Bromocriptine-KB

Bromocriptine is a drug belonging to the class of ergoline derivatives. This drug acts as a dopamine receptor agonist, mimicking the effects of dopamine in the brain. Bromocriptine is widely used to treat various medical conditions related to the endocrine system and nervous system.

Bromocriptine stimulates dopamine receptors in the brain, which leads to a decrease in the production of prolactin by the pituitary gland. This makes it effective in treating conditions associated with excess prolactin secretion.

Indications Bromocriptine

1. Hyperprolactinemia: Bromocriptine is often used to treat hyperprolactinemia, which is characterized by excess levels of prolactin in the blood. This condition can be associated with menstrual irregularities, infertility, hypogonadism, gynecomastia, and other symptoms.
2. Prolactinoma: Bromocriptine can be used to treat prolactinoma, a tumor of the pituitary gland that causes excess prolactin to be released.
3. Parkinson's Disease: Bromocriptine is sometimes used to treat Parkinson's disease as an adjunct or alternative to other medications.
4. Empty splenic fossa syndrome: This is a rare condition in which fluid or tissue fills the space below the pituitary gland. Bromocriptine may be used to treat symptoms associated with these conditions.
5. Lactation Suppression: After delivery, if the woman does not plan to breastfeed, bromocriptine may be used to suppress lactation.

Release form

Bromocriptine is usually available as a tablet for oral administration. Tablets may have different dosages depending on the medical needs of the patient and the doctor's prescription.

Pharmacodynamics

1. Dopamine agonist: Bromocriptine is an agonist at dopamine receptors, especially dopamine D2 receptors. This leads to stimulation of dopaminergic pathways in the brain.
2. Reducing the secretion of prolactin: Bromocriptine helps reduce the secretion of prolactin, a hormone that is responsible for the regulation of many physiological processes, such as reproductive function, mammary gland and others.
3. Treatment of hyperprolactinemia: Bromocriptine is used in the treatment of hyperprolactinemia, when the level of prolactin in the blood is excessively elevated. This can lead to menstrual irregularities, galactorrhea, infertility and other problems.
4. Improving symptoms of Parkinson's disease: Bromocriptine is also used in the treatment of Parkinson's disease, as its dopaminergic effects can help reduce symptoms of this neurological disease, such as tremors, stiffness and dyskinesia.
5. Regulation of prolactinoma: In the case of prolactinoma, pituitary tumors that produce prolactin, bromocriptine can be used to reduce tumor size and reduce prolactin secretion.
6. Other endocrine and neurological effects: Bromocriptine may also affect other endocrine systems and neurological functions in the body, which may be useful in the treatment of other diseases and conditions.

Pharmacokinetics

1. Absorption: Bromocriptine is usually well absorbed from the gastrointestinal tract after oral administration.
2. Distribution: It has a wide distribution throughout body tissues, including the pituitary gland and hypothalamus.
3. Metabolism: Bromocriptine is metabolized in the liver.
4. Excretion: Bromocriptine is excreted primarily through bile, as well as in urine in the form of metabolites.
5. Half-life: The half-life of bromocriptine is approximately 15 hours.

Dosing and administration

1. Hyperprolactinemia:

   • Initial dosage is usually 1.25 to 2.5 mg taken once or twice daily.
   • The dosage may be gradually increased under medical supervision depending on the response to treatment.
   • The maximum recommended daily dose is usually 15 mg.

2. Parkinson's disease:

   • Initial dosage may be 1.25 to 2.5 mg taken once or twice daily.
   • The dosage can be increased gradually to a maintenance dose under medical supervision.
   • The usual maintenance dose for most patients is 10 to 40 mg per day in divided doses.

3. Amenorrhea and anovulatory cycle:

   • Dosage may vary depending on the patient's response to treatment and goals of treatment.
   • The usual starting dosage is 1.25 to 2.5 mg, taken once or twice daily.
   • The dosage may be increased or decreased under medical supervision.

Use Bromocriptine during pregnancy

1. Prolactinoma:

   • Bromocriptine is often prescribed to reduce the size of prolactinomas, tumors of the pituitary gland that produce prolactin. In pregnant women with prolactinomas, bromocriptine may be used to prevent their growth, which may be stimulated by high levels of estrogen during pregnancy.
   • However, some studies and clinical data indicate that prolactinoma often does not increase in size after conception, allowing some women to discontinue bromocriptine treatment during pregnancy.

2. Risks and safety:

   • Although bromocriptine is widely used during pregnancy in women with prolactinomas, it is important to consider that its safety for the fetus is not guaranteed. Animal studies have shown some risks, but data on the effects in humans are limited.

3. Doctors' recommendations:

   • If pregnant while being treated with bromocriptine, women are often advised to stop taking the drug unless there is a strict indication to continue it, such as large or rapidly growing tumors.
   • Doctors may regularly monitor prolactin levels and the size of the prolactinoma during pregnancy to assess the need to restart bromocriptine treatment.

Contraindications

1. Individual intolerance or allergic reaction: People with a known individual intolerance to bromocriptine or any other component of the drug should avoid its use.
2. Cardiovascular disease: The use of bromocriptine may be contraindicated in patients with serious cardiovascular disease, such as unstable angina, acute myocardial infarction, or heart failure.
3. Hypotension (low blood pressure): Patients with low blood pressure or a tendency to hypotension should use bromocriptine with caution as it may cause a decrease in blood pressure.
4. Vascular disorders: The use of bromocriptine may be contraindicated in the presence of vascular disorders, such as ischemic stroke or severe vascular disease, due to the potential for increased vascular effects of the drug.
5. Pregnancy and breastfeeding: The use of bromocriptine during pregnancy and breastfeeding should be discussed with your doctor as the safety of its use during this period may be limited.
6. Impaired liver function: Patients with impaired liver function may require bromocriptine dosage adjustments or discontinuation.
7. Impaired renal function: If renal function is impaired, bromocriptine dosage may need to be adjusted or discontinued completely.
8. Weakened thyroid function: Bromocriptine may affect thyroid function, so its use may be contraindicated in patients with thyroid dysfunction.

Side effects Bromocriptine

1. Drowsiness and dizziness: These are some of the most common side effects of bromocriptine. They may affect your ability to concentrate and drive.
2. Mental Disturbances: Psychiatric side effects such as anxiety, depression, aggression, hallucinations, and drowsiness may occur.
3. Headache: Some patients may experience headaches or worsening of existing headaches.
4. Nausea and vomiting: These gastric upsets may occur in some patients while taking bromocriptine.
5. Hypotension: Bromocriptine may cause a decrease in blood pressure, which may lead to dizziness or fainting.
6. Heart rhythm disturbances: Some patients may experience heart rhythm disturbances such as tachycardia or arrhythmia.
7. Skin reactions: Allergic skin reactions such as itching, redness, rash or hives may occur.
8. Digestive system dysfunction: Diarrhea, constipation or other gastrointestinal disorders may occur.
9. Vision problems: Some patients may experience vision problems, such as blurred vision or changes in color vision.
10. Other side effects: Include decreased libido, increased milk secretion, dehydration, etc.

Overdose

1. Hypotension: One of the most common symptoms of overdose is a sharp drop in blood pressure, which can lead to dizziness, weakness, fainting, or even loss of consciousness.
2. Tachycardia: Overdose can cause rapid heartbeat and cardiac arrhythmias.
3. Hyperprolactinemia: Because bromocriptine is used to lower prolactin levels, excess bromocriptine in overdose may cause hyperprolactinemia, which may lead to undesirable effects associated with this hormone.
4. Neurological symptoms: Neurological symptoms such as headache, dizziness, drowsiness, agitation, seizures, confusion or hallucinations may also occur.
5. Toxic effect on the liver: In case of overdose, increased levels of liver enzymes and the development of hepatotoxicity may occur.
6. Other systemic effects: Various other systemic complications are possible, including gastrointestinal disorders, allergic reactions, sleep disturbances, and others.

Interactions with other drugs

1. Dopaminergic drugs: Bromocriptine may enhance the dopaminergic effects of other drugs such as levodopa, dopamine and dopamine agonists, which may result in an increased risk of side effects.
2. Antihypertensive drugs: Bromocriptine may enhance the hypotensive effect of antihypertensive drugs, especially angiotensin-converting enzyme inhibitors (ACEIs) and beta-blockers.
3. Antiepileptic drugs: Bromocriptine may interact with some antiepileptic drugs, such as carbamazepine and valproic acid, due to their effects on hepatic metabolism.
4. Drugs that increase hepatic metabolism: Drugs that can increase hepatic metabolism, such as rifampicin or phenytoin, may decrease the concentration of bromocriptine in the body.
5. Drugs that reduce hepatic metabolism: Drugs that may decrease hepatic metabolism, such as cytochrome P450 inhibitors (eg, ketoconazole), may increase bromocriptine concentrations and increase the risk of bromocriptine side effects.