Dysfunctions associated with hyperprolactinemia including amenorrhea with or without galactorrhea, infertility or hypogonadism. Prolactin-secreting adenomas, Acromegaly, Parkinson’s Disease.
Dopamine Agonist; Antiparkinson agent
Bromocriptine mesilate is a nonhormonal, nonestrogenic agent that inhibits the secretion of prolactin in humans, with little or no effect on other pituitary hormones, except in patients with acromegaly, where it lowers elevated blood levels of growth hormone. Bromocriptine mesilate is a dopamine receptor agonist, which activates post-synaptic dopamine receptors.The dopaminergic neurons in the tuberoinfundibular process modulate the secretion of prolactin from the anterior pituitary by secreting a prolactin inhibitory factor (thought to be dopamine); in the corpus striatum the dopaminergic neurons are involved in the control of motor function. Clinically, it significantly reduces plasma levels of prolactin in patients with physiologically elevated prolactin as well as in patients with hyperprolactinemia.
General: It is recommended that Bromocriptine mesilate be taken with food. Patients should be evaluated frequently during dose escalation todetermine the lowest dosage that produces a therapeutic response. Hyperprolactinemic Indications: The initial dosage is 1.25 mg to 2.5 mg tablet daily. An additional 2.5 mg tablet may be added to the treatment regimen as tolerated every 2-7 days until an optimal therapeutic response is achieved. Acromegaly: The initial recommended dosage is 1.25 to 2.5 mg on retiring (with food) for 3 days. An additional 1.25 to 2.5 mg should be added to the treatment regimen as tolerated every 3-7 days until patient obtains optimal therapeutic benefit. Parkinson’s Disease: The initial dose of Bromocriptine mesilate is 1.25 mg of a 2.5 mg tablet twice daily with meals. Prolactinomas: 2.5 mg to 3.75 mg daily Inhibition of lactation: 5 mg (1 tablet twice) daily with morning & evening meals for 14 days
Bromocriptine may interact with dopamine antagonists, butyrophenones, and certain other agents. Compounds in these categories result in a decreased efficacy of Bromocriptine: phenothi-azines, haloperidol, metodopramide, pimozide. Concomitant use of Bromocriptine with other ergot alkaloids is not recommended.
Safety & efficacy of bromocriptine mesilate have not been established in patients with renal or hepatic disease. Care should be exercised when administering Bromocriptine therapy concomitantly with other medications known to lower blood pressure.
The incidence of adverse effects are: nausea , headache, dizziness, fatigue, lightheadedness, vomiting, abdominal cramps, nasal congestion, constipation, diarrhea & drowsiness. A slight hypotensive effect may accompany treatment.
Pregnancy Category B. Nursing Mothers: Bromocriptine should not be used during lactation in postpartum women.
Keep below 30°C temperature, away from light & moisture. Keep out of the reach of children.
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