Indications:

APIVISTA Syrup is indicated for:

• Anorexia (loss of appetite) due to various conditions like illness, malnutrition, or weakness.
• Convalescence following surgery, illness, or generalized weakness where the body requires increased nutritional intake.
• Improving appetite in patients with conditions leading to weight loss or poor nutritional intake.
• Liver support, as it helps in improving liver function and bile secretion.

Pharmacology:

1. Cyproheptadine HCl (2 mg per 5 ml):

• Cyproheptadine is an antihistamine with antiserotonergic properties. It works by blocking histamine receptors and serotonin receptors in the body, which helps increase appetite. It is commonly used as an appetite stimulant and can help patients who have poor or diminished appetite due to illness or chronic conditions.
• It also has mild anticholinergic effects, helping to promote a sense of hunger.

2. Tricholine Citrate (275 mg per 5 ml):

• Tricholine Citrate is a choline salt that has hepatoprotective (liver-protecting) properties. It helps improve liver function,
  stimulates bile secretion, and aids in fat metabolism. 
• By enhancing bile flow, Tricholine Citrate supports the digestion and absorption of fats and other nutrients, which can be particularlyuseful in patients with fatty liver or those requiring hepatic support.

3. Sorbitol Solution (70%) (3.575 gm per 5 ml):

• Sorbitol is a sugar alcohol that works as a mild laxative, helping to relieve constipation. It improves bowel motility, ensuring proper digestive health.
• It is also used as a solvent and sweetener in syrup formulations. Sorbitol helps make the syrup more palatable, and its mild laxative effect can assist in cases of gastrointestinal sluggishness often seen in patients with poor appetite or convalescence.

Mechanism of Action:

• Cyproheptadine increases appetite by blocking serotonin receptors that can suppress hunger. It is particularly beneficial in patients experiencing anorexia
  or poor appetite due to illness, malnutrition, or stress.
• Tricholine Citrate helps by improving liver function, supporting fatmetabolism, and enhancing the absorption of essential nutrients.
• Sorbitol works as a mild laxative, promoting gastrointestinal motility and reducing bloating and discomfort, which often accompanies poor digestion and appetite issues.

Dosage and Administration:

• Adults and Children over 12 years:
• 10 ml (2 teaspoons) twice a day, or as directed by the physician.
• Children (6 to 12 years):
• 5 ml (1 teaspoon) twice a day, or as directed by the physician.
• Children (2 to 6 years):
• 2.5 ml (½ teaspoon) twice a day, or as directed by the physician.

Note: The dosage may vary depending on the clinical condition and the individual patient’s needs. It is recommended to use the syrup under the guidance of a healthcare provider.

Contraindications:

• Hypersensitivity to Cyproheptadine or any other component of the syrup.
• Glaucoma, especially narrow-angle glaucoma, due to the anticholinergic effects of Cyproheptadine.
• Severe liver impairment, unless advised by a healthcare provider.
• Pregnancy and lactation: Should be used cautiously and only when absolutely necessary, and under medical supervision.

Warnings and Precautions:

• Sedation:
  Cyproheptadine can cause drowsiness or sedation in some patients, especially when starting treatment. Caution should be exercised when performing tasks requiring alertness, such as driving or operating heavy machinery.
• Liver Conditions: Tricholine Citrate supports liver function, but patients with severe liver disorders should use the syrup under close
  supervision and in appropriate dosages.
• Elderly: Elderly patients are more susceptible to the sedative effects of Cyproheptadine and should use this product with caution.
• Drug Interactions:
• CNS depressants: Cyproheptadine may enhance the sedative effects of other CNS depressants such as alcohol, antihistamines, barbiturates, and benzodiazepines.
• Anticholinergics: Should be used cautiously with other anticholinergic drugs due to potential additive side effects.
• Tricyclic Antidepressants (TCAs): Cyproheptadine may interact with TCAs or other serotonergic drugs, leading to increased sedation or possible interactions with serotonin levels.

Side Effects:

Common Side Effects:

• Drowsiness or sedation (especially when starting the treatment).
• Dry mouth, blurred vision, or constipation due to the anticholinergic effects of Cyproheptadine.
• Gastrointestinal discomfort such as mild nausea or diarrhea due to Sorbitol.

Rare Side Effects:

• Allergic reactions such as rash, urticaria, or swelling.
• Difficulty urinating or urinary retention, particularly in patients with underlying urinary tract issues.
• Changes in appetite or sudden weight changes.

Drug Interactions:

• CNS depressants: Cyproheptadine may enhance the sedative effects of other CNS depressants such as alcohol, antihistamines, barbiturates, and benzodiazepines.
• Tricyclic Antidepressants (TCAs): Cyproheptadine may interact with TCAs or other serotonergic drugs, leading to increased sedation or possible interactions with serotonin levels.
• Anticholinergics: Should be used cautiously with other anticholinergic drugs due to potential additive side effects.

Storage:

• Store in a cool, dry place at room temperature (15–25°C).
• Keep away from direct sunlight and moisture.
• Shake well before use.
• Keep the product out of reach of children.

Disclaimer: The contents herein above are specifically for Doctors or Healthcare Professionals and not for the public in general. Always consult a healthcare provider before starting the medication or supplement, especially in patients with pre-existing medical conditions or those who are pregnant or breastfeeding.