Introduction
Bromocriptine Mesylate is a medication primarily used to treat conditions associated with excessive prolactin secretion, such as hyperprolactinemia and prolactinomas. It is also utilized in the management of Parkinson's disease and certain types of pituitary tumors.
Uses
Bromocriptine Mesylate is used for:
- Treating hyperprolactinemia and prolactin-secreting pituitary tumors.
- Managing Parkinson's disease, often in combination with other treatments.
- Alleviating symptoms of acromegaly, a condition caused by excessive growth hormone.
| Brand Name | Bromocriptine Mesylate |
|---|---|
| Type | |
| Weight | |
| Generic | Bromocriptine Mesylate |
| Manufacturer | |
| Available in | English বাংলা |
Mechanism of Action
Bromocriptine Mesylate acts as a dopamine agonist. It binds to dopamine receptors in the brain, particularly D2 receptors, which reduces the release of prolactin from the pituitary gland. This action helps to correct the hormonal imbalance caused by excess prolactin. In Parkinson's disease, it helps to restore dopamine levels in the brain, improving motor control.
How Long Does It Take to Work?
The onset of action for Bromocriptine Mesylate can vary. For hyperprolactinemia, initial effects may be observed within 1 to 2 weeks, but optimal results may take several weeks. For Parkinson's disease, it may take a few weeks to see noticeable improvements in symptoms.
Absorption
Bromocriptine Mesylate is well absorbed from the gastrointestinal tract. Peak plasma concentrations are typically reached within 1 to 2 hours after oral administration.
Route of Elimination
The drug is primarily metabolized in the liver. Bromocriptine and its metabolites are excreted mainly through the bile and feces. A smaller amount is excreted via the urine.
Dosage
General: It is recommended that Bromocriptine mesilate be taken with food. Patients should be evaluated frequently during dose escalation to determine the lowest dosage that produces a therapeutic response.Hyperprolactinemic lndications: The initial dosage is 0.5 mg to 2.5 mg tablet daily. An additional 2.5 mg tablet may be added to the treatment regimen as tolerated as tolerated every 2-7 days until an optimal therapeutic response is achieved.Based on limited data in children of age 11 to 15 the initial dose is 0.5 to 2.5 mg tablet daily. Dosing may need to be increased as tolerated until a therapeutic response is achieved. The therapeutic dosage ranged from 2.5-10 mg daily in children with prolactin-secreting pituitary adenomas.
Acromegaly: The initial recommended dosage is 0.5 to 2.5 mg on retiring (with food) for 3 days. An additional 0.5 to 2.5 mg should be added to the treatment regimen as tolerated every 3-7 days until patient obtains optimal therapeutic benefit. The maximal dosage should not exceed 100 mg/day.
Parkinson's disease: The basic principle of bromocriptine mesilate therapy is to initiate treatment at a low dosage. The initial dose of Bromocriptine mesilate is 0.5 of a 2.5 mg tablet twice daily with meals. If necessary,the dosage may be increased every 14-28 days by 2.5 mg/day with meals.The safety of bromocriptine mesilate has not been demonstrated in dosages exceeding 100 mg/day.
The dosage of Bromocriptine Mesylate depends on the condition being treated:
- For hyperprolactinemia: Initial dose is usually 1.25 mg to 2.5 mg daily, gradually increased to 7.5 mg to 15 mg daily.
- For Parkinson's disease: Starting dose is typically 1.25 mg to 2.5 mg daily, with a gradual increase up to 10 mg to 20 mg daily as needed.
- For acromegaly: Initial dose is 1.25 mg to 2.5 mg daily, increased up to 20 mg daily based on response.
Administration
Bromocriptine Mesylate is administered orally in the form of tablets. It should be taken with food to reduce gastrointestinal side effects.
Side Effects
Common side effects include:
- Nausea
- Dizziness
- Headache
- Fatigue
- Constipation
Serious side effects may include:
- Severe hypotension
- Psychiatric effects such as hallucinations or confusion
- Cardiac issues such as arrhythmias
Toxicity
Toxicity is rare but can occur with overdoses. Symptoms may include severe nausea, vomiting, hypotension, and altered mental status. Immediate medical attention is required if overdose is suspected.
Precautions
Precautions include:
- Monitoring for signs of orthostatic hypotension and managing it appropriately.
- Use with caution in patients with a history of psychiatric disorders.
- Regular monitoring of liver function and blood pressure.
Interaction
Bromocriptine Mesylate may interact with other medications, including:
- Antihypertensive drugs: May enhance hypotensive effects.
- Antipsychotics: May reduce the effectiveness of bromocriptine.
Disease Interaction
Use with caution in patients with:
- Cardiovascular disorders
- Severe hepatic impairment
- History of psychiatric disorders
Drug Interaction
Drug interactions include:
- Antimicrobials like erythromycin or ketoconazole: May affect bromocriptine metabolism.
- Other dopamine agonists: Can increase the risk of side effects.
Food Interactions
Taking bromocriptine with food may help reduce gastrointestinal side effects. There are no significant food interactions, but a consistent dietary routine is advised to manage side effects effectively.
Pregnancy Use
Bromocriptine Mesylate should be used during pregnancy only if the benefits outweigh the risks. Consult a healthcare provider for a thorough risk-benefit analysis.
Lactation Use
Bromocriptine is excreted in breast milk, and its use during lactation is generally not recommended. Consult a healthcare provider to explore alternative treatments if necessary.
Acute Overdose
In case of an acute overdose, symptoms may include severe nausea, vomiting, hypotension, and confusion. Immediate medical attention is required to manage these symptoms and prevent complications.
Contraindication
Bromocriptine Mesylate is contraindicated in:
- Patients with hypersensitivity to bromocriptine or any component of the formulation.
- Severe cardiovascular conditions.
- Uncontrolled hypertension.
Use Direction
Follow the prescribed dosage and administration instructions. Do not exceed the recommended dose and consult a healthcare provider for any necessary adjustments or concerns.
Storage Conditions
Store Bromocriptine Mesylate at room temperature, away from light and moisture. Keep the medication in its original container and out of reach of children.
Volume of Distribution
The volume of distribution of Bromocriptine Mesylate is approximately 8 to 12 liters, indicating its distribution throughout the body, with a focus on the central nervous system.
Half Life
The half-life of Bromocriptine Mesylate is approximately 6 to 8 hours. This can vary based on individual metabolism and other factors.
Clearance
Bromocriptine Mesylate is primarily cleared through the liver and excreted via bile and feces. The renal clearance is minimal compared to hepatic clearance.
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