Drug interactions
Cyproheptadine + Pitolisant
Severity: Major
Cyproheptadine and Pitolisant: major interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Pitolisant promotes wakefulness by blocking H3 autoreceptors, which raises brain histamine release. Centrally acting H1 antagonists such as cyproheptadine can oppose this histaminergic effect and reduce the benefit of pitolisant.
What this interaction means in plain words
Cyproheptadine and Pitolisant can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Cyproheptadine belongs to Respiratory; Pitolisant belongs to Central Nervous System.
Why it happens
Pharmacodynamic antagonism: brain-penetrant H1 blockade counteracts the histamine-mediated wake-promoting effect of pitolisant.
What to do
Avoid concurrent use and choose a non-sedating or non-brain-penetrant antihistamine if one is needed. If both are required, monitor for loss of wakefulness efficacy.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Other interactions of Cyproheptadine
- Cyproheptadine + Isocarboxazid Contraindicated
- Cyproheptadine + Phenelzine Contraindicated
- Cyproheptadine + Tranylcypromine Contraindicated
- Alfentanil + Cyproheptadine Major
- Belladonna and opium + Cyproheptadine Major
- Benzhydrocodone / acetaminophen + Cyproheptadine Major
Other interactions of Pitolisant
- Alfuzosin + Pitolisant Major
- Amiodarone + Pitolisant Major
- Amisulpride + Pitolisant Major
- Anagrelide + Pitolisant Major
- Asenapine + Pitolisant Major
- Bupropion + Pitolisant Major
Frequently asked questions
Can I take Cyproheptadine with Pitolisant?
MediHelp rates the interaction as major. Cyproheptadine and Pitolisant can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Pitolisant promotes wakefulness by blocking H3 autoreceptors, which raises brain histamine release. Centrally acting H1 antagonists such as cyproheptadine can oppose this histaminergic effect and reduce the benefit of pitolisant.
How serious is the interaction between Cyproheptadine and Pitolisant?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid concurrent use and choose a non-sedating or non-brain-penetrant antihistamine if one is needed. If both are required, monitor for loss of wakefulness efficacy.
What other medicines interact with Cyproheptadine?
MediHelp also lists interactions of Cyproheptadine with, for example, Isocarboxazid, Phenelzine, Tranylcypromine. The full list is on the Cyproheptadine page.
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