Classes
DEA Class; OTC, Rx
Common Brand Names; Periactin
- Antihistamines, 1st Generation
Description
Oral piperidine antihistamine (H1-blocker) that also antagonizes serotonin receptors
Has sedative and anticholinergic effects
Primarily used to treat perennial and seasonal allergic rhinitis, vasomotor rhinitis, urticaria, and allergic conditions in adults and children as young as 2 years
Indications
Indicated for
- Hypersensitivity Reaction
- Spasticity Associated With Spinal Cord (Off-label)
- Migraine Headache Prophylaxis (Off-Label)
- Decreased Appetite Secondary to Chronic Disease (Off-label)
- Drug-Induced Sexual Dysfunction (Off-label)
- Serotonin Syndrome (Off-Label)
Contraindications
Documented hypersensitivity
Premature infants and neonates
Nursing women
Concomitant monoamine oxidase inhibitor therapy
Narrow-angle glaucoma
Stenosing peptic ulcer, pyloroduodenal obstruction
Symptomatic prostatic hypertrophy
Bladder neck obstruction
Elderly, debilitated patients
Adverse Effects
Psychiatric/neurologic: CNS depression, drowsiness, sedation ranging from mild drowsiness to deep sleep (most frequent), dizziness, lassitude, disturbed coordination; less commonly, restlessness, insomnia, tremors, euphoria, nervousness, irritability, delirium, seizures, toxic psychosis, paresthesia
Muscular: Weakness
Cardiovascular: Palpitation, tachycardia, palpitation, ECG changes (eg, widened QRS), arrhythmias (eg, extrasystole, heart block), hypotension, hypertension, dizziness, sedation, hypotension
GI: Epigastric distress, anorexia, nausea, vomiting, diarrhea, constipation
Hepatic: Cholestasis, hepatitis, hepatic failure, hepatic function abnormality, jaundice (rare)
Skin: Eczema, pruritus, inflammation, papular rash, erythema on exposed skin
Sensory: Visual disturbances, blurred vision, diplopia, tinnitus, acute labyrinthitis
Renal: Dysuria, urinary retention
Respiratory: Thickening of bronchial secretions, wheezing, nasal stuffiness
Other: Vertigo, sweating, chills, early menses, headache, impotence, dryness of mouth, nose, and throat, facial dyskinesia, tightness of chest, faintness
Warnings
Elimination reduced in renal insufficiency
Use with caution in cardiovascular disease, including hypertension
Elderly patients: Avoid use in elderly because of high incidence of anticholinergic effects; may exacerbate existing lower urinary conditions or benign prostatic hyperplasia; if used, administer at low end of dosage range
May cause CNS depression, which may impair mental abilities; use caution when operating heavy machinery
Use caution in cardiovascular disease, including hypertension and ischemic heart disease
Use with caution in patients with increased intraocular pressure, history of asthma or other chornic breathing disorders, or thyroid dysfunction
Nonanticholinergic antihistamines should be considered first for treatment of allergic reaction in the elderly (Beers criteria)
Antihistamines may cause excitation in young children
Pregnancy and Lactation
Pregnancy category: B
Lactation: Excretion in milk unknown; contraindicated
Maximum Dosage
0.5 mg/kg/day PO or 32 mg/day PO, whichever is less.
0.5 mg/kg/day PO or 32 mg/day PO, whichever is less.
15 to 17 years: 0.5 mg/kg/day PO or 32 mg/day PO, whichever is less.
13 to 14 years: 16 mg/day PO.
7 to 12 years: 16 mg/day PO.
2 to 6 years: 12 mg/day PO.
Less than 2 years: Safety and efficacy have not been established.
Safety and efficacy have not been established.
Use is contraindicated.
How supplied
Cyproheptadine hydrochloride
tablet
- 4mg
oral solution
- 2mg/5mL
