Cyproheptadine

Aka: Cyproheptadine, Periactin

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II. Indications

  1. Allergic Rhinitis
  2. Urticaria
  3. Serotonin Syndrome (not FDA approved)
  4. Appetite Stimulant (not FDA approved)

III. 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

IV. 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

V. Dosing: Allergic Rhinitis or Urticaria

  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

VI. Dosing: Serotonin Syndrome

  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

VII. Adverse Effects

  1. See Antihistamine
  2. See Anticholinergic Toxicity
  3. Sedation

VIII. Safety

  1. Pregnancy category B
  2. Avoid in Lactation

IX. Resources

  1. Cyproheptadine (DailyMed)
    1. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=d3ce21de-849a-47ab-8405-968d8de6f1e9

X. References

  1. Olson (2020) Clinical Pharmacology, Medmaster Miami, p. 146-7
  2. Hamilton (2020) Tarascon Pocket Pharmacopoeia

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Related Studies

Cost: Medications

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
FPNotebook does not benefit financially from showing this medication data or their pharmacy links. This information is provided only to help medical providers and their patients see relative costs. Insurance plans negotiate lower medication prices with suppliers. Prices shown here are out of pocket, non-negotiated rates. See Needy Meds for financial assistance information. GoodRx is another tool for finding lower drug prices.

Ontology: Cyproheptadine (C0010620)

Definition (NCI_NCI-GLOSS) A drug that is used to treat asthma, allergies, and colds, and to relieve itching caused by certain skin disorders. It has also been used to stimulate appetite and weight gain, and is being studied in the treatment of weight loss caused by cancer and its treatment. Cyproheptadine belongs to the family of drugs called antihistamines.
Definition (MSH) A serotonin antagonist and a histamine H1 blocker used as antipruritic, appetite stimulant, antiallergic, and for the post-gastrectomy dumping syndrome, etc.
Definition (CSP) serotonin antagonist and histamine H1 blocker used as an antipruritic, appetite stimulant, antiallergic, and to treat the post-gastrectomy dumping syndrome.
Definition (PDQ) The hydrochloride salt of a synthetic methyl-piperidine derivative with antihistaminic and anti-serotoninergic properties. Cyproheptadine competes with free histamine (HA) for binding at HA-receptor sites, thereby competitively antagonizing histamine stimulation of HA-receptors in the gastrointestinal tract, large blood vessels, and bronchial smooth muscle. This agent also competes with free serotonin for binding at serotonin receptor sites. Cyproheptadine exhibits anticholinergic and sedative properties and has been shown to stimulate appetite and weight gain. Check for "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=315774&idtype=1" active clinical trials or "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=315774&idtype=1&closed=1" closed clinical trials using this agent. ("http://nciterms.nci.nih.gov:80/NCIBrowser/ConceptReport.jsp?dictionary=NCI_Thesaurus&code=C28949" NCI Thesaurus)
Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH D003533
SnomedCT 26462003, 372683000
LNC LP18932-1, MTHU006211
English Cyproheptadine, cyproheptadine, Piperidine, 4-(5H-dibenzo(a,d)cyclohepten-5-ylidene)-1-methyl-, Cyproheptadine [Chemical/Ingredient], MK 141, 4-(5H-Dibenzo(a,d)cyclohepten-5-ylidene)-1-methylpiperidine, 5-(1-Methylpiperidylidene-4)-5H-dibenzo(a,d)cyclopheptene, CYPROHEPTADINE, cyproheptadine (medication), antihistamines cyproheptadine, Cyproheptadine (product), Cyproheptadine (substance)
Swedish Cyproheptadin
Czech cyproheptadin
Finnish Syproheptadiini
Russian TSIKLOGEPTADIN, PERITOL, ПЕРИТОЛ, ЦИКЛОГЕПТАДИН
Portuguese Ciproeptadina, Ciproheptadina, Cipro-Heptadina
Polish Cyproheptadyna
Japanese シプロヘプタジン, 塩酸シプロヘプタジン
Spanish ciproheptadina (producto), ciproheptadina (sustancia), ciproheptadina, Ciproheptadina
French Cyproheptadine
German Cyproheptadin
Italian Ciproeptadina
Derived from the NIH UMLS (Unified Medical Language System)

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