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

• Pregnancy Rating: B

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

Mechanism of Action

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

References

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

Authors

Nicole Zadzilka, Neil Young, Daniel Ostermayer