Cyproheptadine (Periactin) Adverse Reactions
- abdominal pain
- appetite stimulation
- blurred vision
- cholestasis
- confusion
- constipation
- diarrhea
- dizziness
- drowsiness
- elevated hepatic enzymes
- headache
- hepatitis
- hypotension
- impaired cognition
- insomnia
- jaundice
- nausea/vomiting
- palpitations
- restlessness
- seizures
- sinus tachycardia
- urinary retention
- weakness
- xerophthalmia
- xerostomia
Cyproheptadine (Periactin) Adverse Reactions
CNS depression, manifested as drowsiness and/or dizziness, can occur during therapy with cyproheptadine. There is considerable individual patient response to sedative effects, so patients should be warned of the possibility of impaired cognition. These side effects may disappear after a few days of medication. Geriatric patients may be more predisposed to developing adverse CNS depressant effects, and alcohol intake will increase the risk of sedation. If symptoms persist or are severe, a dose reduction or change to another H1-antagonists may be advisable. Other possible CNS effects include headache, confusion, and muscular weakness. H1-antagonists can also cause CNS stimulation; although, this is more likely to occur in children. Symptoms may include restlessness, insomnia, palpitations, and in severe cases, seizures.
Cyproheptadine possesses a moderate degree of anticholinergic activity. Anticholinergic effects that can occur during therapy include thickening of bronchial secretions, xerostomia, urinary retention, insomnia, nervousness, xerophthalmia, and/or blurred vision. Geriatric patients are more susceptible to these adverse reactions, since endogenous cholinergic activity declines with age.
H1-antagonists can cause adverse GI effects including nausea/vomiting, diarrhea, constipation, and/or abdominal pain. Some of these adverse reactions may be relieved by taking the drug with meals or milk. Cyproheptadine has been associated with appetite stimulation. Rare cases of drug-induced hepatotoxicity (e.g., hepatitis, cholestasis, jaundice, and/or elevated hepatic enzymes) have been associated with cyproheptadine therapy. In one case, acute hepatitis was followed by a protracted cholestasis. The authors proposed that the hepatotoxicity might occur due to the tricyclic structure of cyproheptadine.
Adverse cardiovascular responses are likely to be associated with the anticholinergic properties or the quinidine-like anesthetic effects of antihistamines. These responses may include sinus tachycardia, extrasystoles, palpitations, and/or cardiac arrhythmias. Alpha-adrenergic blockade may lead to hypotension. Hypertension may also occur, but is usually not of clinical significance.
[ Last revised: 4/4/2003 4:08:00 PM ]
References
. Larrey D, Geneve J, Pessayre D, et al. Prolonged cholestasis after cyproheptadine-induced acute hepatitis. J Clin Gastroenterol 1987;9:102 - 4.
. Periactin® (cyproheptadine) package insert. West Point, PA: Merck and Company, Inc.; 1999 Jan.
Related entries
Syndicate
|
