Comprehensive medication guide to Cyproheptadine including estimated pricing, availability information, side effects, and how to find it in stock at your local pharmacy.
Estimated Insurance Pricing
$0–$15 copay for generic Cyproheptadine on most commercial plans; typically Tier 1–2 on most formularies; 90-day supply often available at lower per-unit cost via mail-order.
Estimated Cash Pricing
$15–$66 retail for generic Cyproheptadine 4 mg (30 tablets); as low as $5–$11 with GoodRx or SingleCare coupons for a 30-day supply.
Medfinder Findability Score
88/100
Summarize with AI
On this page
Cyproheptadine hydrochloride is a first-generation antihistamine and serotonin antagonist that has been in clinical use since 1961. Originally marketed under the brand name Periactin (now discontinued in the U.S.), it is available today only as a generic medication. It is prescribed for a wide range of allergic conditions including seasonal and perennial allergic rhinitis, urticaria (hives), allergic conjunctivitis, cold urticaria, and dermatographism.
Beyond its FDA-approved allergy indications, Cyproheptadine is also commonly prescribed off-label for appetite stimulation in underweight children (particularly those with failure to thrive or cystic fibrosis), management of serotonin syndrome, migraine prevention in children and adolescents, and treatment of antidepressant-induced sexual dysfunction.
Cyproheptadine is not a controlled substance and does not require DEA scheduling. It is available as 4 mg tablets and a 2 mg/5 mL oral solution (liquid), making it suitable for adults and children ages 2 and older.
We have a 99% success rate finding medications, even during nationwide shortages.
Need this medication?
Cyproheptadine works through a unique combination of three pharmacological mechanisms that distinguish it from modern second-generation antihistamines. First, it is a competitive H1 histamine receptor antagonist — it blocks histamine from binding at receptor sites in the nose, eyes, skin, and throughout the body, reducing the allergic response (sneezing, itching, hives, runny nose).
Second, and most distinctively, Cyproheptadine is a potent serotonin (5-HT2A and 5-HT2C) receptor antagonist. This antiserotonergic activity explains its unique off-label applications: blocking serotonin in the hypothalamus stimulates appetite (serotonin normally suppresses it); blocking 5-HT2A receptors is used to treat serotonin syndrome (excess serotonin toxicity); and blocking serotonin signaling can counteract antidepressant-induced sexual dysfunction.
Third, Cyproheptadine has significant anticholinergic activity, blocking muscarinic acetylcholine receptors. This contributes to common side effects including dry mouth, constipation, blurred vision, and urinary retention. Because it also crosses the blood-brain barrier (unlike second-generation antihistamines), it causes sedation in most patients — a predictable consequence of blocking H1 receptors in the central nervous system.
4 mg — tablet
Standard adult and pediatric (7-14 years) dose; scored tablet; most commonly prescribed form
2 mg/5 mL — oral solution
Liquid formulation for young children (ages 2-6) and adults who cannot swallow tablets; 5 mL teaspoon = 2 mg
Cyproheptadine is generally available in 2026 with no formal national shortage listed by the FDA or ASHP. Multiple generic manufacturers produce it, and it is distributed through major pharmaceutical wholesalers nationwide. The brand Periactin has been discontinued in the U.S., but generic Cyproheptadine is widely accessible.
That said, localized stock-outs do occur — particularly for the oral solution (2 mg/5 mL), which is stocked in smaller quantities at many retail pharmacies. Individual pharmacies that receive few Cyproheptadine prescriptions may carry minimal inventory. This means the same prescription that fills smoothly at one pharmacy might hit an empty shelf at another across town.
If you're having trouble finding Cyproheptadine at your usual pharmacy, medfinder contacts pharmacies near you to check which ones have it in stock and texts you the results — saving you the hold music and repeat phone calls.
Because Cyproheptadine is not a DEA-scheduled controlled substance, it can be prescribed by any licensed healthcare provider without special DEA registration or additional training. Any prescriber with a valid DEA number (or state prescribing authority) can write for it.
Common prescriber types for Cyproheptadine include:
Primary care physicians (PCPs) and family medicine physicians
Allergists and immunologists
Pediatricians (for allergy and off-label appetite stimulation)
Dermatologists (for urticaria, dermatographism, and cold urticaria)
Neurologists and headache specialists (for migraine prevention)
Psychiatrists and psychiatric NPs (for antidepressant-induced sexual dysfunction, akathisia)
Nurse practitioners (NPs) and physician assistants (PAs) — fully authorized in all 50 states
Because Cyproheptadine is not a controlled substance, telehealth providers can prescribe it in virtually all states without requiring an in-person visit. Telehealth platforms like Teladoc, MDLive, and Ro offer same-day or next-day appointments with e-prescription delivery directly to your pharmacy of choice.
No. Cyproheptadine is not a DEA-scheduled controlled substance. It can be prescribed by any licensed healthcare provider — including primary care physicians, nurse practitioners, physician assistants, and telehealth providers — without any special DEA registration or scheduling restrictions.
Because it is not controlled, there are no limits on prescription quantity (90-day supplies are allowed), no restrictions on early refills, and it can be prescribed via telehealth in virtually all states without an in-person visit requirement. This makes obtaining and refilling Cyproheptadine significantly simpler than controlled medications like stimulants or benzodiazepines.
The most frequently reported side effects of Cyproheptadine include:
Drowsiness and sedation (most common — affects most patients)
Increased appetite and weight gain
Dry mouth
Dizziness
Constipation
Blurred vision
Difficulty urinating (especially in men with enlarged prostate)
Nausea
Serious side effects (seek medical attention):
Seizures (especially in children — rare but serious)
Severe allergic reaction (rash, hives, swelling, difficulty breathing)
Urinary retention (inability to urinate)
Hallucinations, severe confusion, or delirium (anticholinergic syndrome — more common in overdose or elderly patients)
Paradoxical excitation in children (hyperactivity, irritability instead of sedation)
Know what you need? Skip the search.
Cetirizine (Zyrtec)
Second-generation antihistamine; once daily, less sedating, OTC; preferred for most allergy patients seeking less drowsiness
Loratadine (Claritin)
Second-generation antihistamine; once daily, non-sedating, OTC; preferred for daytime use and elderly patients
Fexofenadine (Allegra)
Second-generation antihistamine; least sedating option; once or twice daily, OTC; must take on empty stomach
Hydroxyzine (Vistaril)
First-generation antihistamine (Rx only); similar sedating and anticholinergic profile; also used for anxiety and pruritus
Prefer Cyproheptadine? We can find it.
MAO Inhibitors (phenelzine, tranylcypromine, selegiline, linezolid, rasagiline)
majorContraindicated combination — significantly prolongs and intensifies anticholinergic effects; do not take within 14 days of each other
CNS Depressants (alcohol, benzodiazepines, opioids, sleep medications)
majorAdditive CNS depression — excessive sedation, impaired coordination, risk of respiratory depression at high doses
SSRIs and SNRIs (fluoxetine, sertraline, venlafaxine)
moderateCyproheptadine may reduce effectiveness of serotonergic antidepressants by blocking serotonin receptors; occasionally prescribed intentionally to counteract SSRI-induced sexual dysfunction
Anticholinergic Drugs (tricyclics, bladder medications, Parkinson's medications)
moderateAdditive anticholinergic effects — worsened dry mouth, constipation, urinary retention, confusion
Diphenhydramine (Benadryl) and other first-generation antihistamines
moderateDual antihistamine use increases sedation and anticholinergic effects significantly with no added benefit; avoid combination
Cyproheptadine is a remarkably versatile and affordable medication that has remained clinically relevant for over six decades. Its unique combination of antihistamine and antiserotonergic properties means it does things modern antihistamines simply can't do — from stimulating appetite in underweight children to treating life-threatening serotonin syndrome. For most patients, the cost is minimal: generic Cyproheptadine is available for under $11 per month with a discount card.
While there is no formal national shortage in 2026, localized stock-outs can make it difficult to fill at the first pharmacy you try — particularly for the oral solution. The most important things patients can do are refill early (don't wait until the last dose), maintain a relationship with a pharmacy that knows to keep it in stock, and know alternatives in case a brief gap occurs.
If you're struggling to find Cyproheptadine at a pharmacy near you, medfinder can help — enter your medication and location, and the service contacts pharmacies near you to find which ones can fill your prescription, then texts you the results.
Medfinder Editorial Standards
Our medication guides are researched and written to help patients make informed decisions. All content is reviewed for accuracy and updated regularly. Learn more about our standards
ChatGPT
Claude
Perplexity
Grok
Gemini