| CYPROHEPTADINE HYDROCHLORIDE
Classifications: antihistamine (h1-receptor antagonist); antipruritic; Therapeutic: antihistamine; h1-receptor antagonist
Pregnancy Category: B
4 mg tablets
Potent piperidine antihistamine with pharmacologic actions that acts by competing with histamine for H1-receptor sites on effector cells, thus preventing histamine-mediated responses.
Has significant antipruritic, local anesthetic, and antiserotonin activity. Produces mild central depression and moderate
Symptomatic relief of various allergic conditions, including hay fever, vasomotor rhinitis, allergic conjunctivitis, urticaria
caused by cold sensitivity, and pruritus of allergic dermatoses. Effective in treatment of anaphylactoid reactions as adjunct
to epinephrine and other standard measures after acute symptoms have been controlled.
Cushing's disease, carcinoid syndrome, vascular headaches, appetite stimulant.
Hypersensitivity to cyproheptadine or other H1-receptor antagonist antihistamines; acute asthma attack; lactation. Safe use in children <2 y not established.
Older adult and debilitated patients; patients predisposed to urinary retention; glaucoma; asthma; COPD; hyperthyroidism;
cardiovascular or hepatic disease, hypertension; GI or GU tract obstruction, children with a family history of SIDS; pregnancy
Route & Dosage
Adult: PO 4 mg t.i.d. or q.i.d. (420 mg/d), max 0.5 mg/kg/d
Geriatric: PO Start with 4 mg b.i.d.
Child: PO 0.25 mg/kg/d in 34 divided doses (max: 12 mg/d for 26 y, 16 mg/d for 612 y)
- GI adverse effects may be minimized by administering drug with food or milk.
- Store in tightly covered container at 15°30° C (59°86° F) unless otherwise directed.
Adverse Effects (≥1%) GI: Dry mouth,
nausea, vomiting, epigastric distress, appetite stimulation, weight gain, transient decrease in fasting blood sugar level,
increased serum amylase level, cholestatic jaundice
. CNS: Drowsiness,
dizziness, faintness, headache, tremulousness, fatigue
, disturbed coordination. Respiratory:
Thickened bronchial secretions. Skin:
Skin rash. Special Senses:
Dry nose and throat. Urogenital:
Urinary frequency, retention, and difficult urination.
Diagnostic Test Interference
As a general rule, antihistamines are discontinued about 4 d before skin testing procedures are to be performed because they may produce false-negative results.
and cns depressants
add to CNS depression; tricyclic antidepressants
and other anticholinergics
have additive anticholinergic effects; may inhibit pressor effects of epinephrine.
Readily absorbed from GI tract. Duration:
69 h. Distribution:
Distribution into breast milk not known. Metabolism:
In liver. Elimination:
Assessment & Drug Effects
- Monitor level of alertness. In some patients, the sedative effect disappears spontaneously after 34 d of drug administration.
- Since drug may cause dizziness, supervision of ambulation and other safety precautions may be warranted.
Patient & Family Education
- Avoid activities requiring mental alertness and physical coordination, such as driving a car, until reaction to the drug
- Drug causes sedation, dizziness, and hypotension in older adults. Report these symptoms. Children are more apt to manifest
CNS stimulation (e.g., confusion, agitation, tremors, hallucinations). Reduction in dosage may be indicated.
- Cyproheptadine may increase and prolong the effects of alcohol, barbiturates, narcotic analgesics, anxiolytics, and other
- Monitor weight and keep physician informed of any significant weight gain.
- Maintain sufficient fluid intake to help to relieve dry mouth and also reduce risk of cholestatic jaundice.