Cyproheptadine

Perennial/seasonal allergic rhinitis, vasomotor rhinitis, allergic conjunctivitis from inhalant/food allergens, mild uncomplicated urticaria/angioedema, blood/plasma allergic reactions, cold urticaria and dermatographism. Anaphylactic reactions: adjunct to epinephrine and standard measures only after acute manifestations are controlled. It is not initial rescue or a substitute for epinephrine.

Increased appetite/weight gain is reported as an adverse effect, not a labeled appetite-stimulation indication. No independent weight-gain, migraine or serotonin-syndrome dose algorithm supplied. Different clinical uses require diagnosis-specific professional review; do not use sedating medication to delay emergency care.

Use a calibrated oral device for syrup mL; household spoons are unsuitable. Tablet is scored, but confirm exact dispensed product for half-tablet dosing. Renal insufficiency reduces elimination, yet labels give no validated numeric renal/hepatic or dialysis adjustment; clinician individualization is required. No independent missed-dose doubling or off-label escalation.

Newborn/premature infants; nursing mothers; hypersensitivity to cyproheptadine or structurally similar drugs; MAO-inhibitor therapy; angle-closure glaucoma; stenosing peptic ulcer; symptomatic prostatic hypertrophy; bladder-neck or pyloroduodenal obstruction; the label’s elderly, debilitated patients category. Below 2 is unestablished, distinct from explicit neonatal contraindication.

No boxed warning appears in selected oral labels. Prescription status and explicit neonatal/lactation/MAO/obstruction restrictions remain applicable. No blanket pediatric, frail-older-adult or pregnancy safety claim.

Sleepiness, dizziness, dry mouth, constipation, blurred vision and weight gain/increased appetite are reported; excitation, hallucinations, seizures, hypotension, palpitations, urinary retention, photosensitivity and blood abnormalities also occur. Tablet label reports cholestasis, hepatitis/hepatic failure. Overdose may cause CNS depression or stimulation and anticholinergic signs; seek emergency/Poison Control advice. Legacy labels include ipecac/lavage/physostigmine directions; they are not a home treatment protocol and are not propagated as an automatic modern management algorithm.

Contraindicated during MAO-inhibitor therapy because anticholinergic antihistamine effects can be prolonged/intensified. Labels do not give a validated universal post-stop washout interval; recent MAO therapy needs pharmacist/prescriber review before dosing.

Alcohol, hypnotics, sedatives, tranquilizers and antianxiety agents may add impairment. Review other antihistamines/anticholinergic products to avoid duplicate exposure; no quantified dose-reduction formula is supplied. The selected syrup’s 5% alcohol is formulation-specific and not assumed for every oral solution.

Below 2 safety/effectiveness are unestablished; newborn/premature use is prohibited. Children need supervision for sedation/excitation and overdose prevention. Ages 15–17 lack an explicit dose-table row. Older adult trial evidence is limited and adverse sensitivity greater; respect the explicit elderly, debilitated contraindication before considering any cautious starting dose.

Renal insufficiency diminishes elimination. No numerical renal/hepatic adjustment or dialysis supplement is supplied; assess organ function and clinical response rather than infer standard safety. Tablet postmarketing hepatic injury reports make jaundice/liver symptoms clinically relevant, but do not establish a universal liver-test schedule.

Limited human studies did not show increased malformations but cannot exclude harm; use in pregnancy only if clearly needed after benefit/risk review. Selected contraindications prohibit use while nursing because serious infant effects are possible; the later lactation paragraph advises choosing discontinuation of nursing or drug. Human milk excretion is unknown. No legacy category-based pregnancy guarantee or automatic breastfeeding permission.

Competes at histamine and serotonin receptor sites, with sedative and atropine-like effects. These explain allergic symptom relief and many adverse effects; they do not establish the drug as emergency anaphylaxis rescue or approve appetite treatment.

After a single radiolabeled 4 mg dose, at least 40% of radioactivity was recovered in urine and 2–20% in stool; parent was not detected in urine during chronic dosing. Main urinary metabolite is a quaternary ammonium glucuronide conjugate. Elimination diminishes with renal insufficiency. Selected labels supply no validated plasma elimination half-life, CYP dosing algorithm or therapeutic concentration target.

Review allergy diagnosis/severity, exact age/weight, nursing status, organ disease, glaucoma/obstruction/frailty and MAO/CNS-depressant exposure. Follow benefit, sedation/excitation, BP-related symptoms, visual/urinary effects and weight/appetite change. Relevant liver/blood symptoms require evaluation; no routine serum level or universal lab interval asserted.

Use exact tablet/syrup regimen and calibrated mL measurement; never double or treat a young child from an adult bottle without instructions. Avoid alcohol, unsafe activities and duplicate sedating products; supervise children. Epinephrine/emergency services remain primary for acute anaphylaxis. Report urinary retention, severe confusion, jaundice or rash. Suspected excess ingestion needs immediate Poison Control/emergency assessment; no induced vomiting at home.

Appearance

White/off-white round flat-faced tablet; B137 one side, score on other.

Selected packages

PD-Rx Pharmaceuticals bottles 30 or 100; NDC 72789-102-30/-01.

Status

Prescription oral product; other generic imprints require exact package verification.

Tablet

4 mg cyproheptadine HCl per tablet; selected ingredients include lactose.

Selected syrup

2 mg/5 mL(0.4 mg/mL), yellow mint-flavored 473 mL bottle; NDC 64980-504-48.

Excipients

Selected Rising/Lyne syrup contains alcohol 5%, sucrose and sorbic acid 0.1%; no universal sugar-free/alcohol-free claim.

Route scope

Oral tablets/syrup; no unverified injection, compounded concentration or weight-gain supplement approval.

Tablets 20–25°C in well-closed child-resistant container. Selected syrup 20–25°C with 15–30°C excursions, tight light-resistant container. Keep securely away from children, use actual expiration and calibrated device; no universal compounded or after-opening stability interval supplied.