Bromocriptine user's manual
- Bromocriptine user's manual
Bromocriptine is a drug from the group of inhibitors of prolactin and antiparkinsonian agents.
The active ingredient is bromocriptine mesylate (bromocriptine 2.5 mg). Auxiliary components are silicon dioxide, magnesium stearate, talc, starch, cellulose.
The active substance of the drug is derived from ergot and a stimulator of peripheral receptors. This substance inhibits the production of the hormone prolactin and the process of physiological lactation.
The use of bromocriptine allows normalizing the menstrual cycle, reducing the size and number of benign neoplasms (cysts) in the mammary glands. This is due to the ability of the drug to eliminate the imbalance of estrogen and progesterone.
The use of this drug can normalize the production of luteinizing hormones and eliminate the symptoms of polycystic ovaries.
The use of bromocriptine slows the growth of prolactin-dependent adenomas of the pituitary gland and reduces their size.
When bromocriptine is used in high dosage, stimulation of the hypothalamus and dopamine receptors is observed, the processes in these systems are normalized.
The use of bromocriptine contributes to the provision of antiparkinsonian action: the elimination of tremors, slowed movements, depressive states and other manifestations of Parkinson's disease. The effectiveness of the drug persists for a long period of time.
The drug intake promotes suppression of somatotropic and adrenocorticotropic hormones. In this case, the drug does not affect the level of other hormones of the pituitary gland, if their quantitative content is normal.
- After taking a single dose of the drug, a decrease in prolactin occurs after 2 hours, the maximum effect of the drug is observed after 8 hours.
- The antiparkinsonian effect occurs after half an hour - 40 minutes, the maximum effectiveness of the drug develops after 2 hours.
- The decrease in the level of somatotropic hormone is observed after 60-120 minutes after taking a single dose, the maximum effectiveness of the drug develops after 1-2 months of using Bromocriptine.
Bromocriptine has the ability to enter breast milk. Excretion of the substance is carried out by bile and kidney.
Method of administration, dose
Tablets should be taken orally while eating.
For menstrual disorders and during the treatment of female infertility, the drug is used at a dose of 1.25 mg to 3 times a day. As necessary, the dose of the drug can be increased to 7.5 mg per day. The drug should be taken before the normalization of the menstrual cycle. In order to prevent the development of disorders, the drug can be used for the prevention of several menstrual cycles.
During the treatment of premenstrual syndrome, the start of the medication is scheduled for the 14th day of the cycle. The initial dose is 1.25 mg per day and can be increased to 5 mg. Treatment continues until the onset of menstruation.
In the treatment of acromegaly, the initial recommended dose is 1.25 mg three times a day. With good tolerability of the drug and in the absence of undesirable side effects, the dose is increased to 20 mg per day.
During the treatment of hyperpolaktinemia in males, the drug is prescribed at 1.25 - 10 mg to 3 times a day.
For the treatment of prolactin, the dose of the drug can be from 1.25 mg to 5 mg three times a day. Treatment is continued until the normal level of prolactin.
If benign tumors are found in the mammary gland, the drug is used at a dose of 1.25 mg to 7.5 mg per day. Dosage should be increased gradually, under the supervision of the attending physician.
The exact dosage and duration of the use of tablets Bromocriptine should be selected by the attending physician, taking into account the clinical manifestations of the disease and the individual characteristics of the patient's body.
Lactation, postpartum conditions
In order to stop lactation, bromocriptine is used according to the following scheme:
- 1 day of taking the drug - the dose of the drug is 1.25 mg twice a day.
- The next two weeks of therapy - 2.5 mg twice a day.
Reception of tablets should be started no earlier than 4 hours after childbirth or abortion. A few days after the withdrawal of the use of the drug, minor discharges of breast milk are possible. In this case, the resumption of medication for 7 days at a dose of 2.5 mg twice daily will contribute to the complete cessation of discharge.
With the postnatal engorgement of the breast, the drug is taken 1 time at a dose of 2.5 mg. It is possible to re-take the medication after 6-12 hours. This does not lead to an end to the secretion of breast milk.
When mastitis begins , the drug is taken in the same way as indicated for the cessation of lactation. As necessary, the treatment is supplemented with antibacterial drugs.
Treatment of Parkinson's Disease
In order to protect the patient from the development of unwanted side effects, therapy should begin with a minimum dose of 1.25 mg once a day, preferably in the evening. The duration of the initial scheme of admission is 7 days.
With good tolerability, a daily dosage increase of 1.25 mg 2-3 times a day is recommended.
Therapeutic effect occurs after 6 weeks - 2 months of regular use of tablets. If the positive medical effect is not observed, then in the future it is possible to increase the daily dose of the medicine: every day by 2.5 mg.
The average therapeutic dosage during mono-and combined treatment is 10-40 mg of bromocriptine per day.
In case of poor drug tolerance and the development of undesirable side effects, dosage should be reduced gradually. After elimination of side effects, the dose may be increased again on the recommendation and under the supervision of the attending physician.
In the event that the patient has motor disorders and takes levodopa, before starting the use of bromocriptine, the dose of levodopa should be reduced. If bromocriptine treatment has the necessary therapeutic effect, the dosage of levodopa continues to gradually decrease and eventually abolish the use of this drug.
Introduction to the regimen of therapy of Brmo-cerebrin is carried out with poor tolerance of levodopa and in case of undesirable side effects.
In case of an overdose of the drug, it is possible to develop hallucinations, headache, lowering the level of blood pressure.
In this case, you need to see a doctor immediately. As a therapy, parenteral administration of metoclopramide (Cerucal) is recommended.
Indications for use
The drug Bromocriptine can be used during the treatment of the following diseases:
- Violations of the menstrual cycle, premenstrual syndrome, luteal phase insufficiency, infertility (including prolactin-independent), polycystic ovary.
- Prolactin-dependent diseases that are accompanied or not accompanied by an increase in the concentration of prolactin.
- Hyperprolactinemia, which is triggered by the intake of certain groups of drugs: psychostimulants, drugs for high blood pressure.
- Hyperprolactinemia in males, oligospermia, impotence, libido disorders.
- Conservative therapy of macro- and microadenomas of the pituitary gland.
- Preoperative conditions in order to reduce the size of the tumor. Postoperative conditions, which are accompanied by an increased level of prolactin.
- Complex therapy of acromegaly in combination with radiotherapy and surgical intervention. In some cases, the drug is used as an alternative to surgery or radiation treatment.
- Suppression of physiological lactation, prevention of lactation after abortion.
- Postnatal breast engorgement, mastitis.
- Mastalgia, which is accompanied by premenstrual syndrome or fibrocystic mastopathy.
- Parkinson's disease (all stages).
Contraindications to the use of bromocriptine are: increased blood pressure in the postpartum period, the development of psychoses, tremors (essential and family), cardiovascular diseases, peptic ulcer, liver failure.
Bromocriptine also can not be used in toxicoses in pregnant women, patients under 15 years of age and in case of individual intolerance of active or auxiliary drugs, as well as ergot derivatives.
Bromocriptine is used with extreme caution in Parkinson's disease, accompanied by dementia, during breastfeeding and with simultaneous antihypertensive treatment.
Bromocriptine during pregnancy and GW
Women of childbearing age should be mindful of the careful attitude to the selection of reliable contraceptives during the use of bromocriptine. Preference is recommended to give non-hormonal means of protection from unwanted pregnancy.
In the event that against the background of the use of the drug comes pregnancy and the patient wishes to save the child, the use of bromocriptine should be stopped immediately. This recommendation does not apply to cases where the potential benefits of using the drug pain than possible harm to the fetus.
The use of bromocriptine during the first 2 months of bearing a child does not contribute to the negative impact of pregnancy and its outcome.
During breastfeeding, the drug can be used only in the case of objective indications for admission, as directed and under the supervision of a physician.
Use of pills Brmocryptin may provoke the development of such undesirable side effects: dizziness, vomiting, nausea, increased fatigue. These adverse reactions do not require the withdrawal of tablets. It is also possible to develop a stroke, heart attack, constipation, sudden falling asleep, drowsiness, hallucinations, psychomotor agitation, psychosis, visual impairment, caries, dry mouth, nasal congestion, allergic reactions, seizures in the calf area.
In the case of long-term use of tablets, the probability of developing Raynaud's syndrome increases. During the treatment of Parkinson's disease - confusion, discharge from the nose, fainting, stomach ulcers, gastric bleeding, appetite disorders, nausea, pain in the abdomen and back, frequent urination.
Interaction with other drug groups
Simultaneous use with such drugs as Erythromycin, Jozamycin, as well as other agents from the group of antibiotics-macrolides, provoke an increase in the concentration of bromocriptine in the blood plasma of the patient.
With simultaneous use with ethanol, it is possible to increase the undesirable side effects of Bromocriptine.
Bromocriptine reduces the effectiveness of oral contraceptives.
In the treatment of elevated prolactin levels, simultaneous use with preparations containing domperidone is not desirable because of the risk of a decrease in the effectiveness of bromocriptine.
Bromocriptine is not recommended for use with MAO inhibitors, furazolidone, ergot alkaloids.
In the case of simultaneous use with methyldopa, reserpine, metoclopramide, molindone, the risk of unwanted side effects increases.
In order to reduce the risk of nausea, it is advisable to use anti-emetic medications 40-60 minutes before taking bromocriptine.
Women should remember that the background of the drug increases the likelihood of early postpartum conception. Bromocriptine promotes the rapid restoration of the functioning of the ovaries.
If pregnancy occurs during the treatment of pituitary adenoma, after stopping the use of the drug, it is necessary to constantly monitor the condition of the adenoma, including examining the patient's vision.
In the event that the drug is used to suppress postpartum lactation, continuous monitoring of the blood pressure level during the first 7 days of using bromocriptine is required.
If a patient has a history of mental disorders, then a large dose of the drug is prescribed with extreme caution and under the supervision of a doctor.
In the treatment of diseases that are not accompanied by an increase in the level of prolactin, bromocriptine is used in the lowest effective dose.
In the event that bromocriptine has a negative effect on the lungs (pleural effusion, presence of infiltrate in the lungs), then use the drug immediately stop and consult a doctor.
Before starting the use of the drug in order to treat benign neoplasms, possible malignant neoplasms should be excluded.
The patient should carefully observe the oral hygiene. If the dryness of the oral cavity worries the patient for more than 14 days is recommended to consult a doctor.
Against the background of the application of Bromocriptine, the patient must undergo systematic monitoring of the condition and functioning of the kidneys, liver, cardiovascular system, and blood tests.
In the event that against the background of the use of the drug in the patient there is an increase in the level of blood pressure, the development of headache and visual impairment, it is necessary to immediately stop taking Bromocriptine, consult a doctor and undergo an appropriate examination.
If there is a significant increase in prolactin-size therapy with Bromocriptine, it should be immediately resumed.
If a history of the patient has a stomach ulcer, then it is better to abstain from applying Bromocripine. In the event that the intended benefit of using the drug exceeds the possible risk, the patient should be informed of the possibility of developing disorders from the gastrointestinal tract and the need in this case to see a doctor.
Bromocriptine may contribute to the development of side effects such as visual impairment, dizziness, drowsiness, so when taking tablets, one should refrain from managing transportation and performing work that requires increased concentration.
Storage of tablets Bromocriptine should be carried out in a dark place, protected from direct sunlight. The recommended storage temperature is from 15 to 30 degrees.
The cost of the drug Bromocriptine is formed depending on the manufacturer of the medicine:
- Bromocriptin-Richter (Hungary) tablets 2.5 mg, 30 pcs. - 335-340 rubles.
- Bromocriptine Ozone (Russia) 2.5 mg, 30 pcs. - 300-315 rub.
- Bromocriptine Poly (Italy) 2.5 mg, 30 pcs. - 360-400 rub.
Exact structural analogues (identical active substance) of the drug Bromocriptine are the following drugs: Abergin, Parlodel, Bromergon.
If necessary, you can also discuss with your doctor the possibility of using drugs such as Dostinex, Norprolac, and Alkaline.