-81098-60-4

19. Cisapride (usp/inn)

20. Cisapride-[13c,d3]

21. (.+/-.)-cisapride

22. Prestwick0_000430

23. Prestwick1_000430

24. Prestwick2_000430

25. Chembl1729

26. Schembl16131

27. Gtpl240

28. Spbio_002359

29. Chebi:95129

30. Cid_5311047

31. Hms1569e22

32. Hms3370f16

33. 4-amino-5-chloro-n-[1-[3-(4-fluorophenoxy)propyl]-3-methoxy-4-piperidinyl]-2-methoxybenzamide

34. 4-amino-5-chloro-n-{1-[3-(4-fluoro-phenoxy)-propyl]-3-methoxy-piperidin-4-yl}-2-methoxy-benzamide

35. Tox21_110699

36. Bdbm50005836

37. Stl058624

38. Akos005710823

39. Tox21_110699_1

40. Ac-1912

41. Ccg-213491

42. Ncgc00025262-02

43. Ncgc00168465-01

44. 4-amino-5-chloro-n-[1-{3-[(4-fluorophenyl)oxy]propyl}-3-(methyloxy)piperidin-4-yl]-2-(methyloxy)benzamide

45. Ls-15011

46. Ft-0623916

47. C06910

48. D00274

49. L000938

50. Brd-a12896037-001-02-7

51. 4-amino-5-chloro-2-methoxy-n-[1-[3-(4-fluorophenoxy)propyl]-3-methoxy-4-piperidinyl]benzamide

52. 4-amino-5-chloro-n-(1-[3-(4-fluorophenoxy)propyl]-3-methoxy-4-piperidinyl)-2-methoxybenzamide, Cis- #

2.3 Create Date
2005-03-25
3 Chemical and Physical Properties
Molecular Weight 465.9 g/mol
Molecular Formula C23H29ClFN3O4
XLogP33.4
Hydrogen Bond Donor Count2
Hydrogen Bond Acceptor Count7
Rotatable Bond Count9
Exact Mass465.1830623 g/mol
Monoisotopic Mass465.1830623 g/mol
Topological Polar Surface Area86 Ų
Heavy Atom Count32
Formal Charge0
Complexity581
Isotope Atom Count0
Defined Atom Stereocenter Count0
Undefined Atom Stereocenter Count2
Defined Bond Stereocenter Count0
Undefined Bond Stereocenter Count0
Covalently Bonded Unit Count1
4 Drug and Medication Information
4.1 Therapeutic Uses

Anti-Ulcer Agents; Gastrointestinal Agents; Serotonin Agonists

National Library of Medicine's Medical Subject Headings online file (MeSH, 1999)


Cisapride is indicated for the symptomatic treatment of nocturnal (and daytime /Not included in US product labeling/) heartburn, and of esophagitis due to reflux and delayed gastric emptying. Treatment may continue for up to 8 weeks; however, tolerance to cisapride may develop at some point in therapy. /Included in US product labeling/

USP Convention. USPDI - Drug Information for the Health Care Professional. 16th ed. Volume I. Rockville, MD: U.S. Pharmaceutical Convention, Inc. 1996 (Plus updates)., p. 849


Cisapride is indicated in the treatment of gastroparesis, including idiopathic, diabetic, and intestinal pseudo-obstruction. Treatment may continue for up to 8 weeks; however, tolerance to cisapride may develop at some point in therapy. /NOT included in US product labeling/

USP Convention. USPDI - Drug Information for the Health Care Professional. 16th ed. Volume I. Rockville, MD: U.S. Pharmaceutical Convention, Inc. 1996 (Plus updates)., p. 849


... Reduce the consumption of laxatives in patients who chronically abuse these agents.

American Medical Association, Council on Drugs. AMA Drug Evaluations Annual 1994. Chicago, IL: American Medical Association, 1994., p. 946


For more Therapeutic Uses (Complete) data for CISAPRIDE (7 total), please visit the HSDB record page.


4.2 Drug Warning

Cisapride generally is well tolerated. Adverse effects on the GI tract and nervous system are most common and those most frequently requiring discontinuance of the drug(usually because of intolerable diarrhea and/or abdominal pain). The most common adverse GI effects (e.g., diarrhea) are extensions of the drug's pharmacologic activity. Because of differences in the pharmacologic profiles of the drugs, adverse nervous system effects are less common with cisapride than with metoclopramide whereas diarrhea is more common with cisapride.

McEvoy G.K. (ed.). American Hospital Formulary Service-Drug Information 96. Bethesda, MD: American Society of Health-System Pharmacists, Inc. 1996 (Plus Supplements)., p. 2146


In adults receiving cisapride for motility disorder in US placebo-controlled clinical trials, including those with gastroesophageal reflux disease, the most frequent adverse effects of cisapride were headache, diarrhea, abdominal pain, nausea, constipation, and rhinitis. The frequency of diarrhea, abdominal pain, constipation, flatulence, and rhinitis appears to be dose dependent, occurring more frequently in patients receiving oral cisapride 20 mg 4 times daily than in those receiving 10 mg 4 times daily. Many adverse effects reported with cisapride occurred at a frequency similar to that associated with placebo, and a causal relationship to the drug often could not be established.

McEvoy G.K. (ed.). American Hospital Formulary Service-Drug Information 96. Bethesda, MD: American Society of Health-System Pharmacists, Inc. 1996 (Plus Supplements)., p. 2146


Dehydration was reported in more than 1% of patients receiving cisapride in controlled clinical trials. Limited evidence indicates that cisapride does not adversely affect glycemic control in insulin-dependent (type I) diabetic patients with delayed gastric emptying.

McEvoy G.K. (ed.). American Hospital Formulary Service-Drug Information 96. Bethesda, MD: American Society of Health-System Pharmacists, Inc. 1996 (Plus Supplements)., p. 2147


Viral infection occurred in about 4% of patients receiving cisapride in controlled clinical trails and required discontinuance of the drug in 0.2% of patients. Fever was reported in about 2% of patients receiving cisapride in controlled clinical trials and required discontinuance in 0.1%.

McEvoy G.K. (ed.). American Hospital Formulary Service-Drug Information 96. Bethesda, MD: American Society of Health-System Pharmacists, Inc. 1996 (Plus Supplements)., p. 2147


For more Drug Warnings (Complete) data for CISAPRIDE (6 total), please visit the HSDB record page.


5 Pharmacology and Biochemistry
5.1 MeSH Pharmacological Classification

Serotonin Receptor Agonists

Endogenous compounds and drugs that bind to and activate SEROTONIN RECEPTORS. Many serotonin receptor agonists are used as ANTIDEPRESSANTS; ANXIOLYTICS; and in the treatment of MIGRAINE DISORDERS. (See all compounds classified as Serotonin Receptor Agonists.)


Anti-Ulcer Agents

Various agents with different action mechanisms used to treat or ameliorate PEPTIC ULCER or irritation of the gastrointestinal tract. This has included ANTIBIOTICS to treat HELICOBACTER INFECTIONS; HISTAMINE H2 ANTAGONISTS to reduce GASTRIC ACID secretion; and ANTACIDS for symptomatic relief. (See all compounds classified as Anti-Ulcer Agents.)


Gastrointestinal Agents

Drugs used for their effects on the gastrointestinal system, as to control gastric acidity, regulate gastrointestinal motility and water flow, and improve digestion. (See all compounds classified as Gastrointestinal Agents.)


5.2 ATC Code

A - Alimentary tract and metabolism

A03 - Drugs for functional gastrointestinal disorders

A03F - Propulsives

A03FA - Propulsives

A03FA02 - Cisapride


5.3 Absorption, Distribution and Excretion

The placental transfer of cisapride, a new prokinetic agent, was studied in a sheep model. The pharmacokinetics of cisapride were studied in the lamb, the pregnant ewe, and the fetus by obtaining blood samples from chronically implanted arterial catheters. Comparable pharmacokinetic parameters were found in the lamb and the adult sheep: half-life, 1.39-1.83 hr; total plasma clearance, 1998-2160 ml/kg/hr; AUC, 92.6-100.1 ng.hr/ml. Cisapride plasma concentrations after continuous infusion were predicted correctly based on the parameters obtained after IV bolus. There was a materno-fetal transfer of cisapride following a single IV bolus administered to the mother. Cisapride crossed the placenta within 5 min and equilibrated with maternal plasma within 20 to 30 min after dosing. The average fetal-to-maternal plasma concentration ratio was 0.71. The amniotic fluid also contained measurable amounts of cisapride. The protein binding of cisapride in maternal and fetal plasma is 89.0% and 88.4%, respectively; the free fraction is 4 times larger than in humans. Cisapride crosses the ovine placental barrier. The sheep placenta is less permeable than the human placenta, but the higher free fraction of cisapride facilitates placental transfer.

PMID:1673393 Veereman-Wauters G et al; Drug Metab Dispos 19 (1): 168-72 (1991)


5.4 Metabolism/Metabolites

IPA COPYRIGHT: ASHP The metabolism of cisapride in vitro using Liver fractions of dogs, rabbits, and rats and the metabolites identified by high performance LC and by MS are described. Main bi otransformat i on routes were oxi dat i ve N-dealkylat i on at the pi peri di ne ni trogen and aron at i c hydroxylat i on at the fluorophenyl or at the benzami de moi ety. ENG ~21 nq~_~n_~.


(+-)-Cisapride has known human metabolites that include 3-Fluoro-4-hydroxycisapride, 4-Fluoro-2-hydroxycisapride, and Norcisapride.

S73 | METXBIODB | Metabolite Reaction Database from BioTransformer | DOI:10.5281/zenodo.4056560


5.5 Mechanism of Action

Cisapride exerts its effect by increasing the release of acetylcholine from the postganglionic nerve endings of the myenteric plexus. This release of acetylcholine increases esophageal activity and increases esophageal sphincter tone, thereby improving esophageal clearance and decreasing reflux of gastric and duodenal emptying as a result of increased gastric and duodenal contractility and antroduodenal coordination. Duodenogastric reflux is also decreased. Cisapride improves transit in both small and large bowel.

USP Convention. USPDI - Drug Information for the Health Care Professional. 16th ed. Volume I. Rockville, MD: U.S. Pharmaceutical Convention, Inc. 1996 (Plus updates)., p. 849