Generic Cyproheptadine

Introduction

Cyproheptadine is an antihistamine belonging to the first‑generation H₁‑receptor antagonist group. In the United Kingdom it is licensed primarily for the treatment of allergic conditions such as urticaria and allergic rhinitis, and it is also used off‑label to stimulate appetite in patients with refractory weight loss. The active compound, cyproheptadine, exerts its therapeutic effect by blocking histamine receptors and possesses additional antiserotonergic activity, which contributes to its usefulness in certain neurological and gastrointestinal disorders. The medication is marketed by several manufacturers; the original brand name is Periactin (formerly by Schering‑Plough, now part of Merck). The generic form, which contains the same active compound, is widely available and offers a cost‑effective alternative for adult patients throughout the UK.

What is Cyproheptadine?

Cyproheptadine is the generic version of Periactin, containing the same active compound cyproheptadine. It is classified as a first‑generation antihistamine with additional antiserotonergic properties. The drug was first synthesized in the 196s and has been incorporated into the British National Formulary (BNF) as a prescription‑only medicine for adults. While multiple pharmaceutical companies manufacture the generic formulation, the active ingredient remains identical to the brand product, providing equivalent clinical efficacy. Our online pharmacy provides this generic alternative as a cost‑effective treatment option for patients who need reliable allergy relief or appetite stimulation.

How Cyproheptadine Works

Cyproheptadine blocks the H₁‑histamine receptor located on smooth muscle, endothelial cells and sensory nerves. By preventing histamine from binding, it reduces vasodilation, capillary permeability and the activation of sensory nerve endings that produce itching and sneezing. In addition, cyproheptadine antagonises several serotonin (5‑HT₂) receptors, which moderates serotonergic neurotransmission in the central nervous system. This antiserotonergic effect underlies its appetite‑stimulating properties and its use in certain serotonin‑dependent migraine prophylaxis protocols.

After oral ingestion, cyproheptadine is rapidly absorbed, reaching peak plasma concentrations within 1–2 hours. The drug is highly protein‑bound (≈ 95 %) and undergoes hepatic metabolism principally via CYP2D6 and CYP3A4 pathways. The elimination half‑life is approximately 8 hours in healthy adults, allowing for once‑ or twice‑daily dosing depending on the indication. Because it readily crosses the blood‑brain barrier, central nervous system effects such as sedation are common.

Conditions Treated with Cyproheptadine

• Allergic rhinitis and seasonal hay fever – Histamine release in the nasal mucosa causes congestion, rhinorrhoea and sneezing; cyproheptadine reduces these symptoms effectively.
• Chronic urticaria (hives) – By stabilising cutaneous mast cells, the drug limits wheal formation and pruritus.
• Food‑related hypersensitivity – Occasionally used for mild to moderate food allergy manifestations when other antihistamines are unsuitable.
• Serotonin‑mediated migraine prophylaxis – The antiserotonergic action can diminish migraine frequency in selected patients, although this is an off‑label use.
• Appetite stimulation in underweight adults – Particularly in conditions such as cancer‑related cachexia, cystic fibrosis, or post‑surgical recovery where increased caloric intake is clinically desirable.

In the UK, the National Institute for Health and Care Excellence (NICE) references cyproheptadine as a second‑line option for refractory urticaria after second‑generation antihistamines have failed. Its dual antihistamine/antiserotonergic profile makes it uniquely useful for patients with overlapping allergic and gastrointestinal symptoms.

Suitable Candidates for Cyproheptadine Treatment

Cyproheptadine is appropriate for adult patients who:

• Have persistent allergic rhinitis or chronic urticaria that does not adequately respond to non‑sedating antihistamines.
• Require an appetite‑stimulating adjunct for medically documented weight loss, provided other causes have been excluded.
• Experience mild to moderate serotonin‑related migraine attacks and have contraindications to first‑line migraine preventatives.

The drug should be avoided or used with caution in:

• Individuals with known hypersensitivity to cyproheptadine or any of its excipients.
• Patients with severe hepatic impairment, as metabolism may be markedly reduced.
• Those taking monoamine oxidase inhibitors (MAOIs) or other serotonergic agents, because of increased risk of serotonin syndrome.
• Pregnant or breastfeeding women, unless the potential benefit justifies the risk (currently classified as Category B3 in the UK).

Older adults (≥ 65 years) may experience enhanced sedation and anticholinergic effects; dose adjustments and close monitoring are recommended.

Risks, Side Effects, and Interactions

Common

• Drowsiness or fatigue
• Dry mouth, thirst, or mild constipation
• Increased appetite leading to weight gain
• Dizziness, especially when standing (orthostatic hypotension)

These effects are dose‑dependent and typically diminish after the first few days of therapy as the body acclimates.

Rare

• Visual disturbances (blurred vision, difficulty focusing)
• Hepatic enzyme elevation (transaminases)
• Extrapyramidal symptoms (rare, due to central serotonergic blockade)

Patients experiencing any of these should contact a healthcare professional promptly.

Serious

• Severe allergic reaction (anaphylaxis, angio‑edema)
• Cardiac arrhythmias, particularly in patients with pre‑existing conduction disorders
• Serotonin syndrome when combined with MAOIs, selective serotonin reuptake inhibitors (SSRIs), or tramadol

Immediate medical attention is required for any signs of serious adverse events.

Clinically Relevant Drug–Drug Interactions

• MAO Inhibitors – Concomitant use can precipitate serotonin syndrome; a wash‑out period of at least 14 days is advised.
• CYP2D6/CYP3A4 inhibitors (e.g., erythromycin, ketoconazole) – May increase cyproheptadine plasma levels, raising the risk of sedation and anticholinergic side effects.
• Central nervous system depressants (e.g., benzodiazepines, alcohol) – Additive sedative effects; patients should limit alcohol intake.
• Anticholinergic agents (e.g., oxybutynin) – Combined anticholinergic load can exacerbate dry mouth, urinary retention, and constipation.

Practical Use: Dosing, Missed Dose, Overdose

• Standard adult dosing for allergic indications: 4 mg (typically one tablet) taken once daily at bedtime. Some clinicians increase to 4 mg twice daily (morning and night) if symptoms persist.
• Appetite stimulation: 4 mg taken twice daily, preferably with meals to reduce gastrointestinal upset.
• Maximum recommended dose: 8 mg per day for most adult indications; higher doses have not shown additional benefit and increase adverse‑event risk.

Missed dose: If a dose is forgotten, take it as soon as remembered unless it is close to the next scheduled dose. In that case, skip the missed dose and continue the regular schedule; do not double‑dose.

Overdose: Symptoms may include profound drowsiness, tachycardia, dilated pupils, and seizures. Immediate medical evaluation is essential. Supportive care, airway protection, and monitoring of cardiac rhythm are the mainstays of treatment.

Precautions:

• Take the medication with a full glass of water; food can delay absorption but does not affect overall efficacy.
• Avoid operating heavy machinery or driving until you know how cyproheptadine affects you.
• Chronic alcohol consumption may potentiate hepatic metabolism alterations; discuss alcohol use with a clinician.
• Renal impairment does not significantly affect clearance, but severe hepatic disease requires dose reduction.

Buying Cyproheptadine from Our Online Pharmacy

Cyproheptadine can be purchased from our online pharmacy in the UK with a streamlined, discreet ordering process.

• Affordable pricing – We source the generic product close to manufacturer cost, passing savings directly to the patient.
• Verified quality – All batches are supplied by licensed overseas pharmacies that comply with EU‑GMP standards; each shipment includes a Certificate of Analysis.
• Guaranteed delivery – Options include 7‑day express courier for urgent needs and ~3‑week regular airmail for cost‑effective shipping. Packages are sealed in tamper‑evident containers and labelled only with the generic drug name to protect privacy.
• Online‑only access – For patients who encounter limited stock or high prices in local community pharmacies, our broker service connects you with reliable international suppliers while respecting UK import regulations.

By choosing our pharmacy, you receive a trusted, cost‑effective alternative to brand‑name cyproheptadine, ensuring continuity of treatment for allergy control or appetite support.

FAQ

• Is Cyproheptadine available in both brand‑name and generic forms in the UK?
  Yes. The original brand‑name formulation is marketed as Periactin, while generic versions containing the same active compound are widely distributed. Generic preparations are typically less expensive and are considered therapeutically equivalent.

• Does Cyproheptadine require refrigeration?
  No. The tablets should be stored at controlled room temperature, ideally between 15 °C and 30 °C, away from excess heat and moisture.

• What do Cyproheptadine tablets look like?
  Generic tablets are usually round, white to off‑white, and scored for ease of splitting. In the UK, they are often supplied in blister packs of 28 tablets, corresponding to a standard four‑week supply at a once‑daily dose.

• Can Cyproheptadine be imported for personal use under UK law?
  Personal import of a prescription‑only medicine is permitted in limited quantities (up to a three‑month supply) for personal use, provided the patient holds a valid prescription from a UK‑registered prescriber. Our pharmacy assists with the necessary documentation to comply with HMRC and MHRA requirements.

• Are there any special warnings for people of Asian descent?
  Pharmacogenomic studies suggest that certain CYP2D6 polymorphisms, which are more prevalent in some Asian populations, may affect cyproheptadine metabolism, potentially leading to higher plasma concentrations. Clinicians may consider dose adjustments or increased monitoring in these individuals.

• How does Cyproheptadine compare with newer, non‑sedating antihistamines?
  First‑generation agents like cyproheptadine have a higher propensity for central nervous system side effects, such as drowsiness, compared with second‑generation antihistamines (e.g., cetirizine, loratadine). However, cyproheptadine’s additional antiserotonergic activity makes it useful for appetite stimulation and certain migraine prophylaxis scenarios where newer antihistamines lack efficacy.

• What should I do if I experience severe drowsiness while taking Cyproheptadine?
  Reducing the dose or shifting the administration to bedtime can mitigate daytime sedation. If drowsiness persists or interferes with daily activities, discuss alternative therapy options with a healthcare professional.

• Does Cyproheptadine interact with over‑the‑counter cough medicines?
  Many cough syrups contain dextromethorphan, which has serotonergic activity. Co‑administration may increase the risk of serotonin syndrome, especially if other serotonergic drugs are used concurrently. It is advisable to avoid such combinations or seek medical advice before use.

• Can I take Cyproheptadine while traveling abroad?
  Yes, but keep the medication in its original packaging with a copy of the prescription and a letter from your prescriber if possible. Ensure you comply with the destination country’s import regulations and keep the tablets in carry‑on luggage to avoid temperature extremes.

Glossary

Antihistamine

A drug that blocks histamine H₁ receptors, reducing allergic symptoms such as itching, swelling, and vasodilation.

Antiserotonergic

Refers to the ability of a substance to inhibit the action of serotonin (5‑HT) at its receptors, influencing mood, appetite, and vascular tone.

First‑generation antihistamine

An older class of antihistamines that readily cross the blood‑brain barrier, often causing sedation and anticholinergic side effects.

Serotonin syndrome

A potentially life‑threatening condition caused by excessive serotonergic activity, characterised by agitation, hyperthermia, hypertension, and neuromuscular abnormalities.

⚠️ Disclaimer

The information provided about Cyproheptadine is for general knowledge only. It does not replace professional medical consultation. All treatment decisions should be made under the supervision of a qualified healthcare provider. We assume all readers are responsible adults capable of making informed decisions about their health. Our online pharmacy offers access to Cyproheptadine for individuals who may have limited availability through traditional pharmacies, prescription‑based insurance schemes, or who are seeking affordable generic alternatives. Always consult your doctor before starting, changing, or discontinuing any medication.