Peritol® [Cyproheptadine]

Pharmacological properties

An antihistamine (an H1 receptor blocker) with antiserotonin activity. prevents the development and facilitates the course of allergic reactions. in addition to antiallergic, it has antipruritic, antiexudative, anticholinergic and sedative effects, stimulates appetite.

When taken orally, it is quickly and well absorbed in the digestive tract. The maximum concentration in the blood is achieved during the first 2 hours; therapeutic concentration level persists for 4-6 hours. Penetration of the drug through the placental barrier and into breast milk is not proven. Intensively metabolized in the liver, from 2 to 20% is excreted through the stomach, 34% - unchanged. At least 40% of the administered dose of the drug is excreted in the urine. The half-life is 16 hours.

Indications

Acute and chronic urticaria, serum sickness, hay fever, vasomotor and allergic rhinitis; allergic reactions that occur when taking medications, exanthema, eczematous, contact dermatitis, neurodermatitis, angioedema, insect bites, carcinoid syndrome, headache of vascular origin (migraine, "histamine" headache). the drug can also be used for anorexia of various origins (anorexia nervosa, idiopathic anorexia), as well as for cachexia (due to an infectious disease, with exhaustion, hyperthyroidism).

Application

Tablets: usually the initial daily dose is 12 mg (1 tablet 3 times a day). this dose can be increased to a maximum of 32 mg / day (until the disappearance of the symptoms of the disease or as directed by the doctor).

Chronic urticaria: 6 mg / day (in ¹/₂ tablets 3 times a day) until the symptoms disappear.

Acute migraine attack: 1 tablet. If the pain continues to bother, taking the drug in the same dose can be repeated after 30 minutes, but not more than 8 mg (2 tablets) for 4-6 hours.

For maintenance therapy, in most cases, it is enough to take 4 mg (1 tablet) 3 times a day.

Anorexia: in case of anorexia, take 1 tablet 3 times a day. For children aged 3-6 years - 6 mg / day (for ¹/₂ tablets 3 times a day). The maximum dose can be increased to 8 mg / day (no more than 2 tablets).

For children aged 7-14 years, the dose is 12 mg / day (1 tablet 3 times a day).

Syrup: adults: usually the initial dose is 12 mg (10 ml of syrup 3 times a day).

This dose can be increased to a maximum of 32 mg / day (4 times in 20 ml of syrup).

In chronic urticaria, adults - 6 mg / day (5 ml of syrup 3 times a day), with migraine - 4 mg / day (10 ml of syrup at the same time). If the pain continues to bother, taking the drug in the same dose can be repeated after 30 minutes. Do not use a dose above 8 mg (10 ml 2 times a day) for 4-6 hours.

For maintenance therapy, usually 12 ml (3 times 10 ml / day) is sufficient. The period of treatment depends on the effectiveness of therapy and the patients condition and is determined by the doctor.

Children aged 2-6 years are prescribed a dose of 0.25 mg / kg body weight; at the age of 7-14 years, the daily dose is 8-12 mg (10 ml of syrup 2-3 times a day).

1 teaspoon contains 5 ml of syrup. 1 dessert spoon contains 10 ml of syrup.

In patients with impaired renal function, liver, it may be necessary to reduce the dose.

Contraindications

Pertolit tablets and syrup are used for:

• hypersensitivity to the components of the drug;

• glaucoma

• peripheral edema;

• benign prostatic hyperplasia;

• violation of urination;

• during pregnancy and lactation;

• children under the age of 2 years.

Side effects

CNS: most often - drowsiness, usually passing through 3-4 days, sometimes as a result of this you have to cancel the drug. other side effects include sedation, dizziness, tinnitus, confusion, impaired coordination of movements, ataxia, disturbed accommodation (mydriasis), double vision, visual hallucinations, anxiety, tremors, irritability, insomnia, paresthesia, neuritis, headaches pain, weakness.

Allergic reactions: erythema, purpura, urticaria, edema. In some cases, Quinckes edema and anaphylactic shock.

Skin: erythema, skin rashes, photosensitivity.

Hemopoietic system: hemolytic anemia, leukopenia, agranulocytosis, thrombocytopenia.

Cardiovascular system: hypotension, tachycardia, extrasystole.

Respiratory systems: thickening of bronchial secretions, dyspnea, runny nose.

Gastrointestinal tract: dry mouth, nausea, vomiting, discomfort in the epigastric region, diarrhea or constipation, cholestasis, hepatitis, jaundice.

Urinary system: frequent urination, difficulty emptying the bladder, urinary retention.

Other side effects: while taking Peritol, the patient’s body weight often increases.

special instructions

In connection with the sedative effect of the drug at the beginning of the course of treatment, it is recommended to use the first dose in the evening after the last meal.

When using Peritol, weakened patients or elderly patients should be careful, because they often develop side effects (dizziness, drowsiness, hypotension).

Care should be taken in treating children, as they may often develop side effects such as anxiety.

In the initial period of therapy, patients may complain of dizziness, drowsiness. Therefore, at the beginning of the course of treatment with Peritol, it is necessary to refrain from driving vehicles and working with mechanisms, as well as performing work that requires increased attention. In the future, the degree of this restriction is determined individually.

In connection with the presence of an anticholinergic effect, caution is advised when prescribing Peritol in such conditions:

• BA

• high intraocular pressure;

• hyperthyroidism;

• cardiovascular diseases;

• AH.

Alcohol can enhance the inhibitory effect of antihistamines on CNS function (sedative effect). Therefore, during the period of treatment with Peritol, it is forbidden to drink alcoholic beverages.

Prolonged use of antihistamines may, in some cases, cause impaired hematopoiesis (leukopenia, agranulocytosis, thrombocytopepia, hemolytic anemia). Therefore, patients with complaints of unexplained fever, sore throat, damage to the oral mucosa, jaundice, ecchymosis, and persistent bleeding should be carefully examined to determine the hemogram. If severe violations are identified, the need to discontinue the drug should be considered.

Peritol syrup contains sucrose. In 1 teaspoon (5 ml) contains 2 g, in 1 dessert spoon (10 mg) - 4 g of sucrose. Therefore, the appointment of a syrup is contraindicated in children with fructose intolerance or impaired glucose / galactose absorption, as well as with sucrose / maltose deficiency.

Peritol contains 5% alcohol. 1 teaspoon of syrup (5 ml) contains 0.25 g, and 1 dessert spoon (10 mg) contains 0.5 g of alcohol. Peritol Syrupit should be prescribed with great care for liver diseases, alcoholism, epilepsy, brain injury or other diseases of the central nervous system. Long-term (more than 1 week) use of syrup in children should be carried out only after careful weighing of the benefit / risk ratio.

Syrup should be used within 4 weeks after opening the bottle.

Interactions

MAO inhibitors enhance and increase the duration of the anticholinergic effect of the drug.

Caution is necessary with the simultaneous use of the drug Peritol and other substances that inhibit the activity of the central nervous system (sleeping pills, sedatives, anxiolytics, alcohol), while it is possible to increase their sedative effect

Overdose

Symptoms: in children - excessive agitation, anxiety, hallucinations, convulsions. in adults - depression, coma, sometimes psychomotor agitation, convulsions.

Treatment: gastric lavage, the use of activated carbon; with the development of pronounced atropine-like effects - parenteral administration of a solution of physostigmine salicylate; according to indications - vasoconstrictor and anticonvulsants. Mechanical ventilation and other resuscitation measures.

Storage conditions

At a temperature of 15–25 ° C. after opening the bottle with syrup, use it for 4 weeks.