Bromocriptine

It is a direct dopaminergic agonist. Improvement of parkinsonian symptoms occurs within 1/2-1hr. of an oral dose of bromocriptine & benefits often lasts from 5-10 hours. If used alone, doses needed in parkinsonism arehigh expensive and often produce intolerable side effects, therefore it may be used at lower doses in conjunction with levodopa - ‘on off’ effect is minimized.

Indications

Parkinson's disease.

Dosage

Initially 1.25 mg (1/2 tab.) daily with meals. Increase after every 14-28 days by 2-5 mg (1 tab.) till max. therapeutic response is achieved. Under no circumstances exceed 100 mg daily.

Contra-Indications

Hypersensitivity to ergot alkaloids.

Special Precautions

Patients driving vehiles or operating heavy machinery, cardiovascular, hepatic & renal impairment. Peptic ulcer. Diabetes, diabetic retinopathy. Concurrent use of oral contraceptives. History of psychotic disorders. Paediatrics: Not usually prescribed. Pregnancy: Safety not established. Lactation: Suppresses milk production and prevents it completely if given within 12 hrs. of delivery. Elderly: Reduced dose may be necessary.

Side Effects

Vomiting, hallucinations, hypotension, nasal stuffiness, conjunctival infection, constipation, nausea, headache, drowsiness.

Drug Interactions

Antihypertensives potentiated. Bioavailability increases if given along with erythromycin. Alcohol reduces tolerance to bormocriptine and vice-versa.