Cyproheptadine HCl
| (sip-row-HEP-tuh-deen HIGH-droe-KLOR-ide) |
| Periactin |
| Tablets |
| 4 mg |
| Syrup |
| 2 mg/5 mL |
| PMS-Cyproheptadine |
| Class: Antihistamine |
Action Competitively antagonizes histamine at H1 receptor sites. Also exhibits antiserotonin activity.
Indications Symptomatic relief of perennial and seasonal allergic rhinitis, vasomotor rhinitis, allergic conjunctivitis; amelioration of allergic reactions to blood or plasma; management of allergic pruritic symptoms, mild skin manifestations of uncomplicated urticaria and angioedema, and cold urticaria.
Contraindications Hypersensitivity to antihistamines; newborn or premature infants; nursing mothers; narrow-angle glaucoma; stenosing peptic ulcer; symptomatic prostatic hypertrophy; asthmatic attack; bladder neck obstruction; pyloroduodenal obstruction; MAO therapy.
Route/DosageAdults: PO 4 mg q 8 hr then 4 to 20 mg/day; not to exceed 0.5 mg/kg/day.
Children: PO Total daily dosage 0.25 mg/kg or 8 mg/m2.
Children 7 to 14 yr: PO 4 mg bid or tid (max, 16 mg/day).
Children 2 to 6 yr: PO 2 mg bid or tid (max, 12 mg/day).
InteractionsAlcohol, CNS depressants: May cause additive CNS depressant effects.
Fluoxetine: Effects of fluoxetine may be reversed.
MAOIs: Anticholinergic effects of cyproheptadine may increase.
Lab Test Interferences In skin testing procedures, antihistamines may prevent or diminish otherwise positive reaction to dermal reactivity indicators.
Adverse ReactionsCARDIOVASCULAR: Orthostatic hypotension; palpitations; tachycardia; reflex tachycardia; extrasystoles; faintness. CNS: Drowsiness (often transient); sedation; dizziness; faintness; disturbed coordination; confusion; restlessness; excitement; nervous tremor; paresthesias; convulsions; hallucinations. DERMATOLOGIC: Photosensitivity; rash. EENT: Dry mouth, nose, and throat; sore throat. GI: Epigastric distress; nausea; vomiting; diarrhea; anorexia; constipation; change in bowel habits. HEMATOLOGIC: Hemolytic anemia; thrombocytopenia; agranulocytosis. HEPATIC: Jaundice. RESPIRATORY: Thickening of bronchial secretions; chest tightness; wheezing; nasal stuffiness; respiratory depression.
PrecautionsPregnancy: Category B. Lactation: Contraindicated in nursing women. Children: Safety and efficacy in children younger than 2 yr not established. Elderly: Dosage reduction may be required. Special risk patients: Use drug with caution in patients with predisposition to urinary retention, history of bronchial asthma, increased intraocular pressure, hyperthyroidism, cardiovascular disease, or hypertension. Hepatic impairment: Use drug with caution in patients with cirrhosis or other liver disease. Respiratory disease: Generally not recommended for treatment of lower respiratory tract symptoms including asthma. Sedatives/CNS depressants: Avoid in patients with history of sleep apnea.
| PATIENT CARE CONSIDERATIONS |
|
Administration/Storage- Administer medication with meals.
- Scored tablets may be crushed.
- Store in tightly closed container at room temperature.
Assessment/Interventions- Obtain patient history, including drug history and any known allergies.
- Assess baseline vital signs and lung sounds.
- For diabetic patients, monitor blood glucose closely if taking sugar-based syrups.
- Monitor weight weekly for significant increases.
- Perform regular assessments and notify health care provider if patient exhibits signs of cardiovascular, neurologic, or respiratory dysfunction
(eg, cardiac arrhythmia, hypotension, increased drowsiness or agitation, confusion, chest tightness, wheezing).
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Patient/Family Education- Instruct diabetic patients to monitor blood glucose closely if taking syrup preparations.
- Alert patients that syrup preparations contain alcohol, and advise against taking any additional alcoholic beverages or CNS depressants throughout therapy.
- Explain potential effects of chronic dryness of oral tissues and encourage patient to maintain good oral hygiene and obtain regular dental care.
- Explain that skin testing procedures may be affected if drug is not discontinued at least 4 days prior to test.
- Tell patient to report any adverse reactions, including changes in urinary habits, to health care provider.
- Instruct patient to take sips of water frequently, suck on ice chips or sugarless hard candy, or chew sugarless gum if dry mouth occurs.
- Advise patient that drug may cause drowsiness and to use caution while driving or performing other tasks requiring mental alertness.
- Caution patients to avoid exposure to sunlight and prolonged exposure to extreme heat and to use sunscreen or wear protective clothing to avoid photosensitivity reaction.
- Instruct patient not to take OTC medications without consulting health care provider.
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