II. Indications
- Allergic Rhinitis
- Urticaria
- Serotonin Syndrome (not FDA approved)
- Appetite Stimulant (not FDA approved)
III. Mechanism
- See Antihistamine
- H1 Receptor Antagonist (First Generation Antihistamine)
- Cyproheptadine is an synthetic methyl-piperidine derivative with moderate Anticholinergic activity
- Cyproheptadine also has antiserotinergic activity
IV. Precautions
- Although FDA approved for children, FDA does not recommend routine Antihistamine use age <4 years
- Deaths have occurred in younger children related to Anticholinergic Toxicity
V. Dosing: Allergic Rhinitis or Urticaria
- Adult (age >14 years): Start 4 mg orally three times daily (maximum 32 mg/day)
- Child (age 7 to 14 years): Start 4 mg orally three times daily (maximum 16 mg/day)
- Child (age 2 to 6 years): Start 2 mg orally three times daily
VI. Dosing: Serotonin Syndrome
- See Serotonin Syndrome
- Start 12 mg orally for first dose
- Next: 2 mg orally every 2 hours until symptoms resolve
- Next 8 mg every 6 hours until syndrome completes
VII. Adverse Effects
- See Antihistamine
- See Anticholinergic Toxicity
- Sedation
VIII. Safety
- Pregnancy category B
- Avoid in Lactation
IX. Resources
- Cyproheptadine (DailyMed)
X. References
- Olson (2020) Clinical Pharmacology, Medmaster Miami, p. 146-7
- Hamilton (2020) Tarascon Pocket Pharmacopoeia
Images: Related links to external sites (from Bing)
Related Studies
| cyproheptadine (on 12/21/2022 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
| CYPROHEPTADINE 2 MG/5 ML SOLN | Generic | $0.05 per ml |
| CYPROHEPTADINE 2 MG/5 ML SYRUP | Generic | $0.05 per ml |
| CYPROHEPTADINE 4 MG TABLET | Generic | $0.10 each |