Periactin: Effective Appetite Stimulation and Allergy Relief
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Synonyms
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Periactin (cyproheptadine hydrochloride) is a first-generation antihistamine and serotonin antagonist indicated for the management of allergic conditions and appetite stimulation. As a multipurpose therapeutic agent with well-established efficacy, it works by blocking histamine H1 receptors and exhibiting anticholinergic properties. This medication is particularly valuable in clinical scenarios where weight gain is medically desirable and for providing symptomatic relief in various allergic presentations. Under proper medical supervision, Periactin offers a dual-action approach to addressing both nutritional and allergic concerns.
Features
- Contains cyproheptadine hydrochloride as the active pharmaceutical ingredient
- Available in 4mg scored tablets for precise dosing
- Exhibits both antihistamine and antiserotonergic properties
- Demonstrates rapid oral absorption with onset of action within 20-30 minutes
- Features a half-life of approximately 8 hours for sustained effect
- Provides dual indication for allergic conditions and appetite stimulation
Benefits
- Effectively stimulates appetite in patients with cachexia or weight loss concerns
- Provides rapid relief from allergic symptoms including itching, hives, and rhinitis
- Helps manage migraine and cluster headaches through serotonin antagonism
- Supports weight gain in pediatric patients with failure to thrive
- Reduces allergic dermatological manifestations through histamine blockade
- Offers cost-effective therapy compared to newer appetite stimulants
Common use
Periactin is commonly prescribed for the management of various allergic conditions including seasonal allergic rhinitis, chronic urticaria, angioedema, and dermatographism. Its appetite-stimulating properties make it particularly valuable in clinical situations requiring weight gain, such as in patients with cancer-related cachexia, HIV-associated wasting syndrome, or elderly patients with unintentional weight loss. The medication is also used off-label for the prevention of migraine headaches and management of serotonin syndrome. Pediatric applications include treatment of failure to thrive when nutritional approaches alone have proven insufficient.
Dosage and direction
For appetite stimulation in adults: Initial dose of 4mg three times daily, which may be increased gradually to a maximum of 32mg daily based on therapeutic response and tolerance. For allergic conditions: 4-20mg daily in divided doses, not to exceed 0.5mg/kg/day. Pediatric dosing for children aged 2-6 years: 2mg two or three times daily, not to exceed 12mg daily. For children aged 7-14 years: 4mg two or three times daily, not to exceed 16mg daily. Administration should occur with food or milk to minimize gastrointestinal discomfort. Dosage adjustments are necessary for elderly patients and those with hepatic impairment.
Precautions
Patients should be cautioned regarding the sedative effects of Periactin and advised to avoid driving or operating machinery until their response to the medication is established. Use with caution in patients with hypertension, cardiovascular disease, hyperthyroidism, or prostatic hypertrophy. The anticholinergic effects may cause dry mouth, blurred vision, and urinary retention. Elderly patients are particularly susceptible to dizziness, sedation, and confusion. Avoid alcohol and other CNS depressants during therapy. Regular monitoring of weight, appetite, and potential side effects is recommended throughout treatment.
Contraindications
Periactin is contraindicated in patients with known hypersensitivity to cyproheptadine or other antihistamines of similar chemical structure. It should not be used in neonates or premature infants due to increased risk of anticholinergic effects. Additional contraindications include narrow-angle glaucoma, bladder neck obstruction, peptic ulcer disease, and concomitant use of MAO inhibitors. Patients with stenosing peptic ulcer, pyloroduodenal obstruction, or symptomatic prostatic hypertrophy should avoid this medication. Use during asthma attacks is contraindicated due to potential thickening of bronchial secretions.
Possible side effect
Common side effects include drowsiness (affecting approximately 20-50% of patients), dizziness, dry mouth, nausea, and appetite increase. Less frequently reported effects include blurred vision, constipation, urinary retention, and weight gain. Rare but serious adverse reactions may include hypotension, palpitations, arrhythmias, hematological abnormalities, and seizures. Pediatric patients may experience paradoxical excitation including agitation, hallucinations, or insomnia. Allergic reactions such as rash, photosensitivity, and anaphylaxis have been reported in rare instances.
Drug interaction
Periactin exhibits significant interactions with CNS depressants including alcohol, benzodiazepines, and opioids, potentially enhancing sedative effects. Concomitant use with MAO inhibitors may prolong and intensify anticholinergic effects. The medication may counteract the effects of adrenergic agents and enhance the effects of anticholinergic drugs. Cyproheptadine may diminish the effectiveness of SSRIs and other serotonergic agents. Use with other appetite stimulants may lead to excessive weight gain. The metabolism may be affected by hepatic enzyme inducers or inhibitors.
Missed dose
If a dose is missed, it should be taken as soon as remembered unless it is nearly time for the next scheduled dose. In that case, patients should skip the missed dose and resume the regular dosing schedule. Doubling of doses to make up for a missed dose is not recommended due to increased risk of side effects. For patients taking multiple daily doses, maintaining consistent timing helps optimize therapeutic effects while minimizing adverse reactions. Healthcare providers should be consulted if multiple doses are frequently missed to assess whether regimen adjustment is necessary.
Overdose
Symptoms of overdose may include severe CNS depression (ranging from drowsiness to coma) or paradoxical CNS stimulation including hallucinations and convulsions. Anticholinergic effects may be pronounced with dry mouth, fixed dilated pupils, flushing, and gastrointestinal symptoms. Cardiovascular manifestations may include tachycardia, hypotension, or cardiac arrhythmias. Treatment involves gastric lavage if presented early, followed by activated charcoal administration. Supportive measures include maintaining airway, monitoring vital signs, and managing symptoms. Physostigmine may be considered in severe cases under careful monitoring.
Storage
Store Periactin tablets at controlled room temperature between 20-25°C (68-77°F) in their original container. Protect from light, moisture, and excessive heat. Keep the medication out of reach of children and pets. Do not transfer tablets to other containers as this may affect stability. Discard any medication that has expired or shows signs of deterioration such as discoloration or unusual odor. Proper disposal methods should be followed according to local regulations, preferably through medication take-back programs.
Disclaimer
This information is provided for educational purposes only and does not constitute medical advice. Periactin is a prescription medication that should only be used under the supervision of a qualified healthcare professional. Individual response to medication may vary, and the prescribing physician will determine appropriate dosage based on specific medical circumstances. Patients should not initiate, discontinue, or change dosage without consulting their healthcare provider. The complete prescribing information should be reviewed before initiating therapy.
Reviews
Clinical studies demonstrate Periactin’s efficacy in appetite stimulation with weight gain of 2-5 kg observed in most patients within 4-8 weeks of therapy. In allergic conditions, 70-80% of patients report significant symptom improvement. Pediatric studies show particular effectiveness in failure to thrive cases where nutritional approaches alone were insufficient. Some patients report sedation as a limiting factor, though this often diminishes with continued use. The medication receives generally positive clinical feedback for its dual-action benefits, though individual tolerance varies. Long-term safety data supports its use for extended periods under medical supervision.