Generic Periactin (Cyproheptadine)

Introduction

Periactin is a prescription medication whose active ingredient is cyproheptadine, an antihistamine with additional antiserotonergic properties. It is supplied as a 4 mg oral tablet and belongs to the first-generation antihistamine class. The drug is approved primarily for the relief of allergic symptoms such as sneezing, itching, and rhinorrhea, as well as for the treatment of certain types of chronic urticaria. In some countries it is also indicated for the management of serotonin-mediated conditions like serotonin syndrome. Off-label, clinicians sometimes use cyproheptadine to stimulate appetite in patients with weight-loss disorders, although such use is not formally approved by regulatory agencies.

What is Periactin?

Periactin is a brand-name formulation of cyproheptadine hydrochloride. Cyproheptadine was first synthesized in the s and later marketed by Sanofi-Aventis under the trade name Periactin. The tablet is available in a fixed 4 mg dose, providing a convenient, once-daily regimen for most indications.

Periactin is the generic version of well-known medications, containing the active compound cyproheptadine. Our online pharmacy provides this generic alternative as a cost-effective treatment option.

Cyproheptadine is also marketed under other brand names such as Cyproheptadine Hydrochloride (generic) and Cypromex in select markets, which improves its recognizability for patients searching for “buy Periactin online” or “generic cyproheptadine cost.”

How Periactin Works

Cyproheptadine exerts its therapeutic effect through two principal mechanisms:

1. Histamine H₁-receptor antagonism - By blocking H₁ receptors on peripheral blood vessels and sensory nerves, the drug reduces the vasodilation, increased vascular permeability, and pruritus that characterize allergic reactions.
2. Serotonin (5-HT₂) antagonism - Cyproheptadine also binds to 5-HT₂ receptors, diminishing the serotonergic stimulation that contributes to symptoms of serotonin excess (e.g., tremor, hyperreflexia) and explaining its utility in serotonin- syndrome.

The onset of antihistaminic action typically occurs within 30-60 minutes after oral ingestion, with peak plasma concentrations reached in 2-3 hours. The elimination half-life ranges from 12 to 20 hours, supporting once-daily dosing for most patients. Metabolism occurs primarily via hepatic cytochrome P450 enzymes (CYP2D6 and CYP3A4), and the metabolites are excreted renally.

Conditions Treated with Periactin

1. Seasonal allergic rhinitis - Cyproheptadine reduces sneezing, nasal itching, and watery discharge by preventing histamine-mediated inflammation of the nasal mucosa.

2. Chronic urticaria (hives) - By stabilizing mast cells and blocking H₁ receptors, the medication alleviates the wheals and itching that persist beyond typical acute allergic episodes.

3. Serotonin syndrome (off-label but FDA-recognized as an emergency use) - The antiserotonergic activity can rapidly reverse life-threatening hyperthermia, agitation, and neuromuscular hyperactivity caused by excess serotonin, especially when used alongside serotonergic agents.

These indications are supported by FDA labeling and EMA assessment reports, which confirm the drug’s efficacy and safety profile for the listed uses.

Off-Label and Investigational Uses of Periactin

While not approved for these purposes, several peer-reviewed studies have explored additional therapeutic roles for cyproheptadine:

• Appetite stimulation in children with cystic fibrosis or cancer-related cachexia - Small clinical trials have shown modest weight gain, likely due to cyproheptadine’s antagonism of serotonin pathways that normally suppress hunger.
• Migraine prophylaxis - Case series suggest that the drug may reduce migraine frequency by dampening serotonergic vasodilation, though robust randomized data are lacking.
• Treatment of functional dyspepsia - The anticholinergic component of cyproheptadine has been investigated for its potential to relax gastrointestinal smooth muscle and improve symptoms.

These uses remain experimental. Patients should only consider them under direct supervision of a qualified healthcare professional, as efficacy and safety have not been formally validated by the FDA or EMA.

Is Periactin the Right Medication for You?

Periactin is most appropriate for adults who experience moderate to severe allergic rhinitis or chronic urticaria that is insufficiently controlled by second-generation antihistamines, or for patients at risk of serotonin excess from polypharmacy.

When it is particularly recommended:

• Persistent itching or hives despite non-sedating antihistamines.
• Need for a single daily dose that also offers anti-serotonin effects.
• Situations where a mild sedative effect is acceptable or beneficial (e.g., nighttime allergy symptoms).

Contraindications and cautions:

• Known hypersensitivity to cyproheptadine or any formulation components.
• Severe hepatic impairment (reduced metabolism may increase plasma levels).
• Concurrent use of monoamine oxidase inhibitors (MAOIs) due to risk of pronounced serotonergic interaction.
• Pregnancy and lactation: the drug is classified as Category C; it should be used only if the potential benefit justifies the potential risk.

Patients with uncontrolled glaucoma, prostatic hypertrophy, or a history of seizures should discuss alternative therapies, as cyproheptadine’s anticholinergic and central nervous system effects may exacerbate these conditions.

Risks, Side Effects, and Interactions

Common

• Drowsiness or sedation
• Dry mouth, thickened saliva
• Increased appetite and weight gain
• Mild constipation

Rare

• Visual disturbances (blurred vision, photophobia)
• Urinary retention, especially in men with enlarged prostate
• Extrapyramidal symptoms (rare tremor or rigidity)

Serious

• Cardiac arrhythmias (QT prolongation) in patients with pre-existing conduction disorders
• Severe hypersensitivity reactions ( Stevens-Johnson syndrome, anaphylaxis)
• Hepatotoxicity (elevated transaminases) in predisposed individuals

Drug-drug interactions

• Selective serotonin reuptake inhibitors (SSRIs) and other serotonergic agents - May increase risk of serotonin syndrome; dose adjustment or avoidance is advised.
• CYP2D6 inhibitors (e.g., fluoxetine, paroxetine) - Can raise cyproheptadine plasma concentrations, enhancing sedation and anticholinergic effects.
• Central nervous system depressants (benzodiazepines, alcohol) - Additive sedation; patients should limit alcohol intake and avoid operating heavy machinery.

Drug-food interactions

• No major food-drug interactions are documented, but a high-fat meal may delay absorption, slightly reducing the onset of action.

Patients should always inform their pharmacist or prescriber of all concomitant medications, supplements, and herbal products.

Use: Dosing, Missed Dose, Overdose

Standard dosing - For allergic rhinitis or chronic urticaria, the usual adult dose is 4 mg once daily taken with or without food. In cases of serotonin syndrome, higher or more frequent dosing may be employed under hospital supervision, but this is outside the scope of routine outpatient use.

Missed dose - If a dose is omitted and the scheduled time is still several hours away, take the missed tablet at the next regular dosing time. Do not double the dose to compensate.

Overdose - Acute overdose may present with pronounced central nervous system depression, severe anticholinergic signs (dry mouth, urinary retention, blurred vision), and cardiac arrhythmias. Immediate medical attention is required; supportive care, gastric decontamination, and cardiac monitoring are standard interventions.

Practical precautions -

• The tablet can be swallowed whole; crushing is not recommended because it may increase the rate of absorption and side-effects.
• Alcohol should be avoided, as it intensifies sedation.
• Patients should refrain from driving or operating hazardous equipment until they know how the drug affects them.

FAQ

• Can I take Periactin with antihistamine eye drops for seasonal allergies? Periactin can be combined with topical antihistamines such as olopatadine eye drops. Because the eye drops act locally and are not systemically absorbed, they do not increase the risk of systemic side effects.

• Is it safe to travel internationally with Periactin tablets? Yes, provided you carry the medication in its original packaging with a copy of the prescription label. Some countries may require a medical certificate for antihistamines, so it is prudent to check local import regulations before departure.

• What should I do if I experience severe drowsiness while driving? Stop driving immediately, move to a safe location, and rest until the drowsiness subsides. If the sedation persists, contact your healthcare provider to discuss dose adjustment or alternative therapy.

• Does Periactin contain any gluten or lactose? The inactive ingredients typically include microcrystalline cellulose, stearic acid, and magnesium stearate. None of these contain gluten or lactose, but formulations may vary by manufacturer; verify the excipient list on the product label if you have sensitivities.

• How long can I store Periactin at room temperature? The tablets remain stable for up to 24 months when stored in a dry place below 30 °C (86 °F) away from direct sunlight. Do not store in the bathroom or near a heat source.

• Will Periactin interfere with hormonal contraceptives? No clinically significant interaction has been reported between cyproheptadine and combined oral contraceptives. However, always inform your pharmacist of all medications to rule out rare interactions.

• Can Periactin be used to treat migraine headaches? Although some case reports suggest benefit, cyproheptadine is not approved for migraine prophylaxis. Use of the drug for this purpose should only occur within a clinical trial or under specialist supervision.

• Is Periactin available in a liquid formulation for patients who cannot swallow pills? Cyproheptadine is primarily marketed as oral tablets. Compounded liquid formulations can be prepared by a pharmacist, but they are not commercially available and may have different stability profiles.

• Does alcohol increase the risk of side effects from Periactin? Yes. Alcohol augments the sedative and anticholinergic effects of cyproheptadine, raising the likelihood of dizziness, drowsiness, and impaired coordination. Limiting alcohol consumption is advisable while taking the medication.

• What is the difference between Periactin and newer non-sedating antihistamines? Periactin belongs to the first-generation antihistamine class, which readily crosses the blood-brain barrier and therefore can cause sedation and anticholinergic effects. Newer second-generation antihistamines (e.g., cetirizine, loratadine) have limited central nervous system penetration, resulting in fewer drowsiness-related side effects.

Glossary

Antihistamine

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

Antiserotonergic

Refers to a substance that antagonizes serotonin receptors, most commonly the 5-HT₂ subtype, thereby reducing serotonergic activity in the nervous system.

First-generation antihistamine

A class of antihistamines that readily enters the brain, often causing sedation and anticholinergic side effects; examples include diphenhydramine and cyproheptadine.

Serotonin syndrome

A potentially life-threatening condition caused by excess serotonergic activity, characterized by hyperthermia, agitation, autonomic instability, and neuromuscular hyperreflexia.

Buying Periactin from Our Online Pharmacy

Patients seeking affordable access to cyproheptadine can obtain Periactin through our online pharmacy. We source the medication from licensed, international suppliers that meet stringent quality-control standards, ensuring each batch is authentic and pharmaco-peptide compliant.

• Cost-effective pricing - By purchasing directly from manufacturers, we keep the price close to wholesale cost, providing a significant saving compared with many retail pharmacies.
• Verified quality - Every shipment is accompanied by a certificate of analysis confirming potency, purity, and compliance with Good Manufacturing Practice (GMP) regulations.
• Discrete, reliable delivery - Orders are packaged in unmarked, tamper-evident containers and dispatched via secure courier services. Standard express delivery typically arrives within 7 days, while regular airmail takes approximately 3 weeks.
• International access - Our pharmacy broker service collaborates with overseas licensed pharmacies, enabling patients in regions with limited local availability to obtain the medication legally and safely.

We prioritize patient privacy and safety, offering a confidential purchasing experience without compromising on the integrity of the product.

Disclaimer

The information presented about Periactin serves only as general educational material. It does not substitute professional medical advice, diagnosis, or treatment. All therapeutic decisions, including those concerning off-label applications, should be made under the guidance of a qualified healthcare professional. Readers are presumed to be responsible adults capable of making informed health choices. Our online pharmacy provides access to Periactin for individuals who may encounter limited availability through conventional pharmacies or insurance formularies, or who are looking for cost-effective generic alternatives. Always discuss any medication changes with your clinician before initiating, altering, or discontinuing therapy.