• Relief of allergic symptoms caused by histamine release including:
  • Seasonal and perennial allergic rhinitis,
  • Chronic urticaria,
  • Cold urticaria.

Unlabeled Uses:

• Stimulation of appetite.

Contraindicated in:

• Hypersensitivity
• Acute attacks of asthma
• Known alcohol intolerance (syrup only).
• Lactation: Lactation

Use Cautiously in:

• Angle-closure glaucoma
• Hepatic impairment
• OB: Safety not established in pregnancy;.
• Geri: Appears on Beers list. ↑ risk of anticholinergic adverse reactions in older adults, including falls, delirium, and dementia. Avoid use in older adults.

CV: arrhythmias, hypotension, palpitations.

Derm: photosensitivity, rash.

EENT: blurred vision.

GI: dry mouth, constipation.

GU: urinary hesitancy, urinary retention.

Metab: weight gain.

Neuro: drowsiness, excitation (increased in children).

Drug-Drug:

• Additive CNS depression with other CNS depressants, including alcohol, opioid analgesics, and sedative/hypnotics.
• MAO inhibitors may intensify and prolong the anticholinergic effects of antihistamines.

(Generic available)

• Tablets: 4 mg;
• Syrup: 2 mg/5 mL;

• PO (Adults): 4 mg every 8 hr (range 4–20 mg/day in 3 divided doses; up to 0.5 mg/kg/day).
• PO (Children 6–14 yr): 2–4 mg every 8–12 hr (not to exceed 16 mg/day).
• PO (Children 2–6 yr): 2 mg every 8–12 hr (not to exceed 12 mg/day).

Periactin

• Antagonizes the effects of histamine at H₁-receptor sites; does not bind to or inactivate histamine.
• Also blocks the effects of serotonin, which may result in increased appetite.

• Decreased symptoms of histamine excess (sneezing, rhinorrhea, nasal and ocular pruritus, ocular tearing and redness).
• Decreased cold urticaria.

Therapeutic Classification: allergy, cold and cough remedies, antihistamines

Absorption: Well absorbed following oral administration.

Distribution: Unknown.

Metabolism/Excretion: Mostly metabolized by the liver.

Half-life: Unknown.

(antihistaminic effects)

• Instruct patient to take cyproheptadine exactly as directed. Take missed dose as soon as remembered. Do not double doses. Syrup should be accurately measured using calibrated medication cup or measuring device.
• Medication may cause drowsiness. Advise patient to avoid driving or other activities requiring alertness until response to the drug is known.
• Advise patient to use sunscreen and protective clothing to prevent a photosensitivity reaction.
• Caution patient to avoid concurrent use of alcohol and other CNS depressants, including opioids.
• Advise patient that frequent mouth rinses, good oral hygiene, and sugarless gum or candy may decrease dry mouth. Patient should notify dentist if dry mouth persists for >2 wk.
• Advise females of reproductive potential to notify health care professional if pregnancy is planned or suspected and to avoid breastfeeding. Monitor infants exposed to cyproheptadine through breast milk for irritability or drowsiness.
• Geri: Teach patient and family about anticholinergic effects and to contact a health care provider if such effects persist.

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