Cyproheptadine 2mg/5ml Syrup

Cyproheptadine is a first-generation antihistamine that competitively blocks H1-histamine receptors. It also possesses significant antiserotonergic activity (blocking 5-HT2 receptors) and anticholinergic properties. Its appetite-stimulating effect is thought to be related to its antiserotonergic activity.

Urgent Side Effects: Seek Medical Help Right Away

Although rare, some people may experience severe and potentially life-threatening side effects while taking this medication. If you experience any of the following symptoms, contact your doctor or seek medical attention immediately:

Signs of an allergic reaction, such as:
+ Rash
+ Hives
+ Itching
+ Red, swollen, blistered, or peeling skin with or without fever
+ Wheezing
+ Tightness in the chest or throat
+ Trouble breathing, swallowing, or talking
+ Unusual hoarseness
+ Swelling of the mouth, face, lips, tongue, or throat
Signs of liver problems, including:
+ Dark urine
+ Tiredness
+ Decreased appetite
+ Upset stomach or stomach pain
+ Light-colored stools
+ Vomiting
+ Yellow skin or eyes
Severe dizziness or fainting
Abnormal or rapid heartbeat
Difficulty urinating
Changes in urination frequency
Confusion
Balance problems
Hallucinations (seeing or hearing things that are not there)
Irritability
Mood changes
Seizures
Fever, chills, or sore throat
Unexplained bruising or bleeding
Feeling extremely tired or weak
Abnormal sensations, such as burning, numbness, or tingling
Changes in vision
Ringing in the ears
Excessive sweating
Menstrual changes

Other Possible Side Effects

Like all medications, this drug can cause side effects. While many people may not experience any side effects or only minor ones, it's essential to discuss any concerns with your doctor. If you experience any of the following side effects or any other unusual symptoms, contact your doctor for advice:

Dizziness, drowsiness, tiredness, or weakness
Headache
Constipation, diarrhea, stomach pain, upset stomach, vomiting, or decreased appetite
Increased appetite
Weight gain
Dry mouth
Dry nose
Stuffy nose
Nervousness and excitability
Restlessness
Shakiness
Sleep disturbances

Reporting Side Effects

This list is not exhaustive, and you may experience other side effects. If you have questions or concerns, contact your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.

Before Taking This Medication: Important Information to Share with Your Doctor

It is essential to inform your doctor about the following conditions and situations to ensure safe treatment with this medication:

Allergies: If you have a known allergy to cyproheptadine or any other component of this medication, inform your doctor. Describe the allergic reaction and any symptoms you experienced.
Health conditions: Tell your doctor if you have any of the following health problems:
+ Bowel blockage
+ Enlarged prostate
+ Glaucoma
+ Difficulty passing urine
+ Stomach or bowel ulcers
Medications: Inform your doctor if you are taking:
+ Certain antidepressant medications, such as isocarboxazid, phenelzine, or tranylcypromine
+ Medications for Parkinson's disease, such as selegiline or rasagiline
+ Linezolid or methylene blue
Age: If you are 65 years or older, inform your doctor.
Breastfeeding: Do not breastfeed while taking this medication. Inform your doctor if you are breastfeeding or plan to breastfeed.
Pediatric considerations: If your child is a premature baby or newborn, do not give them this medication.

Additional Important Information:

This list is not exhaustive, and it is crucial to inform your doctor and pharmacist about all your medications, including prescription and over-the-counter drugs, natural products, and vitamins. Your doctor will help you determine if it is safe to take this medication with your other medications and health conditions. Never start, stop, or change the dose of any medication without consulting your doctor.

It is essential to inform all your healthcare providers, including doctors, nurses, pharmacists, and dentists, that you are taking this medication. Before operating a vehicle or engaging in activities that require alertness, wait until you understand how this medication affects you.

Be aware that this medication may interfere with the results of allergy skin tests. Therefore, it is crucial to notify your doctor and laboratory personnel that you are taking this medication. Prior to consuming alcohol, using marijuana or other cannabis products, or taking prescription or over-the-counter medications that may cause drowsiness, consult with your doctor.

This medication may increase your susceptibility to sunburn. Exercise caution when exposed to sunlight, and notify your doctor if you experience increased sensitivity to the sun.

It is critical to be aware that overdoses of this medication have occurred in children, which can lead to severe health complications and potentially be fatal. If you have questions or concerns, discuss them with your doctor.

When administering this medication to children, exercise caution and consult with their doctor. If you are pregnant or planning to become pregnant, inform your doctor to discuss the potential benefits and risks associated with using this medication during pregnancy.

• Monoamine Oxidase Inhibitors (MAOIs) (concurrent use or within 14 days of MAOI discontinuation)
• Patients with narrow-angle glaucoma
• Patients with prostatic hypertrophy or bladder neck obstruction
• Patients with stenosing peptic ulcer
• Patients with symptomatic prostatic hypertrophy
• Elderly, debilitated patients (due to increased susceptibility to anticholinergic effects)
• Neonates or premature infants
• Nursing mothers

• CNS depressants (e.g., alcohol, sedatives, hypnotics, anxiolytics, opioids, other antihistamines): Potentiation of CNS depression.
• Anticholinergic drugs (e.g., tricyclic antidepressants, atropine, benztropine): Additive anticholinergic effects (dry mouth, blurred vision, urinary retention, constipation).
• Serotonergic agents (e.g., SSRIs, SNRIs, triptans): Cyproheptadine can antagonize the effects of these drugs, particularly in the context of serotonin syndrome treatment, potentially worsening symptoms if used inappropriately.

• Potassium chloride (oral forms): Increased risk of GI lesions due to anticholinergic-induced decreased GI motility.
• Topical anticholinergics (e.g., scopolamine patches): Additive anticholinergic effects.

• Drowsiness
• Dizziness
• Dry mouth
• Blurred vision
• Urinary retention
• Constipation
• Nausea
• Vomiting
• Nervousness
• Irritability
• Paradoxical excitation (especially in children)

Cyproheptadine is classified as Pregnancy Category B. Animal reproduction studies have shown no risk to the fetus, but there are no adequate and well-controlled studies in pregnant women. Use only if clearly needed and the potential benefits outweigh the potential risks.

Cyproheptadine is excreted into breast milk and is contraindicated in nursing mothers due to the potential for serious adverse reactions in the infant (e.g., sedation, irritability, paradoxical excitation) and the potential to decrease milk supply due to anticholinergic effects.

Contraindicated in neonates and premature infants. Use with caution in young children due to increased susceptibility to anticholinergic side effects and the potential for paradoxical excitation (restlessness, irritability, insomnia). Not recommended for children under 2 years of age for allergic conditions.

Elderly patients are more susceptible to the anticholinergic side effects (e.g., sedation, confusion, dry mouth, urinary retention, constipation) and paradoxical excitation. Lower doses are generally recommended, and use should be with extreme caution or avoided if possible, especially in those with pre-existing conditions like glaucoma or prostatic hypertrophy.

• Cyproheptadine is one of the few antihistamines with significant antiserotonergic properties, making it useful off-label for the treatment of serotonin syndrome (particularly mild to moderate cases).
• It is commonly used off-label as an appetite stimulant in various conditions, including cancer cachexia, anorexia nervosa, and in children with poor weight gain.
• Due to its sedating and anticholinergic effects, it is often dosed at bedtime when used for allergic conditions.
• Patients should be warned about the potential for significant drowsiness and impaired ability to perform tasks requiring mental alertness.
• Paradoxical excitation (restlessness, irritability, insomnia) can occur, especially in young children and occasionally in adults.

• Other first-generation antihistamines (e.g., Diphenhydramine, Hydroxyzine)
• Second-generation antihistamines (e.g., Loratadine, Cetirizine, Fexofenadine) for allergic conditions (less sedating)
• For appetite stimulation: Mirtazapine, Dronabinol, Megestrol acetate (depending on underlying cause)
• For serotonin syndrome: Benzodiazepines (for agitation/hyperthermia), supportive care

If your symptoms or health issues persist or worsen, it is essential to contact your doctor for further guidance. To ensure your safety, never share your medication with others or take someone else's medication. Some medications may come with an additional patient information leaflet, so it's a good idea to check with your pharmacist. If you have any questions or concerns about your medication, don't hesitate to discuss them with your doctor, nurse, pharmacist, or other healthcare provider. In the event of a suspected overdose, immediately call your local poison control center or seek medical attention. When seeking help, be prepared to provide detailed information about the overdose, including the medication taken, the amount, and the time it occurred.