Home Drug Guide Cyproheptadine Hydrochloride

Drug Guide

Generic Name

Cyproheptadine Hydrochloride

Brand Names Periactin

Classification

Therapeutic: Antihistamine, Antiserotonin agent

Pharmacological: Serotonin antagonist, Antihistamine (H1) blocker

FDA Approved Indications

Allergic rhinitis
Urticaria (hives)
Pruritus (itching)

Mechanism of Action

Cyproheptadine blocks H1 histamine receptors and inhibits serotonin receptors, reducing allergy symptoms and appetite stimulation.

Dosage and Administration

Adult: 4 mg every 4-6 hours, not exceeding 24 mg/day

Pediatric: Typically 0.25-0.5 mg/kg/day divided in doses, not exceeding adult dose

Geriatric: Start at lower doses due to potential for increased sensitivity

Renal Impairment: Adjust dosage based on severity of impairment; consult specific guidelines

Hepatic Impairment: Use with caution; dose adjustments may be necessary

Pharmacokinetics

Absorption: Well absorbed orally

Distribution: Widely distributed in body tissues

Metabolism: Extensively metabolized in the liver

Excretion: Primarily excreted in urine

Half Life: 9 hours on average

Contraindications

hypersensitivity to cyproheptadine or other phenothiazines
Pregnancy (Category B; safety not established in pregnancy)

Precautions

Use with caution in patients with glaucoma, urinary retention, prostate hypertrophy, bronchial asthma, hypertension, or cardiovascular disease

Adverse Reactions - Common

Drowsiness (Frequent)
Dizziness (Occasional)
Dry mouth (Occasional)

Adverse Reactions - Serious

Allergic reactions (rash, swelling, difficulty breathing) (Rare)
Seizures (Very rare)

Drug-Drug Interactions

Additive sedative effects with CNS depressants, including alcohol
Potential interactions with monoamine oxidase inhibitors

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor for effectiveness in controlling allergy symptoms, and for adverse effects such as excessive sedation or anticholinergic effects.

Diagnoses:

Risk for fall related to sedation
Impaired skin integrity due to allergic reactions

Implementation: Administer with meals to minimize gastrointestinal upset if needed, monitor patient's response and adverse effects.

Evaluation: Assess reduction in allergy symptoms and monitor for adverse reactions.

Patient/Family Teaching

Avoid operating heavy machinery or driving until sedation effect is known.
Notify healthcare provider if signs of allergic reaction occur.
Use the medication as prescribed, do not exceed recommended dose.
Report any new or worsening symptoms.

Special Considerations

Black Box Warnings:

None currently for this medication

Genetic Factors: Not specifically known to be affected by genetic factors

Lab Test Interference: May interfere with certain allergy skin tests

Overdose Management

Signs/Symptoms: Severe drowsiness, hallucinations, seizures, dry mouth, flushed skin, urinary retention

Treatment: Supportive care, activated charcoal if ingestion was recent, and specific measures to manage symptoms; no specific antidote.

Storage and Handling

Storage: Store at room temperature away from light and moisture

Stability: Stable under recommended storage conditions for the duration of shelf life