Does cyproheptadine (antihistamine) cause hypertension?

From the Guidelines

Cyproheptadine does not typically cause hypertension, and its use is not associated with a significant increase in blood pressure. In fact, cyproheptadine, an antihistamine with antiserotonergic properties, is more commonly associated with hypotension (low blood pressure) rather than hypertension (high blood pressure) 1. The medication works by blocking histamine H1 receptors and serotonin receptors, which can lead to vasodilation and a decrease in blood pressure. Cyproheptadine is primarily used to treat allergic reactions, as an appetite stimulant, and sometimes for migraine prevention.

Key Points to Consider

• The typical adult dosage ranges from 4-20 mg daily, divided into multiple doses.
• Common side effects include drowsiness, dry mouth, and increased appetite, but hypertension is not a recognized adverse effect.
• If a patient experiences elevated blood pressure while taking cyproheptadine, it's more likely due to other factors or medications.
• Any unexpected blood pressure changes while on this medication should be reported to a healthcare provider for evaluation, as they may indicate an unusual reaction or interaction with other medications.

Clinical Implications

• The use of cyproheptadine is generally safe in terms of blood pressure effects, and it can be a useful option for patients who require antihistamine therapy without the concern of exacerbating hypertension.
• However, as with any medication, patients should be monitored for any potential side effects, and their blood pressure should be checked regularly if they have a history of hypertension or are at risk for developing it.
• It's essential to consider the individual patient's medical history, current medications, and potential interactions when prescribing cyproheptadine or any other medication.

From the FDA Drug Label

Cyproheptadine has an atropine-like action and, therefore, should be used with caution in patients with: ... Hypertension The FDA drug label does not answer the question of whether cyproheptadine causes hypertension, but rather indicates that it should be used with caution in patients with existing hypertension 2.

From the Research

Cyproheptadine and Hypertension

• There is no direct evidence in the provided studies that cyproheptadine causes hypertension 3, 4, 5, 6, 7.
• The studies focus on the antihistamine's antiserotoninergic and anticholinergic properties, its use in treating serotonin syndrome, and cases of overdose or adverse reactions 3, 4, 5, 6, 7.
• One study mentions a patient experiencing tachycardia, which is a symptom related to cardiovascular issues, but it is not directly linked to cyproheptadine-induced hypertension 5.
• Another study discusses a case of central anticholinergic syndrome in a child after ingesting cyproheptadine, but hypertension is not mentioned as a symptom 7.

Adverse Reactions and Side Effects

• The studies report various adverse reactions and side effects associated with cyproheptadine, including choreoathetosis, delirium, and anticholinergic syndrome 3, 4, 7.
• However, hypertension is not listed as a common or rare side effect of cyproheptadine in the provided studies 3, 4, 5, 6, 7.

Conclusion Not Provided as per Request

(No research papers directly answer the question of whether cyproheptadine causes hypertension)