Cyproheptadine

  • Brand Name : Cyproheptadine
  • Drug Class : Appetite Stimulants
  • Medical Author : John P. Cunha, DO, FACOEP
  • Medical Reviewer :
  • _eael_post_view_count : 7

What Is Cyproheptadine and How Does It Work?

Cyproheptadine is an antihistamine used to treat sneezing, itching, watery eyes, runny nose, and other symptoms of allergies.

What Are Dosages of Cyproheptadine?

Dosages of Cyproheptadine:

Adult and Pediatric Dosage Forms and Strengths

Tablet

  • 4 mg

Oral solution

  • 2 mg/5 mL

Dosage Considerations – Should be Given as Follows:

Hypersensitivity Reaction

  • Adults: 4 mg orally every 8 hours initially; maintenance: 4-20 mg/day, up to 32 mg/day divided every 8 hours between some patients; not to exceed 0.5 mg/kg/day
  • Children under 2 years old: Safety and efficacy not established
  • Children 2-6 years old: 2 mg orally every 8-12 hours; not to exceed 12 mg/day
  • Children 7-14 years old: 4 mg orally every 8-12 hours; not to exceed 16 mg/day
  • Alternatively, a total daily dose of 0.25 mg/kg or 8 mg/m²

Spasticity Associated With Spinal Cord (Off-label)

  • 2-4 mg orally every 8 hours initially; not to exceed 24 mg/day

Migraine Headache Prophylaxis (Off-Label)

  • Adults: 2 mg orally every 12 hours with or without propanol
  • Pediatric, Prophylaxis
  • Children under 3 years: Safety and efficacy not established
  • Children over 3 years and adolescents: 0.2-0.4 mg/kg/day orally divided twice daily; not to exceed 0.5 mg/kg/day

Decreased Appetite Secondary to Chronic Disease (Off-label)

  • Adults: 2 mg orally every 6 hours for one week; THEN 4 mg orally every 6 hours
  • Pediatric, Stimulation of appetite
  • Children under 13 years: Safety and efficacy not established
  • Children over 13 years: 2 mg orally every 6 hours initially; increased to up to 8 mg every 6 hours over 3 weeks

Drug-Induced Sexual Dysfunction (Off-label)

  • 4-12 mg orally 1-2 hours before anticipated coitus or 1-16 mg/day

Serotonin Syndrome (Off-Label)

  • 12 mg initially orally, followed by 2 mg every 2 hours or 4-8 mg orally every 6 hours as needed to control symptoms

Dosing Modifications

  • Non-anticholinergic antihistamines should be considered first when treating allergic reactions (Beers Criteria)
  • Advanced age is associated with reduced clearance and greater risk of confusion, dry mouth, constipation, and other anticholinergic effects and toxicity; use the lower end of dosage range (4 mg orally every 12 hours) for elderly patients, or administer less frequently
  • Renal impairment: Elimination is reduced in renal insufficiency; administer lower doses, and monitor closely

Dosing Modifications

  • Hepatic impairment: Give 75% of normal dose if transaminase levels are greater than 3 times the upper limit of normal (ULN) or bilirubin is 3.1-5 mg/dL
  • Renal impairment: CrCl less than 10 mL/minute, give 75% of normal dose; CrCl greater than 10 mL/minute, give full dose

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