A fixed-dose combination of a first-generation antihistamine (Cyproheptadine) with a lipotropic agent and choleretic (Tricholine Citrate). Primarily used in the Indian context as an appetite stimulant and for the management of functional gastrointestinal disorders, particularly in children and underweight adults. Cyproheptadine acts as an antagonist at serotonin and histamine H1 receptors, while Tricholine Citrate aids in fat metabolism and bile secretion.
Adult: One tablet (Cyproheptadine 2mg + Tricholine Citrate 275mg) two to three times daily, preferably before meals. Maximum: 3 tablets per day. Treatment duration should be limited; re-evaluate after 2-3 months.
Note: Take orally with or without food. Taking before meals may enhance appetite stimulation. Swallow whole with a glass of water. Do not crush or chew. Avoid alcohol and CNS depressants.
Cyproheptadine is a potent antagonist at serotonin (5-HT2) receptors and histamine (H1) receptors. In the hypothalamus, serotonin is known to have a satiety effect. Antagonism of these receptors is believed to stimulate appetite. Its antihistaminic action also contributes to sedation and anti-allergic effects. Tricholine Citrate provides choline, a precursor for acetylcholine and phospholipids (like phosphatidylcholine). It acts as a lipotropic agent, promoting hepatic fat metabolism and export, and as a choleretic, stimulating bile flow, which may aid digestion.
Pregnancy: Category B (US FDA). Not teratogenic in animal studies, but no adequate, well-controlled studies in pregnant women. Use only if clearly needed and potential benefit justifies potential risk to the fetus. Avoid in third trimester due to risk of anticholinergic effects in neonate.
Driving: NOT ADVISABLE. Cyproheptadine causes significant drowsiness and sedation. Patients should be warned not to drive or operate heavy machinery until their response is known.
| Alcohol, Benzodiazepines, Opioids | Additive CNS depression and impaired psychomotor performance. | Major |
| Monoamine Oxidase Inhibitors (MAOIs) - e.g., Phenelzine, Selegiline | Risk of severe anticholinergic crisis, hyperpyrexia, convulsions. | Contraindicated |
| Other Anticholinergics (e.g., Atropine, Tricyclic Antidepressants) | Additive anticholinergic side effects (dry mouth, urinary retention, confusion). | Major |
| CNS Stimulants (e.g., Amphetamines) | Cyproheptadine may antagonize the stimulant effect. | Moderate |
| Serotonergic Drugs (SSRIs, SNRIs, Tramadol) | Theoretical risk of reduced efficacy of these drugs due to serotonin antagonism by Cyproheptadine. | Moderate |
Same composition (Cyproheptadine (2mg) + Tricholine Citrate (275mg)), different brands: