A study of cyproheptadine in the treatment of metastatic carcinoid tumor and the malignant carcinoid syndrome.

Abstract:

:Sixteen patients with metastatic neuroendocrine tumors and the malignant carcinoid syndrome were treated with cyproheptadine (Periactin, Merck, Sharp & Dohme, West Point, PA) at maximum tolerable doses that ranged from 12 to 48 mg daily. Usual side effects were mild sedation and dry mouth, but three patients found it impossible to sustain treatment due to nausea and vomiting. Most patients had significant relief of diarrhea, frequently associated with weight gain. Relief of flushing was uncommon. The therapeutic benefit produced by cyproheptadine would appear to be a peripheral effect because 5-hydroxyindoleacetic acid (5-HIAA) excretion in these patients was not reduced. Although there have been case reports of objective tumor regression with cyproheptadine therapy, this was not observed in any of these 16 patients. Cyproheptadine would appear to be a useful therapeutic tool for the management of diarrhea associated with the malignant carcinoid syndrome. An appropriate initial total daily dose is 0.4 mg/kg divided in three fractions with prompt modification to produce minimal and tolerable side effects.

journal_name

Cancer

journal_title

Cancer

authors

Moertel CG,Kvols LK,Rubin J

doi

10.1002/1097-0142(19910101)67:1<33::aid-cncr282067

subject

Has Abstract

pub_date

1991-01-01 00:00:00

pages

33-6

issue

1

eissn

0008-543X

issn

1097-0142

journal_volume

67

pub_type

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