Cyproheptadine 4mg Tablets

Cyproheptadine is a first-generation antihistamine that competitively antagonizes H1-receptors, thereby blocking the effects of histamine. It also possesses significant antiserotonergic (5-HT2 receptor antagonism) and anticholinergic properties. Its appetite-stimulating effect is thought to be related to its antiserotonergic activity on the hypothalamus.

Serious Side Effects: Seek Medical Attention Immediately

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 help right away:

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
Changes in menstrual cycle

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
Feeling nervous or excitable
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 about side effects, consult 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 circumstances before starting this medication:

If you have a known allergy to cyproheptadine or any other component of this medication. Describe your allergic reaction and the symptoms you experienced.
If you have any of the following health conditions:
+ Bowel obstruction
+ Enlarged prostate
+ Glaucoma
+ Difficulty urinating
+ Stomach or bowel ulcers
If you are taking certain medications, such as:
+ Isocarboxazid, phenelzine, or tranylcypromine (used to treat depression)
+ Selegiline or rasagiline (used to treat Parkinson's disease)
+ Linezolid or methylene blue
If you are 65 years or older
If you are breastfeeding. Note: You should not breastfeed while taking this medication.

Special Considerations for Children:

If your child is a premature baby or a newborn, do not administer this medication. It is not suitable for premature babies or newborns.

Additional Important Information:

This list is not exhaustive, and it is crucial to inform your doctor and pharmacist about all your medications (prescription, over-the-counter, natural products, and vitamins) and health conditions. This will help ensure your safety while taking this medication. Never start, stop, or change the dose of any medication without consulting your doctor first.

It is essential to inform all your healthcare providers, including doctors, nurses, pharmacists, and dentists, that you are taking this medication.

Until you are aware of how this drug affects you, avoid operating a vehicle or engaging in any activities that require alertness.

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 drug.

Before consuming alcohol, using marijuana or other cannabis products, or taking prescription or over-the-counter medications that may cause drowsiness, consult with your doctor.

Be cautious when exposed to sunlight, as this medication may increase your susceptibility to sunburn. If you experience excessive sunburn while taking this medication, notify your doctor.

It is critical to exercise caution when administering this medication to children, as overdoses can occur and may lead to severe health complications or even death. If you have any questions or concerns, discuss them with your doctor.

Additionally, children should use this medication with caution, and it is recommended that you consult with your doctor.

If you are pregnant or planning to become pregnant, inform your doctor, as it is necessary 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 (potentiates anticholinergic effects)
• Severe hepatic impairment
• Newborns or premature infants
• Nursing mothers
• Elderly, debilitated patients with glaucoma, prostatic hypertrophy, bladder neck obstruction, pyloroduodenal obstruction

• CNS Depressants (e.g., alcohol, sedatives, hypnotics, anxiolytics, opioids, tricyclic antidepressants, other antihistamines) - additive CNS depression
• Anticholinergic drugs (e.g., atropine, tricyclic antidepressants, phenothiazines) - additive anticholinergic effects (dry mouth, blurred vision, urinary retention, constipation)

• Topical antihistamines - additive systemic effects
• Potassium chloride (oral) - increased risk of GI lesions due to anticholinergic effects

• None specifically noted as minor, but general caution with any drug affecting CNS or anticholinergic activity.

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

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.

Not recommended. Cyproheptadine is excreted in breast milk and may cause sedation or other adverse effects in the nursing infant. It may also inhibit lactation due to its anticholinergic effects.

Contraindicated in newborns and premature infants. Use with caution in children due to potential for paradoxical excitation (restlessness, irritability) or increased sensitivity to anticholinergic effects. Dosage must be carefully calculated based on age and weight.

Use with extreme caution. Elderly patients are more susceptible to the anticholinergic effects (e.g., dry mouth, urinary retention, constipation, blurred vision) and CNS effects (e.g., sedation, dizziness, confusion, hypotension) of cyproheptadine. Lower doses are often recommended, and it is generally considered a potentially inappropriate medication in the elderly according to Beers Criteria.

• Cyproheptadine is a first-generation antihistamine with significant anticholinergic and antiserotonergic properties, leading to its use for both allergies and appetite stimulation.
• Sedation is a common and often dose-limiting side effect; advise patients to avoid activities requiring mental alertness.
• Paradoxical excitation can occur, especially in children, manifesting as restlessness, insomnia, or nervousness.
• Due to its anticholinergic effects, it should be used with caution or avoided in patients with glaucoma, prostatic hypertrophy, or urinary retention.
• Its use as an appetite stimulant is off-label in many regions but is a common clinical practice, particularly in pediatric populations or those with chronic illness-related cachexia.
• Tolerance to the sedative effect may develop over time, but anticholinergic effects may persist.

• Other first-generation antihistamines (e.g., diphenhydramine, chlorpheniramine) for allergy symptoms (though less potent antiserotonergic effects)
• Second-generation antihistamines (e.g., loratadine, cetirizine, fexofenadine) for allergy symptoms (less sedating, minimal anticholinergic effects)
• Mirtazapine (antidepressant with appetite-stimulating properties)
• Dronabinol (cannabinoid, appetite stimulant for specific conditions)
• Megestrol acetate (progestin, appetite stimulant for specific conditions)
• Nutritional counseling and dietary interventions for appetite/weight gain

If your symptoms or health issues persist or worsen, it's 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 be sure to check with your pharmacist for more information. If you have any questions or concerns about your medication, don't hesitate to reach out to your doctor, nurse, pharmacist, or other healthcare provider. In the event of a suspected overdose, immediately call your local poison control center or seek emergency medical attention. When seeking help, be prepared to provide details about the medication taken, including the amount and time of ingestion.