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cyproheptadine (Periactin)
Tradename: Periactin.
Indications:
- allergies, colds, urticaria, rhinorrhea, sneezing, nasal congestion, allergic conjunctivitis
- pruritus
- Cushing's syndrome secondary to pituitary disorders
- male & female anorgasmy
- appetite stimulation in patients with anorexia nervosa
- serotonin syndrome [4]
Contraindications:
1) narrow-angle glaucoma
2) bladder neck obstruction
3) stenosing peptic ulcer
4) obstruction of the GI tract
5) concurrent use of MAO inhibitors
6) newborns
Dosage:
1) adults:
a) 12-16 mg PO QD divided every 8 hours
b) max: 16 mg/day
2) children 7-14 years:
a) 4 mg PO every 8-14 hours
b) max: 16 mg/day
3) children 2-6 years
a) 2 mg PO every 8-14 hours
b) max: 12 mg/day
4) allergies, colds, urticaria: 4 mg PO TID
5) Cushing's syndrome secondary to pituitary disorders
a) start 8 mg PO QD
b) gradually increase to 24 mg QD
6) male & female anorgasmy
- 4 to 16 mg 60 minutes prior to sexual activity
7) appetite stimulation in patients with anorexia nervosa
a) start 4 mg PO BID/TID
b) gradually increase to 8 mg QID
Tabs: 4 mg.
Syrup: 2 mg/5 mL
Pharmacokinetics:
1) well absorbed after oral administration
2) peak plasma levels occur 6-9 hours after administration
3) 70% excreted in the feces
Adverse effects:
1) common (> 10%)
- slight to moderate drowsiness
- thickening of bronchial secretions
2) less common (1-10%)
- headache, fatigue, increased appetite, weight gain, nervousness, dizziness, nausea, diarrhea, abdominal pain, dry mouth, pharyngitis, arthralgia
3) uncommon (< 1%)
- angioedema, bronchospasm, depression, edema, epistaxis, hepatitis, myalgia, palpitations, paresthesia, photosensitivity, rash, tachycardia, hemolytic anemia, leukopenia, thrombocytopenia, sedation, CNS stimulation, seizures, allergic reactions
4) anticholinergic effects
Drug interactions:
1) additive effects with other CNS depressants
2) MAO inhibitors increase anticholinergic effects
Mechanism of action:
1) histamine H1 receptor antagonist
2) serotonin receptor antagonist
3) some calcium channel blocking activity
Interactions
drug adverse effects (more general classes)
General
H1 receptor antagonist (antihistamine)
sedative/hypnotic (tranquilizer)
Properties
MISC-INFO: elimination route LIVER
KIDNEY
pregnancy-category B
safety in lactation -
Database Correlations
PUBCHEM correlations
References
- The Pharmacological Basis of Therapeutics, 9th ed.
Gilman et al, eds. Permagon Press/McGraw Hill, 1996
- Drug Information & Medication Formulary, Veterans Affairs,
Central California Health Care System, 1st ed., Ravnan et al
eds, 1998
- Kaiser Permanente Northern California Regional Drug
Formulary, 1998
- Deprecated Reference