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At a glance
Typical cost$30–90/mo
Available formsCaps · liquid · sublingual
PrescriptionRequired
AvailabilityCompounded in USA
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HOW IT WORKS

Mast cell stabilization

Prevents mast cells from degranulating — stopping the release of histamine, leukotrienes, and other inflammatory mediators before they trigger symptoms.

H1 receptor antagonism

Blocks histamine H1 receptors directly at target tissues — a second line of action that manages symptoms even when some mediator release occurs.

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Compounded Cyproheptadine
:

Cyproheptadine is a first-generation H1 antihistamine with additional antiserotonergic properties. It is commonly compounded for appetite stimulation, migraine prevention, cyclic vomiting syndrome, and mast cell conditions in both adults and children.

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Compounded Cyproheptadine

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Capsules (custom dose), Oral suspension, Dye-free capsules, Flavored pediatric liquid
$20–$60/month
Compounded in USA

How it works

Cyproheptadine blocks both H1 histamine receptors and serotonin (5-HT2A) receptors. This dual mechanism provides antihistamine effects for allergic conditions while its antiserotonergic action stimulates appetite, reduces migraine frequency, and helps manage serotonin-related symptoms.

Why compounded?

Commercial cyproheptadine (Periactin) has been discontinued by many manufacturers, making compounded versions essential. Compounding also allows pediatric-friendly liquid formulations, custom low doses for sensitive patients, and dye-free or filler-free preparations for patients with MCAS or chemical sensitivities.

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AT A GLANCE
Cost
$20–$60/month
Forms
Capsules (custom dose), Oral suspension, Dye-free capsules, Flavored pediatric liquid
Rx
Required
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Compounded Cyproheptadine

Cyproheptadine is a unique first-generation antihistamine that combines H1 receptor blockade with potent serotonin antagonism. Originally developed for allergic conditions, it has become widely used off-label for appetite stimulation in underweight patients, migraine prophylaxis, and cyclic vomiting syndrome — particularly in pediatric populations.

With the commercial product (Periactin) increasingly difficult to find, compounding pharmacies have become a primary source for cyproheptadine. This is especially important for children who need flavored liquid formulations and for MCAS patients who require excipient-free preparations.

How it Works

Common Uses

  • Appetite stimulation in underweight patients and failure to thrive
  • Migraine prevention (especially in children)
  • Cyclic vomiting syndrome
  • Mast cell activation syndrome (MCAS)
  • Allergic rhinitis and urticaria
  • Serotonin syndrome (adjunct treatment)
  • Nightmares and sleep disturbance (off-label)

HOW IT WORKS

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Other Uses

Dosing Information

⚠️ Dosing should be determined by your prescriber. The information below is general guidance only.

Typical Dosing

Titration Tips

Available Forms

Side Effects

Frequently Asked Questions

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Compounded Cyproheptadine

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HOW IT WORKS

Mast cell stabilization

Prevents mast cells from degranulating — stopping the release of histamine, leukotrienes, and other inflammatory mediators before they trigger symptoms.