Clinical Pharmacology Details


BROMOCRIPTINE


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Indications & Dose:

Prevention of lactation



Adult: Initially 2.5 mg daily for 1 day, then 2.5 mg twice daily for 14 days continued’!


Suppression of lactation



Adult: Initially 2.5 mg daily for 2–3 days, then 2.5 mg twice daily for 14 days


Hypogonadism


Galactorrhoea


Infertility



Adult: Initially 1–1.25 mg daily, dose to be taken at bedtime, increase dose gradually; usual dose 7.5 mg daily in divided doses, increased if necessary up to 30 mg daily, usual dose in infertility without hyperprolactinaemia is 2.5mg twice daily


Acromegaly



Adult: Initially 1–1.25 mg daily, dose to be taken at bedtime, then increased to 5 mg every 6 hours, increase dose gradually


Prolactinoma



Adult: Initially 1–1.25 mg daily, dose to be taken at bedtime, then increased to 5 mg every 6 hours, increase dose gradually. Occasionally patients may require up to 30 mg daily


Parkinson’s disease



Adult: Initially 1–1.25 mg daily for 1 week, dose to be taken at night, then 2–2.5 mg daily for 1 week, dose to be taken at night, then 2.5 mg twice daily for 1 week, then 2.5 mg 3 times a day for 1 week, then increased in steps of 2.5 mg every 3–14 days, adjusted according to response; maintenance 10– 30 mg daily


Children: Under 15, not recommended. 

Contraindications:

Hypersensitivity to bromocriptine or other ergot alkaloids; toxaemia of pregnancy and hypertension in postpartum women, not to breast-feed if lactation prevention fails.

Side Effects:

Nausea, vomiting, constipation, headache, dizziness, postural hy potension,  drowsiness, vasospasm of fingers and toes particularly in patients with Raynaud’s syndrome; high doses, confusion, psychomotor excitation, hallucinations, dyskinesia, dry mouth, leg cramps, pleural effusions (may necessitate withdrawal of treatment), retroperitoneal fibrosis reported (monitoring required). 

Cautions:

Specialist evaluation-monitor for pituitary enlargement, particularly during pregnancy, annual gynaecological assess-ment (postmenopausal, every 6 months), monitor  for peptic ulceration in acromega-lic patients; contraceptive advice if appropriate (oral contraceptives may increase prolactin concentrations); caution inpatients with history or serious  mental disorders or with cardiovascular disease or Raynaud’s syndrome and monitor for retroperitoneal fibrosis; hepatic and renal impairment. Hypotensive reactions in some patients during the first few days of treatment and particular care should be exercised when driving or operating machinery; tolerance may be  reduced by alcohol. 

Precautions:

Hepatic, renal and cardiovascular disease. In patients with history of Psychosis. Concomitant administration with estrogen. Children, diabetes and peptic ulcer.


Pregnancy& breastfeeding: Use with caution.


Old age: May be given

Interaction:

Drugs  


Erythromycine increases plasma concentration


Antipsychotics: antagonism of hypoprolectinaemic and antiparkinsonian effect.


Metaclopramide, Demperidone: antagonise hypoprolectinaemic  effect.


Antihypertensive: Efficacy potentiated by concomitant use of bromocriptine dopamine antagonists phenothiazines, butyrophenones: Decrease efficacy of these drugs.


Erythromycin:Increases efficacy of bromocriptine.


Alcohol: Decreases tolerance to bromo-criptine and vice-versa


 

Warnings:

Adverse Effects:

Lactations:

Special Precautions:

Counselling:

Side Effects Or Adverse Reactions:

Patient And Carer Advice: