Jump to content

Cyproheptadine: Difference between revisions

From Pharmacopedia
[checked revision][checked revision]
← Older edit

MDElliottMD (talk | contribs)

3 user groups
5,188 edits
VisualWikitext
Comprehensive categorization: +First-generation antihistamines
parser-claude: Cyproheptadine MedTemplate refill, Top 300 stub upgrade
 
Line 1: Line 1:
{{MedTemplate
{{MedTemplate
| generic           = Cyproheptadine
| generic           = Cyproheptadine (hydrochloride)
| brand             = Periactin
| brand             = Periactin (US brand discontinued; generic widely available)
| structure         =  
| structure         =
| classes           = Antihistamine
| classes           = [[:Category:Antihistamines|First-generation antihistamine]], [[:Category:Serotonin antagonists|Serotonin 5-HT2 antagonist]], [[:Category:Orexigenics|Appetite-promoting medicine (orexigenic)]]
| mechanism          = H1 and 5-HT2 receptor antagonist
| uses             = <vote slug="allergic-conditions-use">Allergic conditions including urticaria and seasonal allergies (FDA)</vote>, <vote slug="serotonin-syndrome-antidote-use">Serotonin syndrome (off-label; the standard pharmacological antidote alongside supportive care and benzodiazepines)</vote>, <vote slug="appetite-stimulation-cachexia-use">Appetite stimulation in failure to thrive, cachexia, and anorexia (off-label, evidence-supported in pediatric and adult populations)</vote>, <vote slug="migraine-prophylaxis-pediatric-use">Pediatric migraine prophylaxis (off-label)</vote>, <vote slug="ssri-sexual-dysfunction-adjunct-use">SSRI-induced sexual dysfunction (off-label adjunct, modest evidence)</vote>
| uses               =  
| starting_dose     = Allergy: 4 mg PO TID. Serotonin syndrome: 12 mg loading dose PO or by nasogastric tube, then 2 mg every 2 hours until clinical improvement. Appetite stimulation: 2-4 mg PO TID-QID
| starting_dose     =  
| preparations     = Tablets 4 mg; oral syrup 2 mg/5 mL
| preparations       =  
| fda_max           = 32 mg/day adult; weight-based pediatric ceiling
| fda_max          =  
| pill_id           =
| routes             =  
| routes           = Oral
| onset             =  
| onset             = 30-60 minutes
| duration           =  
| duration         = 6-8 hours
| halflife           =
| halflife          = 8-16 hours<ref name="periactin-label">FDA Prescribing Information, Periactin (cyproheptadine hydrochloride), Merck/various, current revision. https://www.accessdata.fda.gov/drugsatfda_docs/label/2009/010407s058lbl.pdf</ref>
| bioavailability    =
| bioavailability   = ~95% (oral)<ref name="periactin-label" />
| pregnancy         =  
| pregnancy        = Limited human data; older agent with substantial use experience.{{citation needed}}
| legal              =  
| legal             = [[USLegal:Prescription only|Rx-only]] in US
| intro              =
| mechanism        = <vote slug="cyproheptadine-mech-claim">First-generation H1 histamine receptor antagonist with substantial additional '''5-HT2A and 5-HT2C serotonin receptor antagonism'''. The 5-HT2A antagonism is the basis of its role as the first-line pharmacological antidote for serotonin syndrome; the 5-HT2C antagonism underlies the appetite stimulation effect (the same receptor mechanism that drives weight gain with mirtazapine and olanzapine).</vote> Anticholinergic and sedating, with the standard first-generation antihistamine Beers-list concerns in elderly patients<ref name="periactin-label" />.
| pharmacokinetics   =  
| pharmacodynamics  =  
| indications        =  
| dosing             =  
| effects            =  
| interactions      = <pharmaInteractions/>
| pregnancy_details  =
| monitoring        =
| counseling        =
| anecdotes          =
| seealso            =
| references        =  
}}
}}
== References ==
<references />


[[Category:Antihistamines]]
[[Category:Antihistamines]]
[[Category:First-generation antihistamines]]
[[Category:Serotonin antagonists]]
[[Category:Orexigenics]]

Latest revision as of 07:28, 23 May 2026

First-generation antihistamine, Serotonin 5-HT2 antagonist, Appetite-promoting medicine (orexigenic)
Cyproheptadine (hydrochloride)
Periactin (US brand discontinued; generic widely available)

Experience

👥 No personal reports yet
⚕ No clinical reports yet

Log in to add your own experience.

Problems

No problems yet. Be the first to suggest one.

+ Add a problem

Titration strategies

No titration strategies yet. Be the first to suggest one.

+ Add a titration strategy

Effects

No effects listed yet. Be the first to suggest one.

+ Add an effect

Relevant anecdote

No anecdotes yet. Share a relevant one.

+ Add an anecdote

Relevant Literature

No literature entries yet.

Log in to submit relevant literature.

Summary
Classes
First-generation antihistamine, Serotonin 5-HT2 antagonist, Appetite-promoting medicine (orexigenic)
Common uses
Allergic conditions including urticaria and seasonal allergies (FDA)0, Serotonin syndrome (off-label; the standard pharmacological antidote alongside supportive care and benzodiazepines)0, Appetite stimulation in failure to thrive, cachexia, and anorexia (off-label, evidence-supported in pediatric and adult populations)0, Pediatric migraine prophylaxis (off-label)0, SSRI-induced sexual dysfunction (off-label adjunct, modest evidence)0
Pharmacy
Starting dose
Allergy: 4 mg PO TID. Serotonin syndrome: 12 mg loading dose PO or by nasogastric tube, then 2 mg every 2 hours until clinical improvement. Appetite stimulation: 2-4 mg PO TID-QID
Preparations
Tablets 4 mg; oral syrup 2 mg/5 mL
US FDA Max
32 mg/day adult; weight-based pediatric ceiling
Pharmacology
Routes
Oral
Onset
30-60 minutes
Duration
6-8 hours
Half-life
8-16 hours[1]
Bioavailability
~95% (oral)[1]
Pregnancy
Limited human data; older agent with substantial use experience.[citation needed]
Legal status
Rx-only in US
Purported mechanism
First-generation H1 histamine receptor antagonist with substantial additional 5-HT2A and 5-HT2C serotonin receptor antagonism. The 5-HT2A antagonism is the basis of its role as the first-line pharmacological antidote for serotonin syndrome; the 5-HT2C antagonism underlies the appetite stimulation effect (the same receptor mechanism that drives weight gain with mirtazapine and olanzapine).0 Anticholinergic and sedating, with the standard first-generation antihistamine Beers-list concerns in elderly patients[1].

References

  1. ↑ 1.0 1.1 1.2 FDA Prescribing Information, Periactin (cyproheptadine hydrochloride), Merck/various, current revision. https://www.accessdata.fda.gov/drugsatfda_docs/label/2009/010407s058lbl.pdf
Retrieved from "https://pharmacopedia.wiki/index.php?title=Cyproheptadine&oldid=6725"