Cyproheptadine

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Contents

[edit] BRAND NAMES

[edit] STRUCTURE

Cyproheptadine.jpg

[edit] MECHANISM OF ACTION

Cyproheptadine is a serotonin and histamine antagonist with anticholinergic and sedative effects.

[edit] INDICATIONS

  • Treatment of acute and chronic allergies and pruritus, such as: dermatitis, including neurodermatitis and neurodermatitis circumscripta, eczema, eczematoid dermatitis, dermatographism, mild local allergic reactions to insect bites, hay fever and other seasonal rhinitis, perennial allergic and vasomotor rhinitis, allergic conjunctivitis due to inhalant allergens and foods, urticaria, angioneurotic oedema, drug and serum reactions, anogenital pruritus and pruritus of chickenpox.
  • Therapy for anaphylactic reactions, adjunctive to adrenalin and other standard measures after the acute manifestations have been controlled.
  • Cyproheptadine has been reported to have beneficial effects in a significant number of patients diagnosed as having vascular types of headache, such as migraine and histamine cephalalgia. Many patients who have not been able to obtain adequate relief from any other agent have reported amelioration of symptoms with Cyproheptadine. The characteristic headache and feeling of malaise may disappear within an hour or two after the first dose.

[edit] DOSAGE

ALLERGIES AND PRURITUS

Adults

The therapeutic range is from 4 mg to 20 mg a day, the majority of patients requiring 12 mg to 16 mg a day. An occasional patient may require as much as 32 mg a day for adequate relief. It is suggested that dosage be initiated with 4 mg three times a day and adjusted according to the size and response of the patient. The dosage is not to exceed 32 mg a day.

Children (7 - 14 years)

The usual dosage is 4 mg three times a day. This dosage may be adjusted as necessary according to the size and response of the patient. If an additional dose is required, it should be taken preferably at bedtime. The dosage is not to exceed 16 mg a day.

Children (2 - 6 years)

It is suggested that dosage be initiated with 2 mg two or three times a day and adjusted as necessary according to the size and response of the patient. If an additional dose is required, it should be taken at bedtime. The total dosage is not to exceed 12 mg a day


MIGRAINE AND VASCULAR TYPES OF HEADACHE

For prophylaxis or treatment the recommended dosage is 4 mg initially, repeated in 1/2 hour if necessary; not to exceed 8 mg in a 4 to 6 hour period. Relief is usually obtained in responsive patients with 2 doses (total 8 mg) and maintained with 4 mg every 4 to 6 hours.


[edit] CONTRAINDICATIONS

  • Acute asthmatic attack.
  • Newborn or premature infants. Use in infants has been associated with apnea, cyanosis, and respiratory difficulty.
  • Nursing Mothers : Because of the higher risk of antihistamines for infants generally, and for newborn and prematures in particular, antihistamine therapy is contraindicated in nursing mothers
  • Hypersensitivity to cyproheptadine and other drugs of similar chemical structure
  • Monoamine oxidase inhibitor therapy
  • Angle-closure glaucoma
  • Stenosing peptic ulcer
  • Symptomatic prostatic hypertrophy
  • Bladder neck obstruction
  • Pyloroduodenal obstruction
  • Elderly, debilitated patients

[edit] WARNINGS AND PRECAUTIONS

Cyproheptadine may cause drowsiness and may increase the effects of alcohol. Drowsiness may continue the following day. Those affected should not drive or operate machinery; alcohol should be avoided.

Antihistamines are more likely to cause dizziness, sedation, and hypotension in elderly patients.

[edit] INTERACTIONS

  • Antihistamines may have additive effects with alcohol and other CNS depressants, eg: hypnotics, sedatives, tranquillisers, anti anxiety agents.
  • MAO inhibitors prolong and intensify the anticholinergic effects of antihistamines.

[edit] PREGNANCY AND LACTATION

  • There are no data on the excretion of cyproheptadine into human milk. Due to the potential for serious adverse reactions in nursing infants, a decision should be made to discontinue nursing or discontinue the drug, taking into account the importance of the drug to the mother.

[edit] SIDE EFFECTS

The side effects that appear frequently are drowsiness and somnolence. Many patients who complain initially of drowsiness may no longer do so after the first three or four days of continuous administration.

[edit] RELATED LINKS

[edit] BIBLIOGRAPHY

[edit] REFERENCES