Usage
This combination medication is primarily prescribed as an appetite stimulant, especially for patients experiencing anorexia or loss of appetite due to various underlying medical conditions. It also serves as a calcium supplement, crucial for growth and various bodily functions.
- Pharmacological Classification: Appetite stimulant, Calcium supplement
- Mechanism of Action: Cyproheptadine, an antihistamine with antiserotonergic properties, stimulates appetite by blocking serotonin’s action on appetite regulation within the hypothalamus. Calcium gluconate and calcium lactate provide supplemental calcium.
Alternate Names
- Cyproheptadine with Calcium
- Calcium Gluconate + Calcium Lactate + Cyproheptadine combination
- Appetite stimulant with Calcium
Some brand names include Calbeon Syrup, Calcyp Syrup, and Cyaptin with Calcium Suspension.
How It Works
Pharmacodynamics: Cyproheptadine acts as a serotonin antagonist in the hypothalamus, thereby increasing appetite. Calcium is essential for numerous physiological processes, including nerve conduction, muscle contraction, and bone formation.
Pharmacokinetics:
- Cyproheptadine: Well-absorbed orally, metabolized in the liver, and excreted mainly in the urine.
- Calcium Gluconate/Lactate: Absorption varies depending on factors such as vitamin D levels and gastrointestinal pH. Excreted through urine and feces.
Mode of Action: Cyproheptadine exerts its appetite-stimulating effect by antagonizing serotonin receptors (specifically 5-HT2) in the hypothalamus. Calcium salts provide elemental calcium which participates in various cellular functions, such as acting as a secondary messenger.
Elimination Pathways: Cyproheptadine is primarily eliminated through hepatic metabolism and renal excretion. Calcium is eliminated through renal and fecal routes.
Dosage
Dosage information for this specific combination needs to be confirmed with the prescribing doctor and should be tailored to individual patient needs. General guidelines for individual components:
Standard Dosage
Adults:
- Cyproheptadine: 2-4 mg two to three times daily. Maximum dose: 0.5 mg/kg/day.
- Calcium: 500-1500 mg of elemental calcium daily, divided into doses.
Children:
- Cyproheptadine: Weight-based dosing varies by age. Consult a pediatric dosing guide.
- Calcium: Pediatric calcium requirements vary by age. Consult pediatric guidelines.
Special Cases:
- Elderly Patients: Dose adjustments may be necessary.
- Patients with Renal Impairment: Dose modification is needed based on creatinine clearance.
- Patients with Hepatic Dysfunction: Dose adjustments may be needed.
- Patients with Comorbid Conditions: Assess the individual’s condition carefully to avoid potential drug interactions or complications.
Clinical Use Cases
Dosage for specific clinical situations such as intubation, surgical procedures, mechanical ventilation, ICU use, or emergency situations should be determined based on individual patient requirements and is not specifically defined for this combination product.
Dosage Adjustments
Dose modifications are based on patient-specific factors like renal/hepatic dysfunction, metabolic disorders, other underlying diseases, and concomitant medications.
Side Effects
Common Side Effects:
- Drowsiness
- Dry mouth
- Dizziness
- Constipation
Rare but Serious Side Effects:
- Allergic reactions (rash, itching, swelling)
- Seizures
- Liver problems
- Cardiac arrhythmias
- Hypercalcemia
Long-Term Effects:
Long-term effects of this combination have not been specifically studied. Chronic use of cyproheptadine might be associated with metabolic changes.
Adverse Drug Reactions (ADR): Any signs of allergic reaction, signs of hypercalcemia (nausea, vomiting, constipation, confusion), or cardiac arrhythmia require urgent attention.
Contraindications
- Hypersensitivity to any component of the medication
- Urinary retention
- Glaucoma
- Pyloric or duodenal obstruction
- Hypercalcemia
Drug Interactions
- Monoamine oxidase inhibitors (MAOIs)
- Alcohol
- Sedatives
- Anticholinergic drugs
- Thiazide diuretics
Pregnancy and Breastfeeding
- Pregnancy: Cyproheptadine is a category C drug (animal studies have shown adverse effects, no adequate studies in humans). Use with caution during pregnancy. Calcium supplementation can be beneficial. Always consult a doctor before using during pregnancy.
- Breastfeeding: Cyproheptadine is excreted in breast milk. Caution is advised. Calcium is present in breastmilk. Use with caution during breastfeeding.
Drug Profile Summary
- Mechanism of Action: Cyproheptadine: Serotonin antagonist; Calcium salts: Provide elemental calcium
- Side Effects: Drowsiness, dry mouth, dizziness, constipation, allergic reactions, hypercalcemia.
- Contraindications: Hypersensitivity, urinary retention, glaucoma, bowel obstruction, hypercalcemia.
- Drug Interactions: MAOIs, alcohol, sedatives, anticholinergics.
- Pregnancy & Breastfeeding: Use with caution during pregnancy and breastfeeding.
- Dosage: Varies by age and condition. Individualized dosing is required.
- Monitoring Parameters: Serum calcium levels, liver function tests, complete blood count.
Popular Combinations
Information on popular combinations for this specific mix is not widely established. It is essential to consult with specialists before combining this with other medications.
Precautions
Standard precautions apply regarding pre-existing medical conditions, drug allergies, and interactions. Specific precautions for pregnant women, breastfeeding mothers, children, and the elderly should be considered. Lifestyle considerations, especially concerning alcohol and sedatives, should be discussed with patients.
FAQs (Frequently Asked Questions)
Q1: What is the recommended dosage for Calcium Gluconate + Calcium Lactate + Cyproheptadine?
A: The dosage needs to be tailored to the individual patient’s requirements. Factors like age, weight, and overall health will influence the final dosage. It’s best to consult with a physician for personalized guidance.
Q2: What are the primary uses of this combination medication?
A: Primarily, it’s used to stimulate appetite in patients with anorexia or diminished appetite due to various reasons. It also serves as a calcium supplement.
Q3: What is the mechanism of action for cyproheptadine in this combination?
A: Cyproheptadine works by blocking serotonin receptors in the hypothalamus, which helps increase appetite.
Q4: Are there any specific drug interactions I should be aware of?
A: Yes, this combination can interact with MAOIs, alcohol, sedatives, and anticholinergic drugs. Always review a patient’s medication list carefully.
Q5: Can this medication be prescribed during pregnancy or while breastfeeding?
A: It should be used with caution during pregnancy and breastfeeding. Discuss the risks and benefits with the patient and consider alternative options if needed.
Q6: What are the common side effects patients might experience?
A: Common side effects include drowsiness, dry mouth, dizziness, and constipation. Monitor patients for these and address them appropriately.
Q7: What are the serious side effects of this combination?
A: Rare but serious side effects include allergic reactions, seizures, liver dysfunction, and cardiac arrhythmias. Advise patients to seek immediate medical help if they experience any of these.
Q8: How should I monitor patients taking this medication?
A: Monitoring should include checking serum calcium levels, liver function tests, and complete blood count, especially with long-term use.
Q9: What precautions should I take when prescribing this medication to elderly patients?
A: Elderly patients may be more susceptible to side effects, so it’s important to start with a lower dose and adjust accordingly. Also, carefully evaluate their kidney and liver function.
