From the FDA Drug Label
Cyproheptadine has an atropine-like action and, therefore, should be used with caution in patients with: ... Hypertension The relationship between Cyproheptadine and hypertension is that Cyproheptadine should be used with caution in patients with hypertension due to its atropine-like action.
- Key points:
- Cyproheptadine should be used with caution in patients with hypertension.
- The exact relationship between Cyproheptadine and hypertension is not fully explained, but caution is advised. 1
From the Research
Cyproheptadine should be used with caution in patients with hypertension, as it may potentially worsen high blood pressure in some patients. This antihistamine medication, which also has antiserotonergic and anticholinergic properties, can cause fluid retention and potentially increase blood pressure due to its anticholinergic effects 2. Additionally, its antagonism of serotonin receptors may interfere with the blood pressure-lowering effects of certain antihypertensive medications, particularly those that work through serotonergic pathways 3.
Key Considerations
- The typical adult dose of cyproheptadine is 4 mg three to four times daily, with a maximum daily dose of 32 mg, but lower doses may be advisable for hypertensive patients 4.
- Blood pressure should be monitored regularly when starting or adjusting cyproheptadine therapy in hypertensive patients.
- If a patient with hypertension requires cyproheptadine for conditions like allergic reactions, migraine prophylaxis, or as an appetite stimulant, consider starting at a lower dose and titrating slowly while monitoring blood pressure closely 5.
- Alternative medications with less impact on blood pressure may be preferable for hypertensive patients when appropriate therapeutic options exist.
Mechanism and Treatment
- Cyproheptadine's anticholinergic effects can cause fluid retention and potentially increase blood pressure.
- The treatment of serotonin syndrome, which can be associated with hypertension, may involve the use of cyproheptadine as an adjunct to supportive care 4.
- In cases of severe hypertension associated with serotonin syndrome, cyproheptadine may be beneficial, but its use should be carefully considered and monitored 3.