CIPLACTIN

1. Introduction

Ciplactin is a brand name for cyproheptadine, a unique multi-action medication with:

• Potent antihistamine (H1-blocker)

• Antiserotonergic (5-HT2 blocker)

• Anticholinergic properties

• Appetite-stimulating effects

2. Key Specifications

• Generic Name: Cyproheptadine hydrochloride

• Brand Names: Ciplactin (India), Periactin (international)

• Dosage Forms:

  • Tablets (4 mg)

  • Syrup (2 mg/5 mL)

• Manufacturer: Cipla (Ciplactin brand)

3. Therapeutic Uses

✔ Allergic conditions (urticaria, allergic rhinitis) ✔ Appetite stimulation in anorexia/cachexia ✔ Serotonin syndrome management ✔ Migraine prophylaxis (especially in children) ✔ Cushing’s syndrome (adjunct therapy)

4. Mechanism of Action

• Dual blockade of H1 and 5-HT2 receptors

• Calcium channel blockade (vascular smooth muscle)

• Anticholinergic effects (muscarinic receptor antagonist)

• Ghrelin modulation (appetite stimulation)

5. Dosage Guidelines

Adults:

• Allergies: 4 mg every 8 hours (max 32 mg/day)

• Appetite: 2 mg QID before meals

• Migraine: 4-8 mg at bedtime

Children (2-12 yrs):

• 0.25 mg/kg/day divided Q8H

• Or 2-4 mg TID (syrup preferred)

Special Notes:

• Take with food/milk to reduce GI upset

• Evening doses help minimize daytime sedation

• Gradual tapering recommended for long-term use

6. Side Effect Profile

Common (anticholinergic effects):

• Sedation (drowsiness in >50%)

• Dry mouth (30%)

• Weight gain (appetite increase)

• Constipation (25%)

Less Common:

• Blurred vision

• Urinary retention

• Hypotension

• Paradoxical excitation (in children)

7. Contraindications

✖ Angle-closure glaucoma ✖ Severe hypertension ✖ Peptic ulcer disease ✖ Prostatic hypertrophy ✖ MAOI use (within 14 days)

8. Drug Interactions

• CNS depressants: Enhanced sedation (alcohol, opioids) • SSRIs/SNRIs: Reduced efficacy (serotonin antagonism) • Antihypertensives: Additive hypotension • Anticholinergics: Cumulative effects

9. Special Populations

Pregnancy: Category B (limited data) Elderly: More sensitive to anticholinergic effects Children: Monitor for paradoxical excitation

10. Clinical Advantages

• Only antihistamine with proven appetite stimulation • Cost-effective serotonin antagonist • Flexible dosing for multiple indications

11. Monitoring Parameters

✓ Weight/BMI (for appetite use) ✓ Mental status changes ✓ Visual acuity (long-term use) ✓ Bowel/bladder function

12. Comparison with Other Antihistamines

13. Conclusion

Ciplactin remains uniquely valuable for its multi-receptor activity, particularly when appetite stimulation or serotonin modulation is needed. While its sedating and anticholinergic effects limit routine use, it fills important niche applications in allergy, neurology and nutrition therapy.