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BROMOCRIPTINE: It is a synthetic ergot derivative & potent dopamine agonist. It has greater action on D2 receptors & is a week a adrenergic blocker but not a exoteric. Decreases protection release from pituitary by actingn depaminergic receptors on lactotroph cells-a strong antigalactopoetic.
Indications: Hyperprolactinemia due to microprolactinomas cousing galactrrhoea, amenorrhoea and infertility in women : guamecp,astoa, impotence and sterility in men. Prevention of physiological laction.
Dosage: Prevention of physiological lactation: start therapy only after patients vital signs are stabilised & no sooner than 4 hrs. after delivery : 2.5 mg twice daily with meals for 14 to 21 days. Galactorroea, amenorroea, females infertility : 2.5 mg 2-3 times daily with meals. Start with low dose of 2-5 mg daily, gradually increasing ot therapeutic dose within Ist week max : 6 months.
Contra-Indication: Hypersensitivity to ergot alkaloids.
Special precautions: It should always be started at a low dose & then gradually increased till response occurs or side effects become limiting Psychiatric disturbances are reported. Instead of oral only mechanical contraceptive measures should be employed. Peptic ulceration. Discontinue if conception occurs. Diabetes, diabetic retinopathy. Hepatic or renal dysfunction. Sever cardiovascular disease. Pituitary adenoma. If pitiutary tumours,evaluate sella trucica before initiating therapy.
Side-effects: Nausea, Vomiting, constipation, postural hypotensions, syncope, behavioral alterations mentla confusion, hallucinations, psychosis.
Drug Interactions: Anti-psychotic drugs oppose the action of bromocriptione and increase the risk of parkinsonism. Domperidonne and metoclopramide may reduce some of the effects of bromcriptine.