Cyproheptadine (Periactin) Indications and Dosage
- allergic conjunctivitis
- allergic rhinitis
- anorexia †
- anorgasmy †
- Cushing’s syndrome †
- headache †
- migraine prophylaxis †
- pruritus
- spasticity †
- urticaria
† non-FDA-approved indication
Cyproheptadine (Periactin) Indications and Dosage
For prevention and treatment of allergic conditions, such as allergic rhinitis, allergic conjunctivitis, pruritus, or cold urticaria:
Oral dosage (oral tablets containing cyproheptadine hydrochloride 4 mg):
Adults and adolescents >= 15 years: 4 mg PO three times per day. Increase as necessary. Usual range is 4 - 20 mg/day, in divided doses. Maximum daily dosage is 0.5 mg/kg/day or 32 mg/day PO, whichever is less.
Adolescents 13 - 14 years and children >= 7 years: 4 mg PO two to three times per day. Maximum dosage is 16 mg/day.
Children 2 - 6 years: 0.25 mg/kg/day in two or three divided doses or 2 mg PO two to three times per day. Maximum dosage is 12 mg/day.
Children < 2 years: Safe and effective use has not been established.
Oral dosage (oral solution containing cyproheptadine hydrochloride 2 mg per 5 ml):
Adults and adolescents > 15 years: 10 ml PO three times per day. Usual range is 4 - 20 mg/day in divided doses. Maximum daily dosage is 0.5 mg/kg/day or 32 mg/day, whichever is less.
Adolescents 13 - 14 years and children >= 7 years: 10 ml PO two to three times per day or 0.25 mg/kg/day in divided doses. Maximum daily dosage is 16 mg/day.
Children 2 - 6 years: 5 ml PO two to three times per day or 0.25 mg/kg/day in divided doses. Maximum daily dosage is 12 mg/day.
Children < 2 years: Safe and effective use has not been established.
For the adjunct treatment of anorexia † nervosa or non-psychogenic anorexia † for stimulation of appetite:
NOTE: Exclude organic causes of weight loss before treatment begins.
Oral dosage:
Adults: Initially, 2 mg PO twice daily or three times daily with meals. May increase over 3 weeks to a usual maintenance dose of 8 - 12 mg/day PO given in two or three divided doses. Weight gain is usually noted during the first few weeks of therapy. In adults with anorexia nervosa, up to 8 mg PO four times per day has been administered
Elderly: Initially, 2 mg PO twice daily or three times daily with meals. May increase over 3 weeks to a usual maintenance dose of 8 - 12 mg/day PO given in two or three divided doses. Treatment period should not exceed 6 months. Weight gain is usually noted during the first few weeks of therapy.
Children 7 - 14 years: Initially, 2 mg PO twice daily or three times daily with meals. Maintenance dose is usually 4 mg PO 2 - 3 times per day. Maximum daily dosage should not exceed 16 mg. Weight gain is usually noted during the first few weeks of therapy.
Children 2 - 6 years: Initially, 2 mg PO two or three times per day with meals. May be increased, but maximum daily dosage should not exceed 12 mg. Weight gain is usually noted during the first few weeks of therapy.
For the treatment of male or female anorgasmy † secondary to antidepressant therapy:
Oral dosage:
Adults: 4 - 12 mg PO given one to two hours before anticipated sexual activity or up to 16 mg/day in divided doses.
For the treatment of Cushing’s syndrome † secondary to pituitary disorders:
Oral dosage:
Adults: Initially, 8 mg/day PO in divided doses. May increase gradually up to 24 mg/day in divided doses.
For prophylaxis and treatment of vascular headache † including migraine † (i.e., migraine prophylaxis † ):
Oral dosage:
Adults: At onset of attack, 4 mg PO. Repeat in 30 minutes, if necessary. Maintenance dose is 4 mg PO every 4 - 6 hours.
For the treatment of spasticity † associated with spinal cord injury:
Oral dosage:
Adults: 4 mg PO at bedtime. May be increased by 4 mg every 3 - 4 days as required for clinical response. Usual dosage: 16 mg/day PO in divided doses. Maximum recommended dose is 36 mg/day.
Maximum Dosage Limits:
- Adults: 0.5 mg/kg/day PO or 32 mg/day PO, whichever is less.
- Elderly: 0.5 mg/kg/day PO or 32 mg/day PO, whichever is less.
- Adolescents 15 - 18 years: 0.5 mg/kg/day PO or 32 mg/day PO, whichever is less.
- Adolescents 13 - 14 years: 16 mg/day PO.
- Children >= 7 years: 16 mg/day PO.
- Children 2 - 6 years: 12 mg/day PO.
- Children < 2 years: Safe and effective use not established.
- Infants: Safe and effective use not established.
Patients with hepatic impairment:
Dosage should be reduced for patients with hepatic impairment; however, specific guidelines for dosage adjustments are not available.
Patients with renal impairment:
Specific guidelines for dosage adjustments in renal impairment are not available; it appears that no dosage adjustments are needed.
† non-FDA-approved indication
[ Last revised: 4/28/2006 3:14:00 PM ]
References
. Schulman EA, Silberstein SD. Symptomatic and prophylactic treatment of migraine and tension-type headache. Neurology 1992;42(suppl 2):16 - 21.
. Gracies JM, Nance P, Elovic E et al. Traditional pharmacological treatments for spasticity. Part II: general and regional treatments. Muscle & Nerve 1997;6:S92 - 120.
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