A retrospective review of cyproheptadine for feeding intolerance in children less than three years of age: effects and side effects. (10th June 2016)

• Record Type: Journal Article
• Authors: Merhar, Stephanie L.; Pentiuk, Scott P.; Mukkada, Vincent A.; Meinzen‐Derr, Jareen; Kaul, Ajay; Butler, Dawn R.
• Is Part Of: Acta pædiatrica. Volume 105:Number 8(2016)
• Page Start: 967
• Page End: 970
• Publication Date: 2016-06-10
• Subjects: Cyproheptadine -- Follow‐up -- Prematurity -- Tube‐fed -- Vomiting; Pediatrics -- Periodicals; Pediatrics; 618.92
• DOI: 10.1111/apa.13477
• Languages: English
• ISSNs: 0803-5253

Abstract

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.