Oraxin Syrup And Drop: Use, Composition, Dose, Adverse Effect

Oraxin syrup is a rational combination of appetite stimulants cyproheptadine hydrochloride with essential amino acids lysine and peptone. It is made by centaur pharmaceuticals Pvt. LTD in India. It is distributed and marketed in Nigeria by AL-TINEZ pharma LTD in Lagos state.

Oraxin syrup

Composition Of Oraxin Syrup

Each 5 ml contains:

Cyproheptadine hydrochloride B.P 2mg

Peptone 25 mg

Lysine hydrochloride USP USP 150 mg

In a palatable syrupy base

Color: caramel

Composition Of Oraxin Syrup Outside Nigeria

Each 5 ml contains:

Cyproheptadine hydrochloride 2 mg

Tricholine citrate 275 mg

Composition Of Oraxin Drop

Each ml contains:

Cyproheptadine hydrochloride 1.5mg

Tricholine citrate 55 mg

Pharmacology

Cyproheptadine is a serotonin and histamine antagonist with sedative properties. It finds clinical application in stimulating the appetite and growth.

Read Also: Diet suitable for oraxin

The appetite stimulating effect of cyproheptadine is probably a consequence of serotonin antagonism. It antagonizes the satiety stimulating effects of serotonin on the satiety center. Weight gain and increased growth in children that have been observed with cyproheptadine can be attributed to an interference with regulation of the secretion of growth hormone.

Peptone is a rich source of not only essential but also other amino acids. Lysine is an essential amino acid which is required for the growth. A diet consisting mainly of rice or wheat is largely deficient in lysine and has to be supplemented.

Tricholine citrate contains three molecules of choline. Clinical interest in choline centers on its lipotropic action and its utility in the treatment of fatty infiltration and cirrhosis of the liver. Choline converts fat into phospholipids like lecithin, which is essential to biomembrane structure and its function.

Lecithin is also a major component of high density lipoprotein (HDL), and is used to mobilize cholesterol from cell membranes. In patients with fatty liver, an increased rate of phospholipid turnover has been observed following administration of choline.

Indications And Use Of Oraxin

Oraxin is indicated for loss of appetite, weight loss, anorexia nervosa, and as an adjunct to anti-tubercular and antiretroviral regimens for weight gain.

In children, oraxin is indicated in underweight children who have inadequate dietary intake or loss of appetite and children suffering from anemia, liver or digestive disorder.

Contraindications

Use of oraxin is contraindicated in newborn or premature infants. Other contraindications to oraxin include hypersensitivity to any ingredient of formulation, angle-closure glaucoma, stenosing peptic ulcer, symptomatic prostatic hypertrophy, bladder neck obstruction and pyloroduodenal obstruction.

Precautions

Cyproheptadine has an atropine-like action therefore, should be used with caution in patients with history of bronchial asthma, increased intraocular pressure, hyperthyroidism, cardiovascular disease and hypertension.

Antihistamines may diminish mental alertness; conversely, particularly, in the young child, they may occasionally produce excitation. Patients should be warned about engaging in activities requiring mental alertness and motor coordination.

Warning

Overdose of antihistamines, particularly in infants and children, may produce hallucinations, central nervous system depression, convulsions and death.

Read Also: What happens when you stop taking oraxin

Antihistamines are more likely to cause dizziness, sedation and hypotension in elderly.

Pregnancy And Lactation

Because of the higher risk of antihistamines in newborns and prematures, antihistamine therapy is contraindicated in nursing mothers.

Drug Interactions

Monoamine oxidase (MAO) inhibitors prolong and intensify the anticholinergic effects of antihistamines. Oraxin syrup may have additive effects with alcohol and other CNS depressants like hypnotics, sedatives, tranquilizers and antianxiety agents.

Adverse Reactions Of Oraxin

Adverse reactions associated with oraxin can be attributed to cyproheptadine. These may include sedation (often transient), dizziness, disturbed coordination, confusion, restlessness; rash, urticaria; blurred vision, diplopia, vertigo, tinnitus; hypotension, palpitation, tachycardia; dryness of mouth, anorexia, diarrhea, constipation, urinary retention; dryness of nose and throat and thickening of bronchial secretions.

Dosage And Administration Of Oraxin

The recommended dose for cyproheptadine is 0.25 mg/kg/dose that has to be taken BID or TD. It has been proven to be safe even for children under 2 years of age.

Dosage Of Oraxin Drop

The recommended dose of oraxin drops should be:

Up to 6 months: 0.75 mg/0.5 ml

6 – 12 months: 1.5 mg/1 ml

1- 2 years: 1.5 – 3 mg/1 -2 ml

Dosage Of Oraxin Syrup

Children

Below 3 years- 2.5 ml twice daily

4-7 years- 2.5 ml thrice daily

7-14 years- 5 ml thrice daily

Adults

10 ml thrice daily

Overdosage Of Oraxin

With oraxin syrup, over dosage reactions will vary from CNS depression to simulation especially in children. Also, atropine-like signs and symptoms as well as gastrointestinal symptoms may occur.

Read Also: Difference between oraxin and apetamin

If vomiting has not occurred spontaneously, the patient should be induced to vomit with syrup of ipecac.

If a patient is unable to vomit, performing gastric lavage followed by an activated charcoal. Isotonic saline is the lavage of choice. Precautions against aspiration must be taken especially in infants and children.

When life-threatening CNS signs and symptoms are present, intravenous physostigmine salicylate may be considered. Dose and frequency of administration are dependent on age, clinical response and recurrence after response.

Saline cathartics is milk of magnesia by osmosis drawn into the bowl and therefore are valuable for their actions in rapping dilution of bowel contents.

Stimulants should not be used for vasopressors that may be used to treat hypertension. The older ld50 cyproheptadine is 123 mg/kg and 295 mg/kg in the mouse and rat respectively.