TRIHEPTA SYRUP

Each 5 ml contains:
Cyproheptadine Hcl  B.P. 2 mg
Lysine Hcl      BP 150 mg
Vitamin B1     BP  5 mg
Vitamin B6     BP  3 mg
Vitamin B12  BP    2 mcg
Nicotinamide  BP   2mg

Read all of this leaflet carefully before you take this medicine.
• Keep this leaflet. You may need to read it again.
• If you have further question, please ask your Pharmacist or your Doctor.
• This medicine has been prescribed for you. Do not pass it on to others. It may harm them, even if their symptoms are the same as yours.

In this leaflet:

1. What Trihepta Syrup is and what it is used for:
2. Precautions and warning before you take Trihepta Syrup
3. How to take Trihepta Syrup
4. Possible side effects.
5. Symptoms and Treatment of Over dosage 
6. How to store Trihepta Syrup
7. Further information

1. WHAT TRIHEPTA SYRUP IS AND WHAT IT IS USED FOR 
Trihepta Syrup is a proprietary combination medicine containing six (6) active ingredients, namely, Cyproheptadine, Lysine Hcl, Thiamine mononitrate (vitamin B1), Pyridoxine Hcl (vitamin B6), Cyanocobalamine (vitamin B12) and Nicotinamide (vitamin B3). Cyproheptadine is an appetite stimulant drug.  Lysine is an essential amino acid while Thiamine, Pyridoxine, Cyanocobalamine and Nicotinamide are essential B-complex vitamins which all work synergistically to enhance metabolic activities in the body. The actions of all six (6) agents in the body may help boost appetite.

2. PRECAUTIONS AND WARNING BEFORE YOU TAKE TRIHEPTA SYRUP
Contraindication:
• Do not take Trihepta syrup if you are allergic or hypersensitive to the active drugs or any of the ingredients of Trihepta syrup.
• You have acute asthma, angle-closure glaucoma, stenosing peptic ulcer, symptomatic prostatic hyperplasia, bladder neck obstruction, and pyloroduodenal obstruction. 
• You are taking monoamine oxidase (MAO) inhibitors
• You are a geriatric or debilitated patient

Pregnancy and Lactation:
• Do not give Trihepta Syrup to pregnant or breast feeding mothers, neonates or premature infants.

Take special care with Trihepta Syrup if:
• You have increased intraocular pressure, hyperthyroidism, cardiovascular disease, hypertension or bronchial asthma   

Taking other Medicines:
Please inform your Pharmacist or Doctor if you are taking or about to take any other medicine, including those obtained without a prescription.

Driving and using Machines 
Trihepta may cause sedation or dizziness, hence avoid operating machinery or any activity that requires alertness when taking Trihepta Syrup.

3. HOW TO TAKE TRIHEPTA SYRUP
• Adults should take a maximum oral dose of 10 ml 3- 4 times daily.
• Children 12 years and above should take a maximum oral dose of 5 ml 2- 3 times daily.

4. POSSIBLE SIDE EFFECTS
Like all medicines, Trihepta Syrup can cause side effects, although not everybody gets them. Side effects like dizziness, sleepiness, insomnia, confusion, seizure, toxic psychosis, palpitation, hypotension, tachycardia, dry mouth, diarrhea, constipation, nausea, vomiting, urine retention, urinary frequency, hemolytic anaemia, blood dyscrasias, rash, urticaria, photosensitivity, anaphylactic shock have been reported.

Possible interactions with food and drugs
Food may delay the rate but not the extent of Cyproheptadine absorption. Trihepta tablet should not be used together with CNS depressant drugs and MAO inhibitors. Concurrent use of Trihepta and Thyrotropin releasing hormone would require close monitoring by your physician.

5. SYMPTOMS AND TREATMENT OF OVER DOSAGE 
Signs and symptoms of overdose may include either CNS depression (sedation, reduced mental alertness, apnoea, and CV collapse) or CNS stimulation (insomnia, hallucinations, tremors, or seizures). Anticholinergic symptoms such as dry mouth, flushed skin, fixed and dilated pupils, and GI symptoms are common, especially in children. Overdose should be treated by emesis with ipecac syrup followed by activated charcoal in conscious patient or gastric lavage if patient is unconscious or ipecac fails.

6. HOW TO STORE TRIHEPTA SYRUP
Keep Syrup out of reach or sight of children and stored below 300c. Keep it in the original package. Check the expiry date on the label and do not use product if expired.  

7. FURTHER INFORMATION
In addition to Cyproheptadine Hcl, Lysine Hcl, Thiamine mononitrate, Pyridoxine Hcl, Cyanocobaolamine and Nicotinamide, the other ingredients in Trihepta Syrup are: Sucrose, Sodium saccharin, Propyl paraben, methyl paraben, Sodium benzoate, Citric acid, Disodium edentate propylene glycol Sodium chloride sodium carboxymethylcellulose, Caramel and Banana flavour.  

Date of publication / review: Effective January, 2014, this publication is subject to review every two years and upon receipt of new product information.