Cyproheptadine

Uses

  • Treatment of serotonin syndrome

Administration

  • Dosage Forms: 4mg tab, 2mg/5ml solution
  • Routes of Administration: oral
  • Common Trade Names: Periactin or Peritol

Adult Dosing

  • initial dose of 12mg is recommended, followed by 2mg every two hours until clinical response is seen

Pediatric Dosing

  • Children younger than two years can be given approximately 0.06mg/kg per dose every six hours, if needed (not to exceed 0.25mg/kg/day).
  • Children two to six years can be given 2mg every six hours, if needed (not to exceed 12mg/day).
  • Children 7 to 14 years can be given 4mg every six hours, if needed (not to exceed 16mg/day).

Special Populations

Renal Dosing

  • No recommendations

Hepatic Dosing

  • No recommendations

Contraindications

  • Allergy to class/drug
  • Treatment in newborns or nursing mothers

Adverse Reactions

Serious

  • Hypotension

Common

  • Sedation

Pharmacology

  • Half-life: 1-4 hours
  • Metabolism: Liver
  • Excretion: Urine

Mechanism of Action

  • Histamine-1 receptor antagonist
  • 5-HT1A and 5-HT2A (seritonin) antagonistic properties
  • Weak anticholinergic activity

Comments

See Also

References

  • 1. Boyer EW. Serotonin syndrome. In: UpToDate, Post TW (Ed), UpToDate, Waltham, MA. (Accessed on January 11, 2016.)