Bromocriptine instructions for use
- Bromocriptine instructions for use
Bromocriptine is a drug from the group of inhibitors of the production of prolactin and anti-parkinsonian drugs.
The active ingredient is the substance bromocriptine mesilate (bromocriptine - 2.5 mg). Auxiliary components are silicon dioxide, magnesium stearate, talc, starch, cellulose.
The active ingredient of the drug is derived from ergot and stimulator of peripheral receptors. This substance inhibits the production of the hormone prolactin and the process of physiological lactation.
The use of bromocriptine allows you to normalize the menstrual cycle, reduce the size and number of benign tumors (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 allows you to normalize the production of luteinizing hormones and eliminate the symptoms of polycystic ovary.
The use of bromocriptine helps to slow the growth of prolactin-dependent pituitary adenomas and reduces their size.
When using bromocriptine in high dosage, stimulation of the hypothalamus and dopamine receptors is observed, processes in these systems are normalized.
The use of bromocriptine contributes to the anti-parkinsonian effect: the elimination of tremor, slow movements, depressions and other manifestations of Parkinson's disease. The effectiveness of the drug is maintained for a long period of time.
Taking the drug helps to suppress somatotropic and adrenocorticotropic hormones. In this case, the drug does not affect the level of other pituitary hormones, if their quantitative content is normal.
- After taking a single dose of medication, a decrease in prolactin occurs after 2 hours, the maximum effect of the drug is observed after 8 hours.
- The anti-Parkinsonian effect occurs after half an hour - 40 minutes, the maximum effectiveness of the drug develops after 2 hours.
- A decrease in the level of somatotropic hormone is observed 60–120 minutes after a single dose, the maximum efficacy of the drug develops after 1-2 months of using bromocriptine.
Bromocriptine has the ability to pass into breast milk. Removal of the substance is carried out by bile and kidneys.
Dosage and administration
Tablets must be taken orally during meals.
For violations of the menstrual cycle and during the treatment of female infertility, the drug is used at a dose of 1.25 mg up to 3 times a day. As needed, the dose of the medicine can be increased to 7.5 mg per day. The drug should be taken to normalize the menstrual cycle. In order to prevent the development of disorders, the drug can be used for prevention for several menstrual cycles.
During the treatment of premenstrual syndrome, the beginning of the medication is prescribed on 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.
When treating 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 hyperpolactinemia in males, the drug is prescribed 1.25 - 10 mg up to 3 times a day.
For treatment with prolactin, the dose may be from 1.25 mg to 5 mg three times a day. Treatment continues until normalization of prolactin levels.
When detecting benign tumors in the area of the mammary glands, the drug is used in a dose of 1.25 mg to 7.5 mg per day. The dosage must be increased gradually, under the supervision of the attending physician.
The exact dosage and duration of use of Bromocriptine tablets should be selected by the attending physician, taking into account the clinical manifestations of the disease and the individual characteristics of the patient.
Lactation Termination, Postpartum Conditions
In order to stop lactation, bromocriptine is used as follows:
- 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.
Pills should be started no earlier than 4 hours after childbirth or abortion. A few days after discontinuation of the use of the drug, slight excretions of breast milk are possible. In this case, the resumption of the medication for 7 days at a dose of 2.5 mg twice a day will contribute to the complete cessation of secretions.
When postpartum breast engorgement, the drug is taken 1 time at a dose of 2.5 mg. You can re-take the drug after 6-12 hours. This does not lead to the cessation of secretion of breast milk.
With the onset of mastitis , the drug is administered in the same way as indicated for the cessation of lactation. As required, the treatment is supplemented with antibacterial drugs.
Parkinson's disease treatment
In order to protect the patient from the development of undesirable side effects, therapy should be started with a minimum dose of 1.25 mg once a day, preferably in the evening. The duration of the initial regimen is 7 days.
With good tolerability, a daily dosage increase of 1.25 mg 2-3 times a day is recommended.
Therapeutic effect comes after 6 weeks - 2 months of regular use of tablets. If a positive therapeutic effect is not observed, then in the future it is possible to increase the daily dose of the drug: every day by 2.5 mg.
The average therapeutic dosage during mono and combined treatment is 10-40 mg bromocriptine per day.
In case of poor tolerability of the drug and the development of undesirable side effects, the 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 a patient has motor impairment and is receiving levodopa, reduce the dose of levodopa before using bromocriptine. If taking Bromocriptine has the necessary therapeutic effect, the dosage of Levopod continues to be gradually reduced and, over time, completely abolishes the use of this remedy.
The introduction of Brmoocriptine into the treatment regimen is carried out in case of poor tolerance of levodopa and in case of undesirable side effects.
In the case of an overdose of the drug may develop hallucinations, headaches, lower blood pressure.
In this case, you should immediately consult a doctor. As a therapy, parenteral administration of the substance metoclopramide (Reglan) is recommended.
Indications for use
The drug Bromocriptine can be used during the treatment of the following diseases:
- Disorders 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 taking certain groups of drugs: psychostimulants, drugs for high blood pressure.
- Hyperprolactinemia in males, oligospermia, impotence, libido disorders.
- Conservative therapy of the pituitary gland macro- and microadenomas.
- Preoperative conditions in order to reduce the size of the tumor. Postoperative conditions that are accompanied by an increased level of prolactin.
- Combined therapy of acromegaly in combination with radiation therapy 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.
- Postpartum 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 psychosis, tremor (essential and familial), cardiovascular diseases, gastric ulcer, liver failure.
Bromocriptine also cannot be used for toxicosis in pregnant women, patients younger than 15 years of age and in case of individual intolerance to active or auxiliary substances of the drug, as well as ergot derivatives.
Bromocriptine is used with extreme caution in Parkinson's disease, accompanied by dementia, during breastfeeding and while conducting antihypertensive treatment.
Bromocriptine use during pregnancy and HB
Women of childbearing age should be aware of careful attention to the selection of reliable contraceptives when using bromocriptine. Preference is recommended to give non-hormonal means of protection from unwanted pregnancy.
In the event that during the use of the drug comes pregnancy and the patient wants to save the child, the use of bromocriptine should be immediately stopped. This recommendation does not apply in cases where the potential benefit from the use of the drug is pain, than the possible harm to the fetus.
The use of bromocriptine during the first 2 months of carrying 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 prescribed, and under the supervision of a physician.
The use of Brmoocriptine tablets can provoke the development of such undesirable side effects: dizziness, vomiting, nausea, and increased fatigue. These adverse reactions do not require discontinuation of pills. It is also possible the development of stroke, heart attack, constipation, sudden sleep, drowsiness, hallucinations, psychomotor agitation, psychosis, visual impairment, caries, dry mouth, nasal congestion, allergic reactions, cramps in the calf.
In the case of long-term use of tablets increases the likelihood of Raynaud's syndrome. During the treatment of Parkinson's disease - confusion, nasal discharge, fainting, stomach ulcers, stomach bleeding, appetite disturbances, nausea, pain in the abdomen and back, increased urination.
Interaction with other groups of drugs
Simultaneous use with such drugs as Erythromycin, Josamycin, as well as other means from the group of antibiotics-macrolides provoke an increase in the concentration of bromocriptine in the patient's blood plasma.
With simultaneous use with ethanol may increase the unwanted side effects of the drug bromocriptine.
Bromocriptine helps reduce the effectiveness of oral contraceptives.
In the course of treatment of elevated levels of prolactin, simultaneous use with drugs that include domperidone is not desirable because of the risk of reducing the effectiveness of bromocriptine.
Bromocriptine is not recommended to be used together with MAO inhibitors, furazolidone, ergot alkaloids.
In the case of simultaneous use with methyldopa, reserpine, metoclopramide, molindone increases the risk of unwanted side effects.
In order to reduce the risk of developing nausea, it is advisable to use antiemetic drugs 40-60 minutes before taking bromocriptine.
Women need to remember that with the use of the drug increases the likelihood of early postpartum conception. Bromocriptine contributes to the rapid restoration of ovarian function.
If, during the treatment of pituitary adenoma, pregnancy occurs, after the drug is discontinued, it is necessary to constantly monitor the condition of the adenoma, including examining the patient's vision.
In case the drug is used to suppress postpartum lactation, constant monitoring of the blood pressure level is required during the first 7 days of bromocriptine use.
If the patient has a history of mental disorders, then a large dose of the drug is prescribed with extreme caution and under medical supervision.
In the course of therapy of diseases that are not accompanied by an increase in the level of prolactin, bromocriptine is used in the minimum effective dose.
In the event that bromocriptine has a negative effect on the lungs (pleural effusion, the presence of infiltrate in the lungs), then the use of the drug is immediately stopped and see a doctor.
Before using the drug to treat benign neoplasms, possible malignant neoplasms should be excluded.
The patient must carefully observe oral hygiene. If the dryness of the mouth bothers the patient for more than 14 days, it is recommended to consult a doctor.
Against the background of Bromocriptine, the patient should undergo a systematic monitoring of the condition and functioning of the kidneys, liver, cardiovascular system, and a blood test.
In the event that the patient has an increase in blood pressure level due to the use of the drug, the development of headache and visual impairment should immediately stop taking Bromocriptine, consult a doctor and undergo an appropriate examination.
If a significant increase in the size of prolactin is observed, therapy with Bromkriptin should be immediately resumed.
If the patient has a history of gastric ulcer, then it is better to refrain from using Bromocripine. In that case, if the intended benefit of using the drug outweighs the possible risk, then the patient should be informed about the possibility of developing disorders of the gastrointestinal tract and the need in this case to consult a doctor.
Bromocriptine can contribute to the development of such side effects as visual impairment, dizziness, drowsiness, so while taking pills should refrain from driving and doing work that require high concentration of attention.
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 drug:
- Bromocriptine-Richter (Hungary) tablets 2.5 mg, 30 pcs. - 335-340 rub.
- Bromocriptine Ozone (Russia) 2.5 mg, 30 pcs. - 300-315 rubles.
- Bromocriptine Poly (Italy) 2.5 mg, 30 pcs. - 360-400 rubles.
The exact structural analogs (identical active substance) of the bromocriptine preparation are the following drugs: Abergin, Parlodel, Bromergon.
If necessary, you can also discuss with your doctor the possibility of using such drugs as Dostinex, Norprolac, Alactin.