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Periactin Disease Interactions

There are 4 disease interactions with Periactin (cyproheptadine).

Moderate

Antihistamines (applies to Periactin) anticholinergic effects

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Gastrointestinal Obstruction, Glaucoma/Intraocular Hypertension, Urinary Retention

Antihistamines often have anticholinergic activity, to which elderly patients are particularly sensitive. Therapy with antihistamines should be administered cautiously, if at all, in patients with preexisting conditions that are likely to be exacerbated by anticholinergic activity, such as urinary retention or obstruction; angle-closure glaucoma, untreated intraocular hypertension, or uncontrolled primary open-angle glaucoma; and gastrointestinal obstructive disorders. Conventional, first-generation antihistamines such as the ethanolamines (bromodiphenhydramine, carbinoxamine, clemastine, dimenhydrinate, diphenhydramine, doxylamine, phenyltoloxamine) tend to exhibit substantial anticholinergic effects. In contrast, the newer, relatively nonsedating antihistamines (e.g., cetirizine, fexofenadine, loratadine) reportedly have low to minimal anticholinergic activity at normally recommended dosages and may be appropriate alternatives.

References

  1. Schuller DE, Turkewitz D "Adverse effects of antihistamines." Postgrad Med 79 (1986): 75-86
  2. "Product Information. Dimetane (brompheniramine)." Wyeth-Ayerst Laboratories PROD (2002):
  3. "Product Information. Chlor-Trimeton (chlorpheniramine)." Schering-Plough PROD
  4. "Product Information. Periactin (cyproheptadine)." Merck & Co., Inc PROD (2002):
  5. "Product Information. Benadryl (diphenhydramine)." Parke-Davis PROD (2002):
  6. "Product Information. Phenergan (promethazine)." Wyeth-Ayerst Laboratories PROD (2001):
  7. "Product Information. Tavist (clemastine)." Sandoz Pharmaceuticals Corporation PROD (2001):
  8. "Product Information. Antivert (meclizine)." Roerig Division PROD (2001):
  9. "Product Information. Marezine (cyclizine)." Glaxo Wellcome PROD (2001):
  10. "Product Information. Optimine (azatadine)." Schering Corporation PROD (2001):
  11. "Product Information. Semprex-D (acrivastine-pseudoephedrine)." Endo Laboratories LLC PROD (2001):
  12. "Product Information. Zyrtec (cetirizine)." Pfizer U.S. Pharmaceuticals PROD (2001):
  13. "Product Information. Drixoral (dextromethorphan)." Schering-Plough PROD (2001):
  14. "Product Information. Poly-Histine-D (pyrilamine)." Bock Pharmacal Company PROD (2001):
  15. Watemberg NM, Roth KS, Alehan FK, Epstein CE "Central anticholinergic syndrome on therapeutic doses of cyproheptadine." Pediatrics 103 (1999): 158-60
  16. "Product Information. Vistaril (hydroxyzine)." Pfizer U.S. Pharmaceuticals PROD (2001):
  17. "Product Information. Dramamine (dimenhydrinate)." Pharmacia and Upjohn PROD (2001):
  18. "Product Information. Tacaryl (methdilazine)." Westwood Squibb Pharmaceutical Corporation PROD (2001):
  19. "Product Information. Temaril (trimeprazine)." Allergan Inc PROD (2001):
  20. Talbert RL, Yee GC, DiPiro JT, Matzke GR, Posey LM, Wells BG "Pharmacotherapy: A Pathophysiologic Approach" Stamford, CT: Appleton & Lange (1999):
View all 20 references
Moderate

Antihistamines (applies to Periactin) asthma/COPD

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Chronic Obstructive Pulmonary Disease

It has been suggested that the anticholinergic effect of antihistamines may reduce the volume and cause thickening of bronchial secretions, resulting in obstruction of respiratory tract. Some manufacturers and clinicians recommend that therapy with antihistamines be administered cautiously in patients with asthma or chronic obstructive pulmonary disease.

References

  1. "Product Information. Dimetane (brompheniramine)." Wyeth-Ayerst Laboratories PROD (2002):
  2. "Product Information. Chlor-Trimeton (chlorpheniramine)." Schering-Plough PROD
  3. "Product Information. Periactin (cyproheptadine)." Merck & Co., Inc PROD (2002):
  4. "Product Information. Benadryl (diphenhydramine)." Parke-Davis PROD (2002):
  5. "Product Information. Phenergan (promethazine)." Wyeth-Ayerst Laboratories PROD (2001):
  6. Maddox DE, Reed CE "Clinical pharmacodynamics of antihistamines." Ann Allergy 59 (1987): 43-8
  7. "Product Information. Tavist (clemastine)." Sandoz Pharmaceuticals Corporation PROD (2001):
  8. "Product Information. Antivert (meclizine)." Roerig Division PROD (2001):
  9. "Product Information. Marezine (cyclizine)." Glaxo Wellcome PROD (2001):
  10. "Product Information. Optimine (azatadine)." Schering Corporation PROD (2001):
  11. "Product Information. Semprex-D (acrivastine-pseudoephedrine)." Endo Laboratories LLC PROD (2001):
  12. "Product Information. Drixoral (dextromethorphan)." Schering-Plough PROD (2001):
  13. "Product Information. Poly-Histine-D (pyrilamine)." Bock Pharmacal Company PROD (2001):
  14. "Product Information. Vistaril (hydroxyzine)." Pfizer U.S. Pharmaceuticals PROD (2001):
  15. "Product Information. Dramamine (dimenhydrinate)." Pharmacia and Upjohn PROD (2001):
  16. "Product Information. Tacaryl (methdilazine)." Westwood Squibb Pharmaceutical Corporation PROD (2001):
  17. "Product Information. Temaril (trimeprazine)." Allergan Inc PROD (2001):
View all 17 references
Moderate

Antihistamines (applies to Periactin) cardiovascular

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Cardiovascular Disease, Hyperthyroidism, Hypotension

Antihistamines may infrequently cause cardiovascular adverse effects related to their anticholinergic and local anesthetic (quinidine-like) activities. Tachycardia, palpitation, ECG changes, arrhythmias, hypotension, and hypertension have been reported. Although these effects are uncommon and usually limited to overdosage situations, the manufacturers and some clinicians recommend that therapy with antihistamines be administered cautiously in patients with cardiovascular disease, hypertension, and/or hyperthyroidism.

References

  1. Schuller DE, Turkewitz D "Adverse effects of antihistamines." Postgrad Med 79 (1986): 75-86
  2. "Product Information. Dimetane (brompheniramine)." Wyeth-Ayerst Laboratories PROD (2002):
  3. "Product Information. Chlor-Trimeton (chlorpheniramine)." Schering-Plough PROD
  4. "Product Information. Periactin (cyproheptadine)." Merck & Co., Inc PROD (2002):
  5. "Product Information. Benadryl (diphenhydramine)." Parke-Davis PROD (2002):
  6. "Product Information. Tavist (clemastine)." Sandoz Pharmaceuticals Corporation PROD (2001):
  7. "Product Information. Antivert (meclizine)." Roerig Division PROD (2001):
  8. "Product Information. Optimine (azatadine)." Schering Corporation PROD (2001):
  9. Smith SJ "Cardiovascular toxicity of antihistamines." Otolaryngol Head Neck Surg 111 Suppl (1994): 348-54
  10. "Product Information. Zyrtec (cetirizine)." Pfizer U.S. Pharmaceuticals PROD (2001):
  11. Woosley RL "Cardiac actions of antihistamines." Annu Rev Pharmacol Toxicol 36 (1996): 233-52
  12. "Product Information. Drixoral (dextromethorphan)." Schering-Plough PROD (2001):
  13. "Product Information. Poly-Histine-D (pyrilamine)." Bock Pharmacal Company PROD (2001):
  14. "Product Information. Vistaril (hydroxyzine)." Pfizer U.S. Pharmaceuticals PROD (2001):
  15. "Product Information. Dramamine (dimenhydrinate)." Pharmacia and Upjohn PROD (2001):
View all 15 references
Moderate

Antihistamines (applies to Periactin) renal/liver disease

Moderate Potential Hazard, High plausibility. Applicable conditions: Renal Dysfunction

Limited pharmacokinetic data are available for the older, first-generation antihistamines. Many appear to be primarily metabolized by the liver, and both parent drugs and metabolites are excreted in the urine. Patients with renal and/or liver disease may be at greater risk for adverse effects from antihistamines due to drug and metabolite accumulation. Therapy with antihistamines should be administered cautiously in such patients. Lower initial dosages may be appropriate.

References

  1. Glazko AJ, Dill WA, Young RM, Smith TC, Ogilvie RI "Metabolic disposition of diphenhydramine." Clin Pharmacol Ther 16 (1974): 1066-76
  2. Paton DM, Webster DR "Clinical pharmacokinetics of H1-receptor antagonists (the antihistamines)." Clin Pharmacokinet 10 (1985): 477-97
  3. Rumore MM "Clinical pharmacokinetics of chlorpheniramine." Drug Intell Clin Pharm 18 (1984): 701-7
  4. Huang SM, Athanikar NK, Sridhar K, Huang YC, Chiou WL "Pharmacokinetics of chlorpheniramine after intravenous and oral administration in normal adults." Eur J Clin Pharmacol 22 (1982): 359-65
  5. Simons KJ, Simons FE, Luciuk GH, Frith EM "Urinary excretion of chlorpheniramine and its metabolites in children." J Pharm Sci 73 (1984): 595-9
  6. Meredith CG, Christian CD Jr, Johnson RF, Madhavan SV, Schenker S "Diphenhydramine disposition in chronic liver disease." Clin Pharmacol Ther 35 (1984): 474-9
  7. Blyden GT, Greenblatt DJ, Scavone JM, Shader RI "Pharmacokinetics of diphenhydramine and a demethylated metabolite following intravenous and oral administration." J Clin Pharmacol 26 (1986): 529-33
  8. Albert KS, Hallmark MR, Sakmar E, Weidler DJ, Wagner JG "Pharmacokinetics of diphenhydramine in man." J Pharmacokinet Biopharm 3 (1975): 159-70
  9. Simons FE, Frith EM, Simons KJ "The pharmacokinetics and antihistaminic effects of brompheniramine." J Allergy Clin Immunol 70 (1982): 458-64
  10. Bruce RB, Turnbull LB, Newman JH, Pitts JE "Metabolism of brompheniramine." J Med Chem 11 (1968): 1031-4
  11. Porter CC, Arison BH, Gruber VF, Titus DC, Vandenheuvel WJ "Human metabolism of cyproheptadine." Drug Metab Dispos 3 (1975): 189-97
  12. Hintze KL, Wold JS, Fischer LJ "Disposition of cyproheptadine in rats, mice, and humans and identification of a stable epoxide metabolite." Drug Metab Dispos 3 (1975): 1-9
  13. Maddox DE, Reed CE "Clinical pharmacodynamics of antihistamines." Ann Allergy 59 (1987): 43-8
  14. Simons FE, Simons KJ, Frith EM "The pharmacokinetics and antihistaminic of the H1 receptor antagonist hydroxyzine." J Allergy Clin Immunol 73 (1984): 69-75
  15. Simons FE, Watson WT, Chen XY, Minuk GY, Simons KJ "The pharmacokinetics and pharmacodynamics of hydroxyzine in patients with primary biliary cirrhosis." J Clin Pharmacol 29 (1989): 809-15
View all 15 references

Periactin drug interactions

There are 328 drug interactions with Periactin (cyproheptadine).

Periactin alcohol/food interactions

There is 1 alcohol/food interaction with Periactin (cyproheptadine).


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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.