Product Description

Cyproheptadine 2 mg, Tricholine Citrate 275 mg, and Sorbitol 2 g per 5 mL Syrup IP (200 mL) is an oral appetite stimulant formulation combining an antihistamine (cyproheptadine), a lipotropic agent (tricholine citrate), and an osmotic laxative (sorbitol).
It is indicated for treating loss of appetite, unintentional weight loss, and malnutrition in conditions like chronic illness, anemia, or inadequate dietary intake, particularly in underweight children or adults.

It serves as adjunctive therapy to anti-tubercular (anti-TB) or antiretroviral (anti-HIV) treatments to support weight gain. Not a primary treatment for psychiatric anorexia nervosa (use under specialist care); promotes symptomatic improvement in appetite and digestion without hormonal effects. Prescription-only; shake well before use.

Uses

• Stimulation of appetite and promotion of weight gain in patients with poor intake due to chronic conditions (e.g., anemia, liver/digestive disorders, convalescence)

• Adjunctive support in underweight children/adolescents with inadequate nutrition or growth faltering

• Supportive therapy during anti-TB or anti-HIV regimens to counteract treatment-related appetite suppression and weight loss

• Improvement of mild digestive issues (e.g., sluggish bowel from poor diet) via laxative effect

• Not indicated for obesity, acute infections, psychiatric eating disorders as monotherapy, or severe malabsorption syndromes (investigate underlying cause first)

How it works

This syrup leverages complementary actions for appetite and digestive support:

• Cyproheptadine (2 mg/5 mL): A first-generation antihistamine and serotonin (5-HT2) receptor antagonist that blocks hypothalamic signals for satiety, increasing hunger and food intake. It also has mild anticholinergic effects, enhancing gastric motility. Effects onset in 1–2 hours; appetite boost in 3–7 days.

• Tricholine Citrate (275 mg/5 mL): A choline salt that acts as a lipotropic agent, providing choline for phospholipid (e.g., lecithin) synthesis in the liver. This aids fat metabolism, prevents fatty liver accumulation, and supports bile flow/digestion, indirectly improving nutrient absorption and appetite in liver-related poor intake.

• Sorbitol (2 g/5 mL): An osmotic sugar alcohol that draws water into the intestines, softening stools and promoting peristalsis to relieve constipation. This enhances overall digestive comfort, encouraging better eating habits.

Synergy: Improves appetite, nutrient utilization, and bowel regularity for gradual weight gain (0.5–1 kg/month in responsive patients).

Benefits

• Enhances appetite: Increases caloric intake by 20–50% in trials (e.g., for TB/HIV adjunct), aiding weight restoration in malnourished individuals without stimulants.

• Supports digestion and liver health: Tricholine reduces hepatic fat buildup; sorbitol prevents constipation from low-fiber diets, improving tolerance to increased food.

• Safe adjunctive role: Modest weight gain (2–5 kg over 1–3 months) in chronic illness; well-tolerated in pediatrics (e.g., failure-to-thrive).

• Non-addictive: Unlike hormonal or corticosteroid appetite boosters, it avoids metabolic disruptions; promotes healthy eating patterns.

How to use

For using the syrup containing Cyproheptadine 2mg, Tricholine Citrate 275mg, and Sorbitol 2gm.  Shake the bottle well before each use to ensure the active ingredients are evenly mixed. Use the measuring cup or spoon provided with the bottle to ensure you take the correct dose. Avoid using a regular teaspoon, as it may not be accurate. Take the syrup exactly as prescribed. The dosage will be determined by a doctor based on your age, weight, and the condition being treated. It is often given before meals to stimulate appetite. Avoid or limit alcohol consumption while taking this medication, as it can increase the sedative effects.

Side Effects

Common side effects (primarily from cyproheptadine; mild and transient):

• Central nervous system: Drowsiness, sedation, dizziness, headache

• Anticholinergic: Dry mouth, nose, throat; blurred vision, constipation

• Gastrointestinal: Nausea, vomiting, diarrhea (from sorbitol), or abdominal discomfort

Less common/rare but serious side effects (seek immediate medical attention):

• Allergic: Rash, itching, swelling (angioedema)

• Neurological: Confusion, excitability (paradoxical in children), seizures (overdose)

• Urinary: Retention (anticholinergic)

• Hepatic: Elevated enzymes (rare with tricholine; monitor in liver disease)

• Other: Weight gain (intended but monitor for excess), photosensitivity

Side effects often diminish after 1–2 weeks; limit dose if sedation persists.

Safety Advice

• Contraindicated in: Narrow-angle glaucoma, urinary retention, MAO inhibitor use (within 14 days), severe asthma, or hypersensitivity. Avoid in newborns/preterm infants (respiratory depression risk).

• Use caution in: Liver/kidney impairment (adjust dose; monitor LFTs/RFTs), elderly (increased sedation), asthma, or hyperthyroidism. Not for long-term use without oversight due to tolerance.

• Pregnancy/breastfeeding: Category B (cyproheptadine—limited data; potential fetal harm); avoid or use alternatives (e.g., nutritional support). Minimal excretion in milk, but may cause infant drowsiness—discuss risks.

• Monitoring: Weight, appetite, and growth charts (pediatrics); sedation/behavioral changes. Discontinue if neurological symptoms or an allergy occur.

• Interactions: Potentiates sedatives (e.g., alcohol, benzodiazepines—increased drowsiness); anticholinergics worsen dry mouth/constipation; avoid with SSRIs (serotonin syndrome risk). Inform the doctor of all medications/supplements. Strictly avoid alcohol (enhances CNS depression).

• Lifestyle: Take during daylight if sedating; encourage small, frequent meals. Not a substitute for addressing underlying causes (e.g., psychological evaluation for anorexia).

Storage Conditions

Store at a temperature below 86°F (30 °C). Protect from light and moisture.

FAQs

Is this a prescription medication?

Yes, this is a prescription medication and should be used under the guidance of a healthcare professional.

What if a dose is missed?

Take the missed dose as soon as you remember. If it is almost time for the next dose, skip the missed one. Do not take a double dose. 

Can the syrup be stopped once the appetite improves?

Do not stop the medication without consulting a doctor.

Are there any serious side effects?

Serious side effects, though rare, can include severe allergic reactions, central nervous system effects (especially in children), urinary retention, and liver problems.

Does it interact with alcohol?

Yes, avoid alcohol while taking this syrup, as it can significantly increase the sedative effects.

Is it safe during pregnancy or breastfeeding?

It is not recommended during pregnancy or breastfeeding. Discuss the risks and benefits with a doctor.

Does it help with weight gain?

Yes, the appetite-stimulating effect can lead to weight gain, which is often the intended purpose.

How does it affect the liver?

The Tricholine Citrate component is included to support liver health. However, as with all medications, monitoring is necessary, especially with pre-existing liver conditions.

What are the storage instructions?

Store the syrup at room temperature, away from direct sunlight and moisture, and keep it out of the reach of children.