A triple-action oral liquid formulation combining a first-generation antihistamine (Cyproheptadine) with a lipotropic agent (Tricholine Citrate) and an osmotic laxative (Sorbitol). Primarily used in the Indian context as an appetite stimulant and hepatoprotective tonic, especially in pediatric and geriatric populations for weight gain and liver function support. It addresses anorexia, undernutrition, and associated symptoms like early satiety and constipation.
Adult: 5 ml to 10 ml (1 to 2 teaspoonfuls) two to three times daily, preferably before meals. Max: 30 ml/day.
Note: Shake the bottle well before use. Use the calibrated measuring device provided. Take orally, preferably 15-30 minutes before meals for optimal appetite stimulation. Can be taken with or without food. Do not mix with other liquids. Maintain adequate fluid intake due to Sorbitol content.
The combination works synergistically. Cyproheptadine antagonizes histamine H1 and serotonin (5-HT2) receptors in the hypothalamic appetite center, stimulating hunger. Its antiserotonergic effect may also reduce early satiety. Tricholine Citrate acts as a lipotropic agent, providing choline which is essential for hepatic fat metabolism (as a methyl donor) and phospholipid synthesis, aiding in liver decongestion and fat mobilization. Sorbitol, a hyperosmotic agent, draws water into the intestinal lumen, softening stools and stimulating peristalsis, relieving constipation often associated with poor dietary habits.
Pregnancy: Category B (US FDA) for Cyproheptadine. No adequate well-controlled studies in pregnant women. Use only if potential benefit justifies potential risk to the fetus. Not recommended during pregnancy unless clearly needed. Tricholine Citrate and Sorbitol data lacking.
Driving: NOT ADVISABLE. Cyproheptadine causes drowsiness and sedation. Patients should be warned not to drive or operate heavy machinery until their response is known, especially during initial therapy.
| CNS Depressants (Alcohol, Benzodiazepines, Opioids) | Additive sedation and CNS depression. Impaired motor skills. | Major |
| Monoamine Oxidase Inhibitors (MAOIs) e.g., Phenelzine | Exaggerated anticholinergic and CNS depressant effects; hypertensive crisis risk. | Contraindicated |
| Anticholinergic drugs (Atropine, Tricyclic Antidepressants, Antipsychotics) | Additive anticholinergic side effects (dry mouth, constipation, urinary retention, confusion). | Major |
| Serotonergic drugs (SSRIs, SNRIs, Tramadol) | Cyproheptadine's serotonin antagonism may reduce efficacy of these drugs. Theoretical risk of serotonin syndrome attenuation if used as treatment. | Moderate |
| Hypertensive agents | Cyproheptadine may counteract the antihypertensive effect of Guanethidine, Bethanidine, etc. | Moderate |
Same composition (Cyproheptadine (2mg/5ml) + Tricholine Citrate (275mg/5ml) + Sorbitol (3gm/5ml)), different brands: