Cyproheptadine

The Basics

What is Cyproheptadine?

Cyproheptadine is used to treat allergic reactions. It is also used as a preventive treatment against migraine.

Brand names for Cyproheptadine

Cyproheptadine

How Cyproheptadine is classified

Antihistamines, Gastrointestinal Agents

Cyproheptadine During Pregnancy

Cyproheptadine pregnancy category

Category BNote that the FDA has deprecated the use of pregnancy categories, so for some medications, this information isn’t available. We still think it’s useful to list historical info, however, given what a common proxy this has been in the past.

What we know about taking Cyproheptadine while pregnant

Reproduction studies have been performed in rabbits, mice, and rats at oral or subcutaneous doses up to 32 times the maximum recommended human oral dose and have revealed no evidence of impaired fertility or harm to the fetus due to cyproheptadine. Cyproheptadine has been shown to be fetotoxic in rats when given by intraperitoneal injection in doses four times the maximum recommended human oral dose. Two studies in pregnant women, however, have not shown that cyproheptadine increases the risk of abnormalities when administered during the first, second and third trimesters of pregnancy. No teratogenic effects were observed in any of the newborns. Nevertheless, because the studies in humans cannot rule out the possibility of harm, cyproheptadine should be used during pregnancy only if clearly needed.

Taking Cyproheptadine While Breastfeeding

What are recommendations for lactation if you're taking Cyproheptadine?

Unless it is intentionally being used to lower maternal serum prolactin levels, cyproheptadine should be avoided during lactation because it may interfere with lactation, particularly in combination with a sympathomimetic such as pseudoephedrine or before lactation is well established. The nonsedating antihistamines are preferred alternatives.

Maternal / infant drug levels

Unless it is intentionally being used to lower maternal serum prolactin levels, cyproheptadine should be avoided during lactation because it may interfere with lactation, particularly in combination with a sympathomimetic such as pseudoephedrine or before lactation is well established. The nonsedating antihistamines are preferred alternatives.

Possible effects of Cyproheptadine on milk supply

Cyproheptadine 16 to 24 mg daily lowers serum prolactin in the treatment of amenorrhea-galactorrhea syndrome because of its antiserotonin activity.[2] Additionally, antihistamines in relatively high doses given by injection can decrease basal serum prolactin in nonlactating women and in early postpartum women.[3][4] However, suckling-induced prolactin secretion is not affected by antihistamine pretreatment of postpartum mothers.[3] Whether lower oral doses of cyproheptadine have the same effect on serum prolactin or whether the effects on prolactin have any consequences on breastfeeding success have not been studied. It is possible that these effects would interfere with initiation of lactation, but the prolactin level in a mother with established lactation may not affect her ability to breastfeed.

Possible alternatives to Cyproheptadine

Desloratadine, Fexofenadine, Loratadine.