Product Description
Drug Class: Prokinetic Agent / Serotonin Agonist + Dopamine Antagonist | Form: Oral Tablet | Prescription Status: Prescription Only (Rx) — DRAP Registered
What is Cidine 1mg Tablet? Cidine 1mg contains Cinitapride Hydrogen Tartrate — a prokinetic agent with a unique dual mechanism that simultaneously stimulates serotonin receptors and blocks dopamine receptors in the gastrointestinal tract to enhance stomach and upper gut motility. Unlike Metoclopramide which relies solely on dopamine blockade, Cinitapride's additional serotonin agonist activity produces a more physiologically coordinated enhancement of gastric emptying and oesophageal sphincter tone. It is specifically designed to be taken 15 minutes before each main meal — ensuring peak prokinetic activity coincides precisely with food entering the stomach for maximum therapeutic benefit. Cidine 1mg is prescribed for functional digestive disorders where slow gastric emptying and poor oesophageal sphincter function cause persistent symptoms affecting quality of life.
What is Cidine 1mg Used For?
- Gastroesophageal reflux disease — GERD with slow gastric emptying component (سینے کی جلن اور تیزابیت)
- Non-ulcer dyspepsia — functional bloating, early fullness, and upper abdominal discomfort (بدہضمی اور پیٹ پھولنا)
- Gastroparesis — significantly delayed stomach emptying causing nausea and fullness (معدے کا کھانا دیر سے خالی کرنا)
- Gastritis-related motility symptoms — nausea and heaviness from stomach inflammation (معدے کی سوزش میں متلی)
- Oesophageal motility disorders — impaired oesophageal peristalsis causing swallowing discomfort
- Post-meal heaviness and slow digestion — persistent discomfort after eating (کھانے کے بعد بھاری پن)
How Does it Work? Cinitapride works through two complementary mechanisms simultaneously. It acts as a serotonin 5-HT4 receptor agonist — stimulating serotonin-mediated enhancement of coordinated gastric and intestinal muscle contractions that accelerate stomach emptying and improve upper gut motility. Simultaneously it blocks dopamine D2 receptors in the gut — removing dopamine's inhibitory effect on gastric smooth muscle contractions. Together these two actions produce more comprehensive and physiologically coordinated prokinetic effect than dopamine blockade alone. Additionally Cinitapride increases lower oesophageal sphincter tone — reducing the reflux of acid from the stomach into the oesophagus, directly addressing the motility component of GERD.
Dosage and Administration
⚠️ Take exactly 15 minutes before each main meal for maximum effectiveness — timing with food is clinically important. Never exceed prescribed dose. Long-term use requires regular medical review due to potential prolactin-related hormonal effects.
| Indication | Usual Adult Dose | Frequency | Timing |
|---|---|---|---|
| GERD / Functional dyspepsia | 1mg | Three times daily | 15 minutes before each main meal |
| Gastroparesis | 1mg | Three times daily | 15 minutes before each main meal |
| Gastritis-related motility disorder | 1mg | Three times daily | 15 minutes before meals as prescribed |
Active Ingredients
| Ingredient | Strength |
|---|---|
| Cinitapride Hydrogen Tartrate | 1mg |
Who Should NOT Take Cidine 1mg?
- Allergy to Cinitapride or any component of the tablet
- Gastrointestinal obstruction, perforation, or bleeding — prokinetics strictly contraindicated
- Phaeochromocytoma — adrenal gland tumour
- Prolactin-dependent tumours — breast cancer or pituitary tumours
- Epilepsy or history of seizures — dopamine blockade lowers seizure threshold
- Parkinson's disease — dopamine antagonism directly worsens symptoms
- Pregnancy and breastfeeding — consult doctor before use
- Children under 18 years — safety not established
- Severe liver or kidney impairment
Side Effects
Common: Mild drowsiness, mild headache, mild diarrhoea or loose stools, mild stomach cramping — generally well tolerated with the serotonin agonist mechanism providing better tolerability than pure dopamine antagonists.
Serious — Stop and seek medical attention immediately: Tardive dyskinesia — involuntary repetitive facial or body movements with prolonged use (غیر ارادی حرکات — فوری ڈاکٹر کو دکھائیں), elevated prolactin levels causing breast tenderness, milk production in non-breastfeeding women or men, or irregular menstrual periods (ماہواری کی بے قاعدگی — ڈاکٹر کو بتائیں), acute dystonia — sudden painful involuntary muscle contractions particularly in neck and face (فوری مدد لیں), severe allergic reaction with swelling of face or throat and difficulty breathing (فوری ہسپتال جائیں), worsening of Parkinson's symptoms if used in parkinsonian patients — avoid entirely.
Drug Interactions
| Medicine | Interaction |
|---|---|
| Anticholinergic medicines (Hyoscine, Procyclidine) | Directly oppose Cinitapride's prokinetic action — significantly reduced effectiveness |
| Other dopamine antagonists (Metoclopramide, Levosulpiride) | Additive dopamine blockade — increased movement disorder and hormonal side effect risk |
| Levodopa / Dopamine agonists | Cinitapride directly opposes their therapeutic effect — avoid combination in Parkinson's patients |
| Serotonergic medicines (SSRIs, Tramadol) | Additive serotonin activity — increased serotonin syndrome risk with combination |
| CNS depressants / sedatives | Additive drowsiness and sedation — use with caution |
| Digoxin | Accelerated gastric emptying may alter Digoxin absorption rate — monitor levels |
| Anticoagulants (Warfarin) | Changes in gastric emptying rate may affect Warfarin absorption — INR monitoring recommended |
| Alcohol (شراب) | May worsen nausea and gastrointestinal discomfort — avoid during treatment |
Storage: Store below 25°C in a cool, dry place. Protect from moisture and direct sunlight. Keep out of reach of children (بچوں کی پہنچ سے دور رکھیں). Do not use after expiry date.
FAQs
Q: Why must Cidine 1mg be taken exactly 15 minutes before meals rather than with food? Cinitapride needs to be absorbed and reach peak concentration in gut tissue before food arrives in the stomach — taking it 15 minutes before eating ensures maximum prokinetic activity precisely when gastric emptying and oesophageal sphincter tone are most critically needed, providing significantly better symptom control than taking with or after food.
Q: How is Cinitapride in Cidine different from Metoclopramide for digestive problems? Cinitapride combines serotonin 5-HT4 agonism with dopamine D2 blockade — producing more physiologically coordinated gastric motility enhancement than Metoclopramide's pure dopamine blockade alone. This dual mechanism generally provides better symptom control with potentially improved tolerability for functional digestive disorders.
Q: Can Cidine 1mg be taken long-term for chronic GERD or dyspepsia? Long-term use requires regular medical reassessment — prolonged dopamine blockade carries risk of elevated prolactin levels and rare movement disorders. Your doctor should periodically evaluate whether continued prokinetic therapy remains necessary and whether the benefits continue to outweigh any emerging risks.
Medical Disclaimer: This information is for general awareness only and does not replace medical advice. Always consult a qualified doctor or pharmacist before taking any prescription medicine.
Reviewed By
Dr. Rasheed Ahmad, Pharm-D (Baqai Medical University, Karachi) — Pharmaceutical Consultant and Medical Content Specialist. This description has been reviewed for clinical accuracy, regulatory compliance, and patient safety before publication.