PROPULSID® (Cisapride)

PROPULSID (cisapride) Limited Access Program Disallowed Medications and Foods List by Generic Name

NOTE: THIS IS A LIST OF DRUGS AND FOODS THAT HAVE THE POTENTIAL FOR INTERACTION WITH CISAPRIDE. Formal studies have not proven the interaction of all of these drugs and foods.

THIS LIST IS NOT COMPREHENSIVE AND IS SUBJECT TO REVISION AS ADDITIONAL INFORMATION BECOMES AVAILABLE.

GENERIC NAME BRAND NAME CATEGORY Medications alfuzosin UROXATRAL® A amantadine Symmetrel®, Symadine® A amiodarone CORDARONE®, PACERONE®, GENERICS A,B,D amitriptyline, alone or in Elavil®, Tryptomer®, Tryptizol®, Laroxyl®, A,D any combination product Saroten®, Sarotex® Lentizol®, Endep®, GENERICS amprenavir AGENERASE® A,B,D,E anagrelide AGRYLIN®, XAGRID® A apomorphine Apokyn®, Ixense®, Spontane®, Uprima® A aprepitant Emend® B aripiprazole Abilify®, Aripiprex® A aripiprazole lauroxil Aristada™ A arsenic trioxide TRISENOX® A asenapine Saphris®, Sycrest® A astemizole HISMANAL® A,E atazanavir REYATAZ® A,B atomoxetine Strattera® A azithromycin ZITHROMAX® A bedaquiline SIRTURO(TM) A benperidol ANQUIL®, GLIANIMON® A,E bepridil VASCOR® A,D betrixaban BEVYXXA® A boceprevir VICTRELIS(TM) B bortezomib VELCADE®, BORTECAD® A bosutinib BOSULIF® A bretylium BRETYLOL® A,D,E bumetanide, IV BUMEX® IV C bumetanide, oral single BUMEX® C agent ONLY (combination use of loop or thiazide diuretics with potassium replacement or with potassium- sparing drugs is ALLOWABLE, monitoring is recommended)

Category: A=Proven or possible QT/torsades de pointes risk; B=cytochrome P450 (CYP) 3A4 inhibitor; C=Possible risk due to hypokalemia or other electrolyte imbalance; D=Listed as contraindicated as specified in Propulsid labeling; E=Not available in United States

June 2018 1

PROPULSID (cisapride) Limited Access Program Disallowed Medications and Foods List by Generic Name

GENERIC NAME BRAND NAME CATEGORY buprenorphine Belbuca®, Butrans®, Bunavail®, Buprenex®, A Suboxone®, Zubsolv® cabozantinib COMETRIQ® A capecitabine Xeloda® A ceritinib ZykadiaTM A,B chloral hydrate Aquachloral®, Novo-Chlorhydrate®, Somnos®, A Noctec®, Somnote® chloroquine ARALEN® A chlorothiazide, IV DIURIL® IV C chlorothiazide, oral single DIURIL® C agent ONLY (combination use of loop or thiazide diuretics with potassium replacement or with potassium-sparing drugs is ALLOWABLE, monitoring is recommended) chlorpromazine ORMAZINE, THORAZINE® A,D cilostazol Pletal® A cimetidine Tagamet ® A cinacalcet Sensipar® A ciprofloxacin, any CIPRO® A formulation citalopram CELEXA® A clarithromycin BIAXIN® A,B,D clemastine TAVIST® A clofazimine LAMPRENE® A,E clomipramine ANAFRANIL® A,D clozapine Clozaril®, Fazaclo®, Versacloz® A conivaptan VAPRISOL® B crizotinib XALKORI® A,B cyamemazine Tercian® A,E dabrafenib TAFINLAR® A darunavir/cobicistat PrezcobixTM A,B dasatinib SPRYCEL® A,B delamanid Deltyba® A,E desipramine NORPRAMIN® A,D dexmedetomidine PRECEDEX, DEXDOR, DEXDOMITOR (IV sedative) A diltiazem, alone or in any CARDIZEM®, TECZEM® A,B combination disopyramide NORPACE®, NORPACE CR® A,D dofetilide TIKOSYN® A,D

June 2018 2

PROPULSID (cisapride) Limited Access Program Disallowed Medications and Foods List by Generic Name

GENERIC NAME BRAND NAME CATEGORY dolasetron ANZEMET® A domperidone MOTILIUM® A, E donepezil Aricept® A doxepin ADAPIN®, SILENOR®, SINEQUAN®, ZONALON® A,D TOPICAL dronedarone MULTAQ® A,B droperidol Inapsine®, Droleptan®, Dridol®, Xomolix® A eliglustat CERDELGA® A elotuzumab Empliciti™ C enasidenib IDHIFA® C encainide ENKAID® A,E epirubicin ELLENCE® A erythromycin E.E.S.®, Robimycin®, EMycin®, Erymax®, Ery-Tab®, A,B,D Eryc Ranbaxy®, Erypar®, Eryped®, Erythrocin Stearate Filmtab®, Erythrocot®, E-Base®, Erythroped®, Ilosone®, MY-E®, Pediamycin®, Zineryt®, Abboticin®, Abboticin-ES®, Erycin®, PCE Dispertab®, Stiemycine®, Acnasol®, Tiloryth®, Generics escitalopram Lexapro® A ethacrynic acid EDECRIN® IV C ezogabine POTIGA® A famotidine Pepcid OTC® A felbamate FELBATOL® A fingolimod GILENYA(TM) A flecainide TAMBOCOR® A fluconazole DIFLUCAN® A,B,D fluorouracil injection (5- ADRUCIL®, EFUDEX® A FU) fluoxetine Prozac®, Sarafem®, Fontex® A flupentixol Depixol®, Fluanxol® A,E fluphenazine APO-FLUPHENAZINE®, MODECATE A,D CONCENTRATE®, MODITEN®, PERMITIL®, PMS- FLUPHENAZINE®, PROLIXIN®, RHO- FLUPHENAZINE fluvoxamine LUVOX® B fosamprenavir LEXIVA B fosphenytoin CEREBYX® A furosemide, IV LASIX® IV C

June 2018 3

PROPULSID (cisapride) Limited Access Program Disallowed Medications and Foods List by Generic Name

GENERIC NAME BRAND NAME CATEGORY furosemide, oral single LASIX® C agent ONLY (combination use of loop or thiazide diuretics with potassium replacement or with potassium-sparing drugs is ALLOWABLE, monitoring is recommended) galantamine RAZADYNE® A gatifloxacin TEQUIN® A gemifloxacin FACTIVE® A granisetron GRANISOL®, KYTRIL®, SANCUSO® A grepafloxacin RAXAR® A,B,F halofantrine HALFAN® A haloperidol HALDOL® A Hawthorn, Crataegus FAROS 300®, Hawthorn®, Cardiplant®, A laevigata Crataegisan®, Crataegutt®, English hawthorn, Faros®, haw, Korodin®, LI 132, maybush, whitethorn, WS 1442 hydrochlorothiazide and UNIRETIC® C moexipril hydrochlorothiazide, oral, Apo-Hydro®, Aquazide H®, BP Zide®, Dichlotride®, C single ingredient Hydrodiuril®, HydroSaluric®, Hydrochlorot®, Microzide®, Esidrex®, Oretic®, generics hydrocodone extended- Hysingla™ ER, Zohydro ER® A release hydroxyzine Atarax®, Vistaril®, Aterax®, Alamon®, Durrax®, A,C Equipose®, Masmoran®, Orgatrax®, Paxistil® Quiess®, Tran-Q®, Tranquizine®, generics ibandronic acid, Boniva® A ibandronate ibutilide CORVERT® A idelalisib Zydelig® B iloperidone Fanapt®, Fanapta®, Zomaril® B imatinib GLEEVEC B imipramine JANIMINE®, TOFRANIL®, VARIOUS A,D indacaterol ARCAPTA(TM) INHALER A indapamide, IV LOZOL® IV (in an acute setting) C

June 2018 4

PROPULSID (cisapride) Limited Access Program Disallowed Medications and Foods List by Generic Name

GENERIC NAME BRAND NAME CATEGORY indapamide, oral single LOZOL®, others C agent ONLY (combination use of loop or thiazide diuretics with potassium replacement or with potassium-sparing drugs is ALLOWABLE, monitoring is recommended) indinavir CRIXIVAN® B,D inotuzumab ozogamicin BESPONSA® A,B IV isavuconazonium sulfate Cresemba ® B isradipine DYNACIRC® A itraconazole SPORANOX® A,B,D ivabradine Procoralan®, Coralan®, Corlentor®, Coraxan®, A,E Ivabid®, Bradia® ivacaftor KALYDECOTM B ketoconazole NIZORAL® A,B,D lapatinib TYKERB® A lenvatinib mesylate LenvimaTM A letermovir PREVYMISTM B levofloxacin LEVAQUIN® A levomepromazine / Nosinan®, Nozinan®, Levoprome® A,B,E methotrimeprazine levomethadyl ORLAAM® A lithium ESKALITH®, Lithobid® A loperamide (at very high Imodium®, Imodium A-D®, Imotil®, generics A doses) available lopinavir / ritonavir KALETRA® A,B macimorelin oral solution MACRILENTM A maprotiline LUDIOMIL® A,D memantine Namenda®, Namenda XR®, Namzaric® (as a A combination product containing Donepezil, Memantine) meropenem / VABOMERE® C vaborbactam intravenous mesoridazine SERENTIL® A,D methadone DOLOPHINE® A metoclopramide Reglan®, Afipran®, Maxolon®, Cerucal®, A Clopamon®, Clopra®, Maxeran®, Maxolon®, Metozolv®, Plasil®, Pramin®, Primperan®, Perinorm®, generics

June 2018 5

PROPULSID (cisapride) Limited Access Program Disallowed Medications and Foods List by Generic Name

GENERIC NAME BRAND NAME CATEGORY metolazone ZYTANIX®, ZAROXOLY®, MYKROX® C mexiletine MEXITIL® A mibefradil POSICOR® B,E micafungin Mycamine® B miconazole ORAVIG® B mifepristone Korlym®, Mifeprex® A mirabegron Myrbetriq® A mirtazapine Remeron® A moricizine ETHMOZINE® A,D,E moxifloxacin AVELOX® A naratriptan AMERGE® A necitumumab Portrazza™ C nefazodone SERZONE® B,D nelfinavir VIRACEPT® A,B nicardipine CARDENE® A nilotinib TASIGNA® A norfloxacin CHIBROXIN®, NOROXIN® A nortriptyline AVENTYL® HYDROCHLORIDE, PAMELOR® A,D octreotide SANDOSTATIN® A ofloxacin FLOXIN® A ombitasvir/paritaprevir/ Viekira PakTM A,B ritonavir/dasabuvir ondansetron ZOFRAN® A osimertinib Tagrisso™ A oxaliplatin Eloxatin® A oxytocin PITOCIN®, Syntocinon® A palbociclib Ibrance® B paliperidone INVEGA® A palonosetron ALOXI® A pamidronate Aredia ® A panobinostat lactate Farydak ® A,C papaverine HCl (when various, generic A given by IV infusion) paroxetine PAXIL® A pasireotide SIGNIFOR® A patiromer for oral Veltassa™ C suspension pazopanib VOTRIENT® A pentamidine IV PENTACARINAT®, PENTAM® A perflutren DEFINITY® A perphenazine TRILAFON® A,D pilsicainide Sunrythm (not ® in USA) A,E pimavanserin Nuplazid® A Category: A=Proven or possible QT/torsades de pointes risk; B=cytochrome P450 (CYP) 3A4 inhibitor; C=Possible risk due to hypokalemia or other electrolyte imbalance; D=Listed as contraindicated as specified in Propulsid labeling; E=Not available in United States

June 2018 6

PROPULSID (cisapride) Limited Access Program Disallowed Medications and Foods List by Generic Name

GENERIC NAME BRAND NAME CATEGORY pimozide ORAP® A piperacillin / tazobactam ZOSYN® C posaconazole NOXAFIL® A,B primaquine No Brand Name A probucol Lorelco® A,E procainamide PROCAN®, PROCANBID®, PRONESTYL®, VARIOUS A,D prochlorperazine COMPAZINE® A,D promazine SPARINE A,D promethazine PHENERGAN® A,D propafenone RYTHMOL SR ®, RYTMONORM ® A propofol (Diprivan®, Propoven®, and other brands) A quetiapine SEROQUEL® A quinidine CARDIOQUIN®, Quinaglute®, Duraquin®, A,D Quinact®, Quinidex®, Cin-Quin®, Quinora®, VARIOUS quinidine sulfate with NUEDEXTA® A,B,D dextromethorphan HBr quinine QUININE SULFATE A,B,E quinupristin and SYNERCID® B dalfopristin ranolazine RANEXA® A resveratrol Various (-forte, -max, -ultra) B rilpivirine EDURANT® A risperidone RISPERDAL® A ritonavir NORVIR® B,D romidepsin ISTODAX® A roxithromycin Rulide®, Xthrocin®, Roxl-150®, Roxo®, Surlid®, A,E Rulide®, Biaxsig®, Roxar®, Roximycin®, Roxomycin®, Rulid®, Tirabicin®, Coroxin® salmeterol SEREVENT® A saquinavir FORTOVASE®, INVIRASE® A,B,D,E sertindole Serdolect®, Serlect® A,D,E sertraline ZOLOFT® A sevoflurane Ulane®, Sojourn® A solifenacin VESICARE® A sorafenib NEXAVAR® A sotalol BETAPACE® A,D sparfloxacin ZAGAM® A,D sulpiride Dogmatil® and others A,E sumatriptan IMITREX® A sunitinib SUTENT® A tacrolimus Prograf® A tamoxifen Nolvadex®(discontinued), Istubal®, Valodex® A Category: A=Proven or possible QT/torsades de pointes risk; B=cytochrome P450 (CYP) 3A4 inhibitor; C=Possible risk due to hypokalemia or other electrolyte imbalance; D=Listed as contraindicated as specified in Propulsid labeling; E=Not available in United States

June 2018 7

PROPULSID (cisapride) Limited Access Program Disallowed Medications and Foods List by Generic Name

GENERIC NAME BRAND NAME CATEGORY telaprevir INCIVEK® B telavancin VIBATIV® A telithromycin KETEK® A,B terfenadine SELDANE® A,E tetrabenazine Nitoman®, Xenazine® A thiethylperazine maleate NORZINE®, TORECAN® A,D thioridazine MELLARIL®, MELLARIL-S® A tiapride Tiapridal®, Italprid®, Sereprile®, Tialaread®, A,E Tiaryl®, Tiaprim®, Tiaprizal®, Sereprid®, Tiapridex® tizanidine ZANAFLEX® A tolterodine Detrol®, Detrol LA® A toremifene FARESTON® A torsemide DEMADEX® IV A,C tramadol ULTRAM ® A trazodone DESYREL®, OLEPTRO® A trifluoperazine STELAZINE® A,D trimethoprim- BACTRIM® A sulfamethoxazole trimipramine SURMONTIL® A,D troleandomycin TAO® B,D vardenafil LEVITRA® A vemurafenib ZELBORAF® A venlafaxine EFFEXOR® A verapamil, alone or in CALAN®, TARKA® A,B any combination voriconazole VFEND® A,B zafirlukast ACCOLATE® B ziprasidone GEODON® A zoledronic acid, Reclast®, Zometa® A zolendronate zolmitriptan ZOMIG® A

June 2018 8

PROPULSID (cisapride) Limited Access Program Disallowed Medications and Foods List by Generic Name

GENERIC NAME BRAND NAME CATEGORY Foods Bitter orange Bitter Orange, Bitter Orange Extract, Bitter B Orange Herb, Bitter Orange Standardized

Common names: bitter orange, bitter orange flower, bitter orange peel, green orange, kijitsu, neroli oil, Seville orange, shangzhou zhiqiao, sour orange, bigarade, neroli flowers, laranja-amarga, laranja-azeda, laranja-cavalo, zhi shi, zhi qiao

Scientific: Citrus aurantium, Citrus aurantium amara, Citrus bergamia, Citrus bigaradia, Citrus vulgaris, or Aurantii pericarpium Grapefruit juice Various fruits, juices, extracts, supplements. B,D Scientific: Citrus paradisi Pomelo Common names: pomelo, pommelo, pummelo, B shaddock, or lusho fruit

Scientific: Citrus decumana, Citrus grandis, Citrus maxima Red wine Various A Shikonin botanical food additive, colorant, herbal B medicine

Chemical names: 54952-43-1; Anchusin; SHIKALKIN; Alkanet extract; Anchusa acid; Alkanna Red

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