What does Peritol do?

1.1. Indications “What does Peritol do?” . Peritol medicine contains the active ingredient cyproheptadine hydrochloride, which is used in the treatment of the following conditions:
Allergic conditions with itching such as acute urticaria, chronic urticaria, pruritus, eczema, drug rash, eczematous dermatitis , neurodermatitis, contact dermatitis, vasomotor rhinitis, insect bites, serum sickness; Symptomatic treatment of vascular headache (histamine headache, migraine). 1.2. Pharmacokinetics Cyproheptadine belongs to the group of antihistamines - serotonin, a drug with sedative and anticholinergic effects. Cyproheptadine's mechanism of action has been shown to bind to histamine H1 receptors and serotonin receptors, so it competitively inhibits binding to histamine and serotonin.
Animal studies have shown that cyproheptadine hydrochloride is resistant to some of the effects of serotonin, as follows:
Bronchospasm (guinea pig experiment); Vasoconstriction (canine experiment); Contraction (experiment on mouse uterus isolated); Edema (tested in rats); Fatal (tested on rats using haemophilus pertussis). Animal studies have shown that cyproheptadine hydrochloride is resistant to some of the effects of histamine as follows:
Bronchospasm (in guinea pigs); Vasoconstriction (canine experiment); Contractions (experimental in utero isolated rat); Anaphylaxis (tested on mice and guinea pigs); Increased gastric secretion (experiment on Heidenhain pouch). 1.3. Pharmacokinetics Peritol is well absorbed from the gastrointestinal tract after oral administration. Peak plasma concentrations are reached 4 to 8 hours after oral administration. The effects of cyproheptadine hydrochloride persist for 4-6 hours after a single dose. However, the drug concentration can still be measured 24 hours after a single dose of 4 mg.
No studies have demonstrated an association between clinical efficacy and plasma concentrations. Metabolism of the drug occurs mainly in the liver, the main metabolite is the quaternary ammonium of cyproheptadine (glucuronide conjugate form). Metabolites have no biological effect.
Elimination of the drug through feces and urine. Of which, at a dose of 4 mg cyproheptadine, 2 - 20% of the dose is eliminated in the feces (34% of which is unchanged), 40% of the dose is excreted in the urine. 50% of the drug cyproheptadine is eliminated by the kidneys as metabolites within 3 days of dosing. At repeated daily doses of 12-20 mg, no unchanged drug appeared, but only metabolites of the drug were excreted in the urine. The half-life of cyproheptadine is 16 hours.

The use of peritol in the treatment of allergic conditions with itching, headache caused by vascular causes. Dosage of the drug depends on the condition and age of the patient, specifically as follows:
The effect of the drug when taking a single dose lasts from 4-6 hours. The daily maintenance dose should be divided into several divided doses, usually 3 times a day or as often as needed to help maintain continued effectiveness. However, the dose should be determined individually for each patient; Sedative effects occur more at the first therapeutic dose, so the first dose is recommended after the evening meal; The starting dose per day in adults is 4 - 20 mg (1 tablet x 1-5 times/day), most suitable doses for patients are 12 - 16 mg (1 tablet x 3 times per day). - 4 times/day); The recommended dose in the treatment of chronic urticaria is 2 mg/time x 3 times/day (1/2 tablet x 3 times); Dosage in the treatment of acute headache: 4mg per day. If pain persists, repeat the above dose after 30 minutes, note that the total dose should not exceed 8mg in 4-6 hours. The maintenance dose in migraine treatment is 12mg/day (1 tablet/time x 3 times/day). Dosage of Peritol 4mg drug on some special subjects as follows:
Patients who can't exercise on their own, elderly people (over 65 years old): Peritol should not be used in these subjects because of the risk of side effects. high; Children: Do not administer Peritol to children under 2 years of age. The recommended dose for children over 2 years of age is 0.25 mg/kg/day or 8 mg/m2. The recommended dose for children 2-6 years old is 4-6mg/day, the maximum dose should not exceed 12mg. For children aged 7-14 years, the dose is 8-12mg/day. In case additional dose is required, it should be used at bedtime, the maximum dose should not exceed 16mg; In patients with hepatic impairment, dose reduction may be necessary because cyproheptadine is metabolised in the liver; For patients with renal impairment, dose adjustment and dose reduction are required.

Some unwanted effects may be encountered when taking Peritol drugs as follows:
Weight gain; Palpitations, extrasystoles, tachycardia; Leukopenia, hemolytic anemia, thrombocytopenia, agranulocytosis; Symptoms of nervous system disorders: Drowsiness, drowsiness, dizziness, ataxia sedation, paresthesia, tremor, convulsions, neuritis, weakness; Eye disorders: accommodation disorder, blurred vision, double vision; Labyrinth and Ear Disorders: Dizziness, acute labyrinthitis, tinnitus; Respiratory and chest disorders: Thick bronchial fluid, dry nose and throat, stuffy nose, difficulty breathing, nosebleeds; Digestive disorders: Nausea, dry mouth, diarrhea, epigastric discomfort, constipation; Urinary and renal disorders: Difficulty urinating, difficulty urinating, urinary retention; Subcutaneous tissue and skin disorders: Purpura, erythema, urticaria, photosensitivity; Nutritional and metabolic disorders: Increased appetite; Low blood pressure, feeling of tightness in the chest, shaking, fatigue, irritability; Anaphylaxis, allergic edema; Hepatobiliary disorders: Liver failure, hepatitis, cholestasis, jaundice, abnormal liver function; Reproductive system disorders: Premature menstruation.

4.1. Contraindications Contraindicated to use Peritol 4mg drug in the following cases:
People who are sensitive to any ingredient of Peritol drug' Acute asthma; Patients with glaucoma; Pyloric obstruction, gastric ulcer with stenosis; Patients with symptoms associated with urinary retention (bladder neck obstruction, prostate enlargement); Patients being treated with MAO inhibitors; Women who are breastfeeding; Exhausted elderly people (over 65 years old), patients unable to move on their own; Infants and children younger than 2 years old. 4.2. Precautions for use Do not use antihistamines in the treatment of lower respiratory tract symptoms, including acute asthma attacks. Treatment with Peritol in particular and with antihistamines in general can reduce alertness. However, for children the drug has a stimulant effect. The drug has anticholinergic effect, so it should be used with caution in the following cases: Cardiovascular disease, hyperthyroidism, hypertension. Alcohol can increase the CNS depressant effect of antihistamines, so patients treated with drugs should not drink alcohol. Each Peritol tablet contains 128mg of lactose. Therefore, patients with hereditary galactose intolerance, glucose-galactose malabsorption or Lapp lactase deficiency should not be treated with this medicine. Although hematopoietic abnormalities such as agranulocytosis, agranulocytosis, hemolytic anemia, thrombocytopenia... rarely occur when using Peritol. However, the patient should check the blood count in case of unexplained fever, pallor, mucosal lesions, shortness of breath, weakness, bleeding... 4.3. Effects of the drug on special subjects Driving, operating machinery: When starting to take the drug, the patient may experience drowsiness, dizziness or drowsiness. Therefore, patients should not drive or operate machinery when taking the drug. Pregnant women: Do not use Peritol in the treatment of pregnant women. Lactation: Do not use Peritol in the treatment of women who are breastfeeding. To avoid unwanted side effects caused by Peritol, patients should carefully read the instruction sheet or follow the doctor's instructions.