Brand Name and Composition

Periactin is the brand name for the generic medication cyproheptadine hydrochloride. It is formulated as tablets and oral syrup to deliver antihistamine effects. The active component, cyproheptadine hydrochloride, is a first-generation antihistamine and antiserotonergic agent.

Pharmacological Class

Periactin belongs to the class of medications known as antihistamines. It primarily functions by blocking histamine H1 receptors to alleviate allergic symptoms and has notable anticholinergic properties. This class includes other drugs with a similar mechanism, but Periactin is distinct due to its antiserotonergic effects.

Mechanism of Action

Periactin operates by obstructing the action of histamine, a natural substance in the body that causes allergy symptoms. Antihistamine activity mitigates symptoms like runny nose, sneezing, and itching. Additionally, it has a moderate ability to antagonize serotonin, which contributes to its efficacy in treating migraine headaches.

Approved Indications

Periactin is prescribed for the management of allergic reactions, such as hay fever, rhinitis, and skin conditions like urticaria. Furthermore, it is indicated as an adjunctive therapy for migraines. It also serves off-label purposes, including appetite stimulation and treatment of cold-induced welts.

Dosage and Administration

The dosage of Periactin varies based on age, condition being treated, and response to therapy. Typically, adults start with an initial dose of 4 mg three times daily, with adjustments made according to therapeutic response. Pediatric doses differ, starting lower and increasing cautiously. The maximum advised daily dose should not exceed 32 mg in adults.

Contraindications and Precautions

Periactin is contraindicated in patients with a known hypersensitivity to cyproheptadine. It is also not recommended for newborns or premature infants. Caution is advised in individuals with glaucoma, peptic ulcer, symptomatic prostatic hypertrophy, bladder neck obstruction, and pyloroduodenal obstruction.

Drug Interactions

Concomitant use with monoamine oxidase inhibitors is contraindicated due to potential for prolonged and intensified anticholinergic effects. Periactin may interact with other central nervous system depressants, potentiating effects such as drowsiness. Alcohol ingestion should be limited due to similar additive CNS depressant effects.

Side Effects Profile

Common side effects of Periactin include drowsiness, dizziness, and dry mouth. Gastrointestinal disturbances such as nausea, constipation, or diarrhea can occur. Less frequently, it may result in hypotension, blurred vision, or central nervous system excitation. Symptoms often manifest early in treatment and may diminish with continued use.

Use in Special Populations

In elderly patients, Periactin should be administered with caution due to increased risk of sedative and confusion effects. Pediatric use requires careful dosing, mindful of potential paradoxical excitement in young children. In pregnancy, it should only be used when benefits outweigh risks, as safety data is limited.

Monitoring and Follow-Up

Monitoring patient response to Periactin involves assessing both efficacy in symptom relief and frequency of adverse effects. Regular check-ups should be scheduled to adjust dosages as necessary and ensure continued therapeutic benefit. Patients experiencing excessive sedation or anticholinergic side effects should be reviewed for potential dose adjustments.

Storage and Handling

Store Periactin at room temperature, away from direct sunlight and moisture. Ensure the medication is kept in its original container, tightly closed when not in use, and out of reach of children and pets. Proper disposal instructions should be followed for any unused or expired medication.

Patient Counseling Information

Patients should be apprised of potential side effects and advised on managing them, such as combating dry mouth with hydration. They should be cautioned about operating machinery or driving if they experience drowsiness. It is crucial to inform the clinician of all concomitant medications to prevent interactions. Encourage adherence to dosing schedules for optimal efficacy.