Periactin: Effective Appetite Stimulation and Allergy Relief
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Synonyms
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Periactin (cyproheptadine hydrochloride) is a versatile prescription medication with dual therapeutic applications, primarily recognized for its potent antihistaminic and appetite-stimulating properties. As a first-generation H1 receptor antagonist, it effectively mitigates allergic responses by blocking histamine activity, while its serotonergic antagonism contributes to increased hunger and weight gain in indicated populations. This comprehensive product card details its pharmacological profile, clinical utility, and essential safety information for healthcare professionals and informed patients. Approved by regulatory bodies, Periactin remains a relevant option in specific clinical scenarios where its unique mechanism of action offers distinct advantages.
Features
- Active ingredient: Cyproheptadine hydrochloride 4mg per tablet
- Pharmaceutical class: First-generation antihistamine, serotonin antagonist
- Administration: Oral tablet formulation
- Onset of action: Typically within 30-60 minutes post-administration
- Duration of effect: 4-6 hours for antihistaminic activity
- Available in blister packs of 30 and 100 tablets
- Requires prescription in most jurisdictions
- Compatible with various patient age groups (pediatric to adult)
- Minimal active metabolites; primarily renal excretion
- White, scored tablets for accurate dosing
Benefits
- Effective appetite stimulation: Promotes weight gain in underweight patients and those with cachexia through serotonin receptor blockade
- Rapid allergic symptom relief: Provides quick relief from urticaria, allergic rhinitis, and conjunctivitis symptoms
- Multi-symptom management: Addresses both allergic manifestations and appetite concerns in compatible cases
- Established safety profile: Decades of clinical use with well-characterized adverse effect patterns
- Flexible dosing: Adjustable regimen allows for personalized therapeutic approaches
- Cost-effective option: Generally more affordable than many newer alternatives while maintaining efficacy
Common use
Periactin is primarily indicated for the management of allergic conditions including seasonal and perennial allergic rhinitis, allergic conjunctivitis, mild uncomplicated allergic skin manifestations of urticaria and angioedema, and as therapy for anaphylactic reactions adjunctive to epinephrine. Additionally, it is employed off-label as an appetite stimulant in cases of malnutrition, cachexia associated with chronic diseases, and failure to thrive in pediatric populations. Some clinical evidence supports its use in serotonin syndrome management and migraine prophylaxis, though these applications require specialist supervision.
Dosage and direction
Adults and children 12 years and older: The typical dosage for allergic conditions is 4mg three times daily, not to exceed 0.5mg/kg/day. For appetite stimulation,起始剂量通常为2mg twice daily, gradually titrated upward based on response and tolerance.
Children 7-14 years: 2-4mg two to three times daily (maximum 16mg daily)
Children 2-6 years: 2mg two to three times daily (maximum 12mg daily)
Geriatric patients: Initiate with lower doses due to increased sensitivity to anticholinergic effects
Administration with food may reduce gastrointestinal discomfort. Tablets should be swallowed whole with water. Dosage adjustments are necessary in hepatic impairment. Treatment duration varies by indication, with allergic conditions typically requiring short-term use while appetite stimulation may involve longer therapy periods with regular monitoring.
Precautions
Exercise caution in patients with narrow-angle glaucoma, stenosing peptic ulcer, pyloroduodenal obstruction, or bladder neck obstruction due to anticholinergic properties. Use with caution in patients with hypertension, cardiovascular disease, hyperthyroidism, or bronchial asthma. Elderly patients may experience heightened sensitivity to adverse effects including confusion, dizziness, and sedation. May impair mental and physical abilities required for driving or operating machinery. Discontinue at least 4 days prior to skin allergy testing to avoid false negative results. Pregnancy Category B: use only if clearly needed. Excreted in breast milk; not recommended during lactation.
Contraindications
Hypersensitivity to cyproheptadine or any component of the formulation. Concurrent monoamine oxidase inhibitor therapy (risk of severe adverse reactions). Neonates and premature infants due to increased risk of anticholinergic effects. Acute asthma attacks. Patients with gastrointestinal obstruction. Severe renal impairment (creatinine clearance <30 mL/min). Prostatic hypertrophy with urinary retention.
Possible side effect
Common (≥1%): Drowsiness, sedation, dizziness, dry mouth/nose/throat, gastrointestinal upset, appetite increase, weight gain, thickened bronchial secretions
Less common (<1%): Headache, fatigue, excitation (especially in children), blurred vision, diplopia, hypotension, tachycardia, urinary retention, constipation, sweating
Rare but serious: Anaphylaxis, agranulocytosis, thrombocytopenia, hemolytic anemia, seizures, angle-closure glaucoma, severe hypotension, arrhythmias
Pediatric patients may experience paradoxical excitation including hallucinations, irritability, and insomnia. Most side effects are dose-dependent and often diminish with continued therapy.
Drug interaction
MAO inhibitors: Contraindicated due to risk of hypertensive crisis and severe anticholinergic effects
CNS depressants: Enhanced sedation with alcohol, barbiturates, benzodiazepines, opioids
Anticholinergic agents: Additive effects with tricyclic antidepressants, antipsychotics, antiparkinsonian drugs
Serotonergic drugs: May decrease effectiveness of SSRIs, SNRIs, triptans
Hypertensive agents: May counteract effects of guanethidine, methyldopa, reserpine
Phenytoin: Cyproheptadine may increase phenytoin levels
Always review complete medication profile including OTC products and herbal supplements before initiation.
Missed dose
If a dose is missed, administer as soon as remembered unless it is nearly time for the next scheduled dose. Do not double the dose to make up for a missed administration. Maintain regular dosing schedule to ensure consistent therapeutic effect. For patients using Periactin for appetite stimulation, consistent timing relative to meals optimizes efficacy.
Overdose
Symptoms may include severe CNS depression (coma) or stimulation (hallucinations, convulsions), anticholinergic effects (flushed skin, hyperthermia, tachycardia, urinary retention), and cardiovascular collapse. In children, paradoxical excitation may occur. Treatment is supportive and symptomatic: gastric lavage if presented early, activated charcoal, physiological saline for hypotension, and benzodiazepines for seizures. Physostigmine may be considered for severe central anticholinergic effects under controlled settings. Dialysis is not effective due to high protein binding.
Storage
Store at controlled room temperature (20-25°C or 68-77°F) in original container. Protect from light and moisture. Keep tightly closed and out of reach of children. Do not use if tablets show discoloration or physical deterioration. Properly discard expired medication through take-back programs or following FDA guidelines.
Disclaimer
This information is for educational purposes and does not replace professional medical advice. Dosage and treatment decisions must be made by qualified healthcare providers considering individual patient circumstances. Off-label uses should be carefully evaluated against evidence and clinical judgment. Report adverse events to FDA MedWatch program or local regulatory authority.
Reviews
“Periactin has been invaluable in our pediatric practice for failure to thrive cases where other interventions failed. The weight gain results are often remarkable within 4-6 weeks of therapy.” - Pediatric Gastroenterologist, 15 years experience
“While sedating compared to second-generation antihistamines, Periactin remains my go-to for severe urticaria cases that don’t respond to conventional treatment. The anti-serotonin effect seems to make the difference.” - Allergist, 12 years experience
“Effective for appetite stimulation in oncology patients experiencing cachexia, though the sedative effects require careful dosing timing. Cost-effectiveness makes it accessible for long-term use.” - Oncology Pharmacist, 8 years experience
“Must monitor elderly patients closely for confusion and urinary retention, but when used judiciously, it provides excellent allergic symptom control with the bonus of appetite improvement.” - Geriatrician, 20 years experience