HUNGRY BEST LIQUID

• Cyproheptadine has a well-recognised appetite-stimulating and weight-gain effect through its antihistamine and antiserotonergic action.
• Useful in children with poor appetite and inadequate weight gain where an organic cause has been excluded.
• Tricholine citrate is a lipotropic agent traditionally included to support hepatic fat metabolism.
• The syrup form allows the dose to be matched to age and weight.
• Also used in convalescence and after prolonged illness, where appetite is slow to return.

Not everyone gets these. Most are mild and settle as the course finishes.

• Poor appetite and failure to gain weight need a diagnosis before an appetite stimulant is used. Tuberculosis, intestinal worms, coeliac disease, anaemia and chronic infection are common and treatable causes that this will mask.
• Cyproheptadine causes marked sedation, which can affect a child's alertness and school performance.
• Contraindicated in neonates, premature infants, and in narrow-angle glaucoma, urinary retention, significant prostatic enlargement and pyloroduodenal obstruction.
• Do not give with, or within fourteen days of, a monoamine oxidase inhibitor.
• Use with caution in asthma, epilepsy and hepatic impairment, and with particular caution in the elderly.
• Sedation is additive with alcohol and other central depressants.
• For short defined courses with review, not indefinite use — the weight gained is largely lost when it is stopped.
• Dose by age and weight on the prescriber's instruction, using the measure supplied.