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Acta Paediatr. 2016 Aug;105(8):967-70. doi: 10.1111/apa.13477. Epub 2016 Jun 10.

A retrospective review of cyproheptadine for feeding intolerance in children less than three years of age: effects and side effects.

Author information

1
Division of Neonatology, Perinatal Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
2
Division of Gastroenterology, Hepatology and Nutrition, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
3
Division of Epidemiology and Biostatistics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
4
Division of Pharmacy, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.

Abstract

AIM:

Premature infants and those with brain injury often suffer from feeding intolerance and vomiting in the first several years of life. Cyproheptadine is a medication with antihistaminergic, antiserotonergic and anticholinergic effects, thought to increase gastric accommodation. We aimed to retrospectively review our experience using cyproheptadine for feeding intolerance and/or vomiting in children under the age of three.

METHODS:

This is a retrospective chart review of 39 patients less than three years of age who were prescribed cyproheptadine for feeding intolerance or vomiting and had follow-up information available.

RESULTS:

Starting dose ranged widely (from 0.069 to 0.825 mg/kg/day). Side effects such as sleepiness and constipation were rare. The medication had a significant positive effect, defined as resolution of vomiting, improved feeding tolerance or improved comfort with feeds, in 67% of children. An additional 28% showed possible improvement, defined as some improvement in vomiting or improvement in vomiting or feeding tolerance in conjunction with other changes in addition to cyproheptadine.

CONCLUSION:

In our experience, cyproheptadine appears to be safe and effective in decreasing vomiting and feeding intolerance in children less than three years of age. A trial of cyproheptadine could be considered before invasive testing in infants with feeding issues.

KEYWORDS:

Cyproheptadine; Follow-up; Prematurity; Tube-fed; Vomiting

PMID:
27194450
DOI:
10.1111/apa.13477
[Indexed for MEDLINE]

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