Apevit-Z
Generic Name
Cyproheptadine HCl + L-Lysine HCl + B vitamins + Zinc
Manufacturer
Popular Pharmaceuticals Ltd.
Country
Bangladesh
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Description
Overview of the medicine
Apevit-Z is an appetite stimulant combining Cyproheptadine (an antihistamine with appetite-stimulating properties) with essential B vitamins, the amino acid L-Lysine, and the trace element Zinc. It is primarily used to promote appetite, improve general health, and address nutritional deficiencies.
Uses & Indications
Dosage
Adults
Adults: 2 teaspoonfuls (10 ml) 2-3 times daily before meals, or as directed by physician.
Elderly
Elderly: Use with caution, especially due to potential for increased drowsiness or anticholinergic effects. Generally, adult dose applies, but may require lower starting dose.
Renal_impairment
Renal impairment: Use with caution. Dosage adjustment may be necessary for Cyproheptadine component. Consult a physician.
How to Take
Take orally before meals to maximize appetite-stimulating effects. Shake the bottle well before use.
Mechanism of Action
Cyproheptadine acts as an H1-receptor antagonist and serotonin antagonist, which is believed to contribute to its appetite-stimulating effects. L-Lysine is an essential amino acid necessary for protein synthesis and tissue repair. B vitamins are crucial coenzymes in metabolic processes. Zinc is vital for immune function, cell growth, and protein synthesis, and also plays a role in taste and appetite regulation.
Pharmacokinetics
Onset
Appetite stimulation effects may be noticeable within a few days to a week of regular use.
Excretion
Cyproheptadine and its metabolites are excreted primarily in urine and feces. B vitamins and Lysine are largely excreted in urine. Excess zinc is mainly excreted in feces.
Half life
Cyproheptadine: approximately 8 hours. B vitamins: vary, generally short. Zinc: long, as it's stored in the body.
Absorption
Cyproheptadine is well absorbed orally, reaching peak plasma concentrations within 1-3 hours. B vitamins are readily absorbed from the GI tract. Lysine is absorbed via active transport. Zinc absorption varies depending on dietary factors and zinc status.
Metabolism
Cyproheptadine is extensively metabolized in the liver. B vitamins are metabolized via various pathways depending on the specific vitamin. Lysine is largely metabolized in the liver. Zinc is primarily regulated homeostatically.
Side Effects
Contraindications
- Hypersensitivity to any component of the formulation
- Newborn or premature infants
- Nursing mothers
- Narrow-angle glaucoma
- Urinary retention or prostatic hypertrophy
- Elderly or debilitated patients with acute illness
Drug Interactions
Anticholinergics
Concurrent use may intensify anticholinergic side effects (e.g., dry mouth, blurred vision, urinary retention).
Monoamine Oxidase Inhibitors (MAOIs)
MAOIs prolong and intensify the anticholinergic effects of Cyproheptadine.
CNS Depressants (e.g., alcohol, sedatives, hypnotics, tranquilizers)
May enhance the central nervous system depressant effects of Cyproheptadine, leading to increased drowsiness and sedation.
Storage
Store in a cool and dry place, below 30°C. Protect from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose may include severe drowsiness, dizziness, incoordination, dry mouth, dilated pupils, flushing, gastrointestinal upset, and in severe cases, central nervous system depression, respiratory depression, convulsions, or coma. Treatment is symptomatic and supportive, including gastric lavage or activated charcoal if ingestion is recent.
Pregnancy & Lactation
Pregnancy: Use with caution during pregnancy, especially in the first trimester. Consult a doctor. Lactation: Contraindicated in nursing mothers due to the potential for adverse effects on the infant and inhibition of lactation.
Side Effects
Contraindications
- Hypersensitivity to any component of the formulation
- Newborn or premature infants
- Nursing mothers
- Narrow-angle glaucoma
- Urinary retention or prostatic hypertrophy
- Elderly or debilitated patients with acute illness
Drug Interactions
Anticholinergics
Concurrent use may intensify anticholinergic side effects (e.g., dry mouth, blurred vision, urinary retention).
Monoamine Oxidase Inhibitors (MAOIs)
MAOIs prolong and intensify the anticholinergic effects of Cyproheptadine.
CNS Depressants (e.g., alcohol, sedatives, hypnotics, tranquilizers)
May enhance the central nervous system depressant effects of Cyproheptadine, leading to increased drowsiness and sedation.
Storage
Store in a cool and dry place, below 30°C. Protect from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose may include severe drowsiness, dizziness, incoordination, dry mouth, dilated pupils, flushing, gastrointestinal upset, and in severe cases, central nervous system depression, respiratory depression, convulsions, or coma. Treatment is symptomatic and supportive, including gastric lavage or activated charcoal if ingestion is recent.
Pregnancy & Lactation
Pregnancy: Use with caution during pregnancy, especially in the first trimester. Consult a doctor. Lactation: Contraindicated in nursing mothers due to the potential for adverse effects on the infant and inhibition of lactation.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 24-36 months from the date of manufacture when stored under recommended conditions.
Availability
Available in pharmacies and drugstores
Approval Status
Approved by local regulatory authorities (e.g., DGDA)
Patent Status
Generic / Off-patent
Clinical Trials
The individual components (Cyproheptadine, B vitamins, Lysine, Zinc) have been extensively studied. Clinical trials for this specific combination primarily focus on its efficacy in appetite stimulation and nutritional support in pediatric and adult populations.
Lab Monitoring
- Routine lab monitoring is generally not required for typical use. In prolonged high-dose therapy or in patients with underlying conditions, liver function tests or complete blood counts may be considered.
- Monitor for signs of zinc deficiency or toxicity in prolonged use.
Doctor Notes
- Before prescribing, assess the underlying cause of appetite loss or poor growth.
- Advise patients about potential drowsiness and interactions with other CNS depressants.
- Emphasize that this is a supplement and should not replace a balanced diet.
Patient Guidelines
- Take the medicine exactly as prescribed or directed.
- Do not exceed the recommended dose.
- Be aware of potential drowsiness and avoid activities requiring mental alertness, such as driving or operating machinery, until you know how the medicine affects you.
Missed Dose Advice
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and resume your regular dosing schedule. Do not double the dose to catch up.
Driving Precautions
This medicine may cause drowsiness, dizziness, or blurred vision, which can impair your ability to drive or operate machinery. Avoid driving or engaging in such activities until you are certain that you can perform them safely.
Lifestyle Advice
- Ensure a balanced and nutritious diet to support overall health and weight gain.
- Stay hydrated by drinking plenty of fluids.
- Engage in regular, moderate physical activity if appropriate.
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