Bromocriptine - instructions for use, real counterparts and release form (tablets 2.5 mg) of the drug for the treatment of infertility, the cessation of lactation in women, including during pregnancy and breastfeeding. Interaction with alcohol and pobochka

In this article, you can read the instructions for using the drug Bromocriptine. Presented are reviews of visitors to the site - consumers of this medication, as well as opinions of medical experts on the use of Bromocriptine in their practice. A big request is to actively add their feedback on the drug: the medicine helped or did not help get rid of the disease, which were observed complications and side effects, possibly not declared by the manufacturer in the annotation. Analogues of Bromocriptine in the presence of existing structural analogs.Use for the treatment of female infertility, menstrual disorders and cessation of lactation in women, including during pregnancy and lactation. Interaction with alcohol and side effects of taking the drug.

Bromocriptine - an ergot derivative, a stimulant of central and peripheral dopamine D2 receptors. Inhibiting the secretion of prolactin, suppresses physiological lactation, contributes to the normalization of menstrual function, reduces the size and number of cysts in the mammary gland by eliminating the imbalance in levels of Progesterone and estrogens. Does not affect the postpartum involution of the uterus and does not increase the risk of thromboembolism. Normalizes the secretion of luteinizing hormone, reduces the severity of the syndrome of polycystic ovaries. Stops growth and reduces the size of prolactin secretion-mediated pituitary adenomas. In high doses, it stimulates the dopamine receptors of the striatum and black brain nucleus, hypothalamus and mesolimbic system and restores the neurochemical balance in these structures.

Has antiparkinsonian action (reduces tremor, stiffness and slowness of movements in all stages of Parkinson's disease),It reduces the severity of concomitant depression, while maintaining efficacy for many years.

Suppresses the secretion of somatotropic and adrenocorticotropic hormones of the pituitary gland, without affecting other hormones of the pituitary gland, if their concentration is within normal limits.

Composition

Bromocriptine + excipients.

Pharmacokinetics

After ingestion, absorption of bromocriptine from the gastrointestinal tract is 28%. Exposed to the effect of "first passage" through the liver. It is excreted mainly with feces - 85.6% and to a small extent with urine - 2.5-5.5%.

Indications

• menstrual cycle disorders;
• female infertility;
• prolactin-dependent diseases and conditions accompanied or not accompanied by hyperprolactinemia (amenorrhea with or without galactorrhea);
• oligomenorrhoea;
• Luteal phase insufficiency;
• secondary hyperprolactinemia associated with taking medications (some psychostimulants, hypotensive drugs);
• prolactin-independent female infertility;
• polycystic ovarian syndrome;
• anovulatory cycles (in addition to anti-estrogen therapy, eg clomiphene);
• premenstrual syndrome (tenderness of the mammary glands, swelling, flatulence, mood disorders);
• hyperprolactinemia in men;
• Prolactin-dependent hypogonadism (oligospermia, lack of libido, impotence);
• prolactinomas: conservative treatment of prolactin secreting micro- and macroadenomas of the pituitary gland;
• preoperative preparation to reduce tumor volume;
• Postoperative treatment if the level of prolactin remains elevated;
• acromegaly: as an additional tool in complex therapy, together with radiotherapy and surgical treatment, or, in special cases, as an alternative to surgical or radiotherapy;
• inhibition of lactation;
• prevention or suppression of postpartum lactation due to medical conditions, after abortion;
• postpartum engorgement of the mammary glands;
• beginning postpartum mastitis;
• benign breast diseases;
• mastalgia with or without premenstrual syndrome;
• mastalgia with benign nodal or cystic gland changes;
• benign nodal or cystic changes, especially fibrocystic mastopathy;
• all stages of idiopathic Parkinson's disease and postencephalitic parkinsonism (monotherapy or in combination with other antiparkinsonian drugs).

Forms of release

Tablets 2.5 mg.

Instructions for use and reception scheme

Inside, with food.

Violations of the menstrual cycle, female infertility: 1.25 mg 2-3 times a day, if necessary, the dose is gradually increased to 5-7.5 mg per day. Treatment continues until the menstrual cycle is normalized and / or ovulation is restored. To prevent relapse, treatment can continue for several menstrual cycles.

Premenstrual syndrome: treatment begins on the 14th day of the menstrual cycle with 1.25 mg per day, the dose is gradually increased by 1.25 mg per day to 5 mg per day (before the onset of menstruation).

Hyperprolactinemia in men: 1.25 mg 2-3 times a day, gradually increasing the dose to 5-10 mg per day.

Prolactinomas: 1.25 mg 2-3 times a day, gradually increasing the dose to several tablets per day, providing the desired level of prolactin in the blood.

Acromegaly: the initial dose of 1.25 mg 2-3 times a day, then, depending on the clinical and side effects, the daily dose can be gradually increased to 10-20 mg.

Cessation of lactation: on the first day to 1.25 mg 2 times (morning and evening), then for 14 days to 2.5 mg 2 times a day. Treatment should begin several hours after birth or abortion, but not in the first 4 hours after them - after stabilization of vital body functions. 2-3 days after drug cancellation, a slight secretion of milk is possible, the resumption of the drug intake for another 1 week at the same dose leads to the cessation of secretion.

Postpartum engorgement of mammary glands: 2.5 mg once, after 6-12 hours the dose can be repeated, undesirable stopping of lactation does not occur.

Benign breast diseases: 1.25 mg 2-3 times a day, the dose is gradually increased to 5-7.5 mg per day.

Parkinson's disease: to ensure optimal tolerability, treatment starts with a small dose: 1.25 mg once a day, preferably in the evening, for 1 week. Dose gradually, weekly increase by 1.25 mg, distributing for 2-3 doses per day. The therapeutic effect occurs within 6-8 weeks of treatment, otherwise you can continue to increase the daily dose, weekly increasing it by 2.5 mg per day. The average therapeutic dose for mono- and combination therapy is 10-40 mg per day.In case of side effects, the daily dose is to be reduced, after each next decrease the dose is prescribed for at least 1 week. With the disappearance of unwanted reactions, the dose can be increased again. Patients with motor disorders noted on the background of taking levodopa, it is recommended to lower the dose of levodopa before the application of bromocriptine. In case of a satisfactory therapeutic effect, a further gradual decrease in the dose of levodopa can be continued, sometimes until its complete cancellation. Treatment with bromocriptine should be started simultaneously with the development of side effects of levodopa, for example, dyskinesia, the effect of end of dose, starting with the minimum effective dose. Higher doses are used in exceptional cases.

Side effect

• nausea, vomiting;
• headache;
• dizziness;
• orthostatic hypotension;
• fatigue;
• myocardial infarction;
• stroke;
• constipation;
• drowsiness;
• sudden falling asleep;
• psychomotor agitation;
• hallucinations;
• psychoses;
• dyskinesia;
• impaired vision;
• decreased visual acuity;
• dry mouth;
• caries;
• periodontal disease;
• nasal congestion;
• an allergic skin rash;
• cramps in the calf muscles;
• Raynaud's symptom;
• allocation of cerebrospinal fluid from the nasal passages;
• fainting;
• peptic ulcer;
• gastrointestinal bleeding;
• retroperitoneal fibrosis (pain in the abdomen, back, loss of appetite, nausea, vomiting, frequent urination).

Contraindications

• arterial hypertension in the postpartum period;
• essential and family tremor;
• Goettington's chorea;
• psychoses;
• cardiovascular diseases (including arterial hypertension, hypotension);
• liver failure;
• ulcerative lesions of the gastrointestinal tract;
• children's age (up to 15 years, due to lack of sufficient clinical experience);
• toxicosis of pregnancy;
• increased sensitivity to bromocriptine and other ergot alkaloids.

Application in pregnancy and lactation

Women of childbearing age during treatment with bromocriptine should ensure reliable, possibly non-hormonal contraception. If the patient wishes to save the pregnancy, he should stop treatment with bromocriptine, except when the benefits of bromocriptine are greater than the harm done to the fetus. Admission of bromocriptine in the first 8 weeks of pregnancy does not have a harmful effect on the course and outcome of pregnancy.After abortion abortion does not increase.

During the lactation period, they are used only on indications.

special instructions

To prevent dizziness, nausea and vomiting at the beginning of treatment, it is advisable to prescribe antiemetics for 1 h before taking the drug.

Periodic monitoring of blood pressure, kidney and liver function is recommended, in case of parkinsonism - additionally the functions of the cardiovascular system, blood paintings.

Women should be warned about the possibility of early postpartum conception, because treatment with bromocriptine after birth can accelerate the resumption of ovarian function.

In the case of pregnancy on the background of pituitary adenoma, after the cessation of bromocriptine treatment, regular monitoring of the condition of the adenoma, including examination of the visual fields, is necessary.

When suppressing postpartum lactation, regular monitoring of blood pressure is necessary, especially in the first week of treatment with bromocriptine.

Before beginning treatment of benign breast diseases, the presence of a malignant tumor of the same localization should be excluded.

With arterial hypertension, sharp, persistent headache with visual impairment or without vision impairment, bromocriptine treatment should be discontinued and the patient should be examined.

In the presence of a history of peptic ulcer disease, it is desirable to abandon the treatment of acromegaly with bromocriptine and apply, if possible, another therapy. In the case where treatment with bromocriptine is still carried out, the patient should be warned about the possible development of gastrointestinal disorders and the importance of treatment in such cases to the treating doctor.

Careful hygiene of the oral cavity is necessary. With continued dryness of the oral cavity for more than 2 weeks, you should consult your doctor.

In the presence of mental disorders, the appointment of large doses requires special care.

In the case of a pronounced increase in prolactinoma size, it is necessary to start treatment again.

In the treatment of diseases not accompanied by hyperprolactinemia, the lowest effective dose of bromocriptine is prescribed.

With the development of pleuropulmonary symptoms (infiltrate in the lungs, pleural effusion), discontinue treatment and conduct a thorough medical examination of the patient.

Impact on the ability to drive vehicles and manage mechanisms

One should refrain from driving a car and taking classes in activities,requiring increased attention and speed of physical and psychomotor reactions (sudden falling asleep, decreased visual acuity). These restrictions are of an individual nature.

Drug Interactions

Reduces the effectiveness of oral contraceptives.

Enhances the effects of levodopa, hypotensive drugs.

Erythromycin, claerythromycin, troleandomycin increase the bioavailability and Cmax of the drug in plasma.

When administered with ritonavir, a 50% dose reduction is recommended.

MAO inhibitors, furazolidone, procarbazine, selegiline, ergot alkaloids (can not be used together), loxapine, methyldopa, metoclopramide, molindone, reserpine, thioxanthins increase the plasma concentration and promote the development of adverse reactions.

Drugs that have an antidopamin effect (butyrophenones, phenothiazines) can weaken the effect of bromocriptine.

The intake of ethanol (alcohol) leads to the development of disulfiram-like reactions: chest pain, hyperemia, tachycardia, nausea, vomiting, reflex cough, pulsating headache, decreased visual acuity, weakness, convulsions.

Analogs of the drug Bromocriptine

Structural analogs for the active substance:

• Aberghin;
• Apo Bromocriptine;
• Bromocriptine Poly;
• Bromocriptin KV;
• Bromocriptine Richter;
• Bromocriptine mesylate;
• Bromergon;
• Parlodel;
• Serokriptin.

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