RT Book, Section
A1 Cantrell, F. Lee
A2 Olson, Kent R.
A2 Anderson, Ilene B.
A2 Benowitz, Neal L.
A2 Blanc, Paul D.
A2 Clark, Richard F.
A2 Kearney, Thomas E.
A2 Kim-Katz, Susan Y.
A2 Wu, Alan H. B.
SR Print(0)
ID 1174607396
T1 CYPROHEPTADINE
T2 Poisoning & Drug Overdose, 7e
YR 2018
FD 2018
PB McGraw-Hill Education
PP New York, NY
SN 9780071839792
LK accessmedicine.mhmedical.com/content.aspx?aid=1174607396
RD 2024/04/18
AB Pharmacology.  Cyproheptadine  is  a  first-generation  histamine  1  (H1)  blocker  with  nonspecific  serotonin  (5-HT)  antagonism.  The  administration  of  cyproheptadine  to  patients  with  serotonin  syndrome  appears  to  antagonize  excessive  stimulation  of  5-HT1A  and  5-HT2  receptors,  resulting  in  improvements  in  clinical  symptoms  (based  on  anecdotal  case  reports).Indications.  Cyproheptadine  may  be  beneficial  in  alleviating  mild  to  moderate  symptoms  in  cases  of  suspected  serotonin  syndrome.ContraindicationsKnown  hypersensitivity  to  cyproheptadine.Angle-closure  glaucoma.Stenosing  peptic  ulcer.Symptomatic  prostatic  hypertrophy.Bladder  neck  obstruction.Pyloroduodenal  obstruction.Adverse  effectsTransient  mydriasis  and  urinary  retention  may  result  from  anticholinergic  properties.Use  in  pregnancy.  FDA  Category  B  (Introduction).  Unlikely  to  cause  harm  with  short-term  therapy.Drug  or  laboratory  interactions.  Additive  anticholinergic  effects  when  given  with  other  antimuscarinic  drugs.Dosage  and  method  of  administration  (adults  and  children):  The  initial  dose  is  4–12  mg  orally,  followed  by  4  mg  every  1–4  hours  as  needed  until  symptoms  resolve  or  a  maximum  daily  dose  of  32  mg  is  reached  (children:  0.25  mg/kg/d  divided  every  6  hours  with  a  maximum  of  12  mg/d).FormulationsOral.  Cyproheptadine  hydrochloride  (Periactin,  others),  4-mg  tablets,  2-mg/5  mL  syrup.Suggested  minimum  stocking  levels  to  treat  a  100-kg  adult  for  the  first  8  hours  and  24  hours:  cyproheptadine  hydrochloride,  first  8  hours:  32  mg  or  eight  tablets  (4  mg  each);  first  24  hours:  32  mg  or  eight  tablets  (4  mg  each).