Parlodel

Parlodel is an agonist of dopamine endings.

[1], [2], [3], [4]

Indications Parlodela

It is used to treat menstrual cycle disorders and infertility in women : pathologies and conditions that depend on the level of prolactin and are accompanied (or not) by hyperprololactinemia (among these are amenorrhea, lutein insufficiency, oligomenorrhea and secondary hyperprolactinemia, which develops during drug treatment of psychoactive and anti-antihypertrophylactic and antihypertrolactinemia of a secondary nature, which develops during drug treatment of psychoactive and anti-antihypertrophylaxis and antihyperprolactinemia of a secondary nature. .

It is also used for PMS, during which pain and swelling in the area of the mammary glands are noted, increased gas formation and instability of mood. It can also be used for infertility in women who are not dependent on prolactin levels: anovulatory cycles (in combination with anti-estrogens) or Stein-Leventhal syndrome.

Men may be prescribed medication for hypogonadism, which arises in connection with indicators of prolactin (impotence, decreased libido or oligospermia). It can also be used in the development of prolactinomas: as a conservative treatment of pituitary micro- and macroadenomas, releasing prolactin. Bromocriptine can also be used before surgical procedures to reduce the size of tumors and facilitate the process of lizirovania.

Parlodel is also used with increased prolactin values during the postoperative period. Medication is prescribed to people with acromegaly as an additional element of the combined treatment, together with radiation therapy and a surgical procedure (can sometimes be used as an alternative to these methods).

The drug is taken to inhibit lactation processes in connection with medical indications (if a woman develops mastitis after childbirth, and in addition to prevent the appearance of lactation after an abortion procedure and engorgement of the mammary glands after childbirth). The drug is prescribed for PCM, nodular, and cystic changes in the region of the mammary glands (their benign form) and for mastodynia.

People with tremors can be prescribed medication at all stages of idiopathic pathology; as monotherapy or in combination with other anti-parkinsonian drugs, it is used in parkinsonism of a postencephalitic nature.

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Release form

The release of the drug is sold in tablets, 30 pieces inside the box.

[6]

Pharmacodynamics

The drug inhibits physiological lactation, slows down the production of prolactin and suppresses the hypersecretion of element GH. In addition, it helps stabilize the menstrual cycle and reduces the number of cysts inside the mammary glands, also reducing their size (by restoring the balance of progesterone with estrogen). Parlodel also stimulates the activity of peripheral and central D2-dopamine endings.

The active component of drugs - ergot alkaloid derivative. Large concentrations of the drug can have a stimulating effect on the end of the black nucleus with a striped brain body, as well as the hypothalamus with the mesolimbic system.

The main element of the drug is bromocriptine. The drug can inhibit the production of hormones STH and ACTH. Bromocriptine has anti-parkinsonian properties.

After the use of a 1-fold portion of the drug after 2 hours there is a decrease in the values of prolactin. The substance reaches its maximum medicinal effect after 8 hours. A decrease in GH is noted after 1-2 hours, and the maximum effect is recorded after 1-2 months of treatment.

The anti-parkinsonian effect is observed after 0.5-1.5 hours, and it reaches its peak values 2 hours after consuming 1-fold portion.

Pharmacokinetics

The medicine taken orally is well absorbed. In volunteers who took the pills inside, the half-suction time of bromocriptine was 0.2-0.5 hours, and plasma Cmax values were noted after approximately 1-3 hours. Plasma indicators of bromocriptine, exceeding a level equal to 50% of Cmax values, are maintained for 3.5 hours.

Impact aimed at reducing the level of prolactin, develops after 12 hours from the moment of oral administration, reaching its maximum levels (decrease in prolactin values by more than 80%) after 5-10 hours. Close to peak indicators of the substance persist for 8-12 hours.

The excretion of the drug from the plasma in an unchanged state occurs in 2 stages, with the final half-life of approximately 15 hours (within 8-20 hours).

Bromocriptine with its metabolic products is almost completely excreted through the liver and only 6% of the ration is excreted by the kidneys. Indicators of protein synthesis - 96%.

Dosing and administration

The drug is taken orally, along with food. A day is allowed to use a maximum of 0.1 g of the substance.

For the treatment of infertility in women and menstrual cycle disorders, 1.25 mg of bromocriptine should be taken 3 times a day. If such a daily portion did not bring results, it is allowed to increase it to 5-7.5 mg of the substance. Treatment is carried out until the stabilization of the cycle or the restoration of ovulation processes. If necessary, several cycles of therapy can be performed - to prevent the development of relapses.

Men with hyperprolactinemia need to take 1.25 mg of the substance 3 times a day, gradually increasing the daily dosage to 5-10 mg.

Women for the treatment of PMS need on the 14th day of the menstruation cycle to start using the medication (with a dosage of 1.25 mg per day). Next, the dose of the drug is gradually increased to 5 mg per day (+1.25 mg daily) - throughout the entire period until the onset of menstruation.

For treatment of prolactinoma, it is necessary to consume 2-3 times a day for 1.25 mg Parlodel. The daily portion of the drug can be increased if it is necessary to stabilize certain indicators of prolactin.

The size of the initial dose of the drug with acromegaly is 1.25 mg with 2-3 times a day, and the subsequent regimen is determined by the severity of negative symptoms and therapeutic efficacy of the drug.

To suppress lactation, it is necessary on the first day, 2 times a day, to take 1.25 mg of the drug, and then, for 14 days, to use 2 times a day for 2.5 mg of the substance. The drug should be taken immediately after the birth of the child - to prevent the onset of lactation (after the condition of the woman will be stabilized). After 2-3 days after the end of treatment, there may be a weak discharge of milk. In such cases, it is required to prolong therapy for 7 days with the use of the above-mentioned portions of drugs.

In the case of engorgement of the mammary glands after childbirth, Parlodel is required to be taken 1-fold per dose of 2.5 mg. Reuse is allowed after a 6-12-hour period (does not lead to undesirable inhibition of the lactation process).

With the development of mastitis after childbirth, a therapeutic regimen with the use of drugs is similar to the course used to inhibit the lactation process. An antibacterial agent may also be added to the treatment regimen.

For the treatment of tumors in the region of the mammary glands, which are of a benign nature, it is required to use 2-3 times a day for 1.25 mg of the drug. In the future, the daily portion of the drug should be increased to 5-7.5 mg.

People with trembling paralysis should start therapy with minimal portions (1.25 mg) to ensure normal tolerance to the drug. Every week, the daily dosage of the medicine is increased by the same 1.25 mg. Drug effects develop after 1.5-2 months of treatment. If there is no effect after this time, it is necessary to continue increasing the dosage. In the event of the development of negative symptoms due to an increase in the portions of the drug, it is necessary to reduce the amount of the substance taken by 7 days. When the patient's condition stabilizes, you can return to the selection of the optimal portion.

Persons with motor disorders, provoked by the use of levodopa, need to reduce the amount of this substance before starting therapy with Parlodel. In some cases, there is a complete abolition of the use of levodopa.

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Use Parlodela during pregnancy

Pregnant Parlodel prescribed very carefully.

Contraindications

Main contraindications:

• endogenous psychosis;
• Huntington's disease;
• Minor's disease;
• bromocriptine hypersensitivity;
• increased blood pressure in the postpartum period;
• reduced blood pressure values;
• ulcers in the gastrointestinal tract;
• preeclampsia;
• diseases affecting the work of the CCC.

Caution is required when combined with antihypertensive drugs, as well as when used in people with parkinsonism, complicated by symptoms of dementia.

Since the active ingredient is excreted with breast milk, the use of drugs during lactation is limited.

Side effects Parlodela

Occasionally, the use of bromocriptine leads to the development of dizziness, nausea, orthostatic collapse or vomiting.

Headaches, psychosis, disorders of visual perception, agitation of a psychomotor nature and a feeling of severe sleepiness may also occur. In addition, stroke, nasal congestion, hallucinations, dry oral mucosa (caries, periodontal disease, orocandiasis, as well as discomfort), myocardial infarction, cramps in the calf muscles, rashes on the epidermis, and signs of allergies can develop.

Prolonged treatment leads to the development of Raynaud's disease.

Therapy with the use of large portions of drugs in parkinsonism can lead to fainting, bleeding inside the gastrointestinal tract (manifested in the form of bloody vomiting and black feces), peptic ulcers and confusion. In addition, this application causes the discharge of cerebrospinal fluid from the nose and Ormond's disease (pain in the back, increased urination, loss of appetite, feeling of general weakness, nausea, pain in the abdominal area and vomiting).

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Overdose

With poisoning, there is a decrease in blood pressure, as well as the development of headaches.

To eliminate these violations, use the substance metoplopramide, which is introduced by the parenteral method.

Interactions with other drugs

Parlodel may impair the therapeutic efficacy of oral contraception.

Erythromycin with clarithromycin and troleandomycin can increase Cmax values and drug bioavailability indicators. When using butyrophenes, the opposite effect is observed.

Selegine with furazolidone, procarbazine, MAOI, haloperidol with loxapine, and in addition, reserpine, ergot alkaloids, phenothiazides, metoclopramide and thioxanthines with methyldopa increase the likelihood of negative symptoms - due to increased plasma indicators of the active element of the drug.

The drug potentiates the therapeutic properties of levodopa and antihypertensive drugs.

Disulfiram-like symptoms occur when the drug is combined with ethyl alcohol (develops tachycardia, vomiting, cough of the reflex type, hyperemia of the epidermis, nausea, pain in the retrosternal region, visual perception disorders, convulsions and pulsating headaches).

If the patient needs to take ritonavir, the daily portion is reduced by half.

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Storage conditions

Parlodel required to keep in a closed from small children, a dark place. Temperatures - no higher than 25 ° C.

[10], [11]

Shelf life

Parlodel allowed to apply within 36 months from the date of manufacture of a therapeutic drug.

Analogs

Analogues of the drug are such means as Ronalin and bromocriptine.

Reviews

Parlodel is considered to be a very effective drug, provided it is administered in accordance with the instructions prescribed by the doctor - this is what the patient reviews say.