Category B—The animal reproduction data and limited human pregnancy experience suggests that cyproheptadine is low risk for structural anomalies. Although reporting bias is evident, preterm birth occurred in three women exposed to the drug during pregnancy. Because preterm birth has been associated with other serotonin antagonists (e.g., selective serotonin reuptake inhibitors), there might be a causal association with cyproheptadine.
No reports describing the use of cyproheptadine during lactation have been located. Chronic use of cyproheptadine will lower serum prolactin levels, and it has been used in the management of galactorrhea. No studies have been found, however, that evaluated its potential to interfere with the normal lactation process. Because of the increased sensitivity of newborns to antihistamines and the potential for adverse reactions, the manufacturer considers cyproheptadine to be contraindicated in nursing mothers.
In general, dose selection for an elderly patient should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic, renal, or cardiac function, and of concomitant disease or other drug therapy
CrCl <10: ↓ dose 0-50%
HD/PD: no supplement
There are no dosage adjustments provided in the manufacturer's labeling.