A triple-action oral liquid formulation combining a first-generation antihistamine (Cyproheptadine), a lipotropic agent and choleretic (Tricholine Citrate), and an osmotic laxative (Sorbitol). Primarily used in the Indian context as an appetite stimulant and digestive tonic, especially in pediatric and geriatric populations for weight gain and management of functional dyspepsia. It addresses poor appetite, indigestion, and associated symptoms like bloating and constipation.
Adult: 5 ml to 10 ml (1-2 teaspoonfuls) three times a day, before meals. Max: 30 ml/day.
Note: Shake well before use. Administer orally, preferably before meals to stimulate appetite. Use the calibrated measuring device provided. Can be taken with or without water. Do not mix with other liquids unless advised.
The combination works through three distinct mechanisms: 1) Cyproheptadine: Antagonizes histamine H1 and serotonin (5-HT2) receptors in the hypothalamic feeding center, stimulating appetite. Its antiserotonergic effect may reduce the sensation of early satiety. 2) Tricholine Citrate: Acts as a lipotropic agent, promoting hepatic fat metabolism and export (via increased lecithin synthesis). It also has choleretic properties, increasing bile flow, which aids in fat digestion and absorption. 3) Sorbitol: An osmotic laxative that draws water into the intestinal lumen, softening stools and stimulating peristalsis, thereby relieving constipation often associated with poor dietary intake or Cyproheptadine use.
Pregnancy: Category B (US FDA for Cyproheptadine). Animal studies show no risk, but human data inadequate. Use only if clearly needed and potential benefit justifies potential risk to the fetus. Not recommended for routine use.
Driving: NOT ADVISABLE, especially during initial therapy. May cause drowsiness, dizziness, and blurred vision. Patient should not drive or operate machinery until effect is known.
| CNS Depressants (Alcohol, Benzodiazepines, Opioids) | Additive sedation and impaired psychomotor performance. | Major |
| Monoamine Oxidase Inhibitors (MAOIs) - e.g., Phenelzine, Selegiline | Increased anticholinergic and CNS depressant effects; risk of hypertensive crisis. | Contraindicated |
| Anticholinergic drugs (Atropine, Tricyclic Antidepressants, Antipsychotics) | Potentiated anticholinergic side effects (dry mouth, urinary retention, constipation, confusion). | Major |
| Serotonergic drugs (SSRIs, SNRIs, Tramadol, Triptans) | Cyproheptadine's serotonin antagonism may reduce efficacy of these drugs. Conversely, risk of serotonin syndrome if Cyproheptadine is withdrawn in a patient on high-dose serotonergic therapy. | Moderate |
| Other appetite stimulants (e.g., Megestrol, Dronabinol) | Additive appetite increase and side effects. | Moderate |
Same composition (Cyproheptadine (2mg/5ml) + Tricholine Citrate (275mg/5ml) + Sorbitol (2gm/5ml)), different brands: