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Cyproheptadine

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Cyproheptadine, Periactin

  • See Also
  1. Antihistamine
  2. Anticholinergic Toxicity
  3. Serotonin Syndrome
  • Indications
  1. Allergic Rhinitis
  2. Urticaria
  3. Serotonin Syndrome (not FDA approved)
  4. Appetite Stimulant (not FDA approved)
  • Mechanism
  1. See Antihistamine
  2. H1 Receptor Antagonist (First Generation Antihistamine)
  3. Cyproheptadine is an synthetic methyl-piperidine derivative with moderate Anticholinergic activity
  4. Cyproheptadine also has antiserotinergic activity
  • Precautions
  1. Although FDA approved for children, FDA does not recommend routine Antihistamine use age <4 years
    1. Deaths have occurred in younger children related to Anticholinergic Toxicity
  1. Adult (age >14 years): Start 4 mg orally three times daily (maximum 32 mg/day)
  2. Child (age 7 to 14 years): Start 4 mg orally three times daily (maximum 16 mg/day)
  3. Child (age 2 to 6 years): Start 2 mg orally three times daily
  1. See Serotonin Syndrome
  2. Start 12 mg orally for first dose
  3. Next: 2 mg orally every 2 hours until symptoms resolve
  4. Next 8 mg every 6 hours until syndrome completes
  • Adverse Effects
  1. See Antihistamine
  2. See Anticholinergic Toxicity
  3. Sedation
  • Safety
  1. Pregnancy category B
  2. Avoid in Lactation
  • Resources
  1. Cyproheptadine (DailyMed)
    1. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=d3ce21de-849a-47ab-8405-968d8de6f1e9
  • References
  1. Olson (2020) Clinical Pharmacology, Medmaster Miami, p. 146-7
  2. Hamilton (2020) Tarascon Pocket Pharmacopoeia