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Roxithromycin, which is frequently used for upper and lower respiratory tract infection, is a semi-synthetic, acid-stable macrolide. On using macrolide with cisapride, it decreases metabolism of cisapride and cause cardiac arrhythmia(e.g. QT prolongation) by the inhibitory action of cytochrome P450. It is known that roxithromycin does not represent this action but we report two cases of our hospital suggested to medical staff the possibility of interaction between roxithromycin and cisapride after studying first, second, and third literature. Accoring to one study, roxithromycin was reported that it has low affinity with cytochrome P450, but the other study classified macrolides into three groups by the affinity with cytochrome P450, Roxithromycin and clarithromycin make a complex with cytochrome P450 in the glucocorticoid pretreated rats. Recently, clarithromycin is defined contraindication with cisapride and it is not also desirable to combine roxithromycin with cisapride.
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