Bromocriptine Mesylate

Bromocriptine Mesylate, a modified version of an occurring ergot alkaloid, has been found to be effective in managing various conditions related to high prolactin levels and neurological issues. Its diverse range of effects makes it suitable for a wide range of medical situations.

Synthesized for the time during the 1960s, Bromocriptine received FDA approval in 1978. Its approval signified a breakthrough in treating Parkinsons' disease and conditions related to prolactin secretion. The journey of Bromocriptine from a lab-created compound to a player in neuroendocrine therapy is quite remarkable.

The main component, Bromocriptine Mesylate, functions as a dopamine D2 receptor agonist. This action is crucial, for its capability to suppress the secretion of prolactin affecting hormonal and nervous systems.

Bromocriptine is available in capsule or tablet form, providing options for how it can be taken. Both versions are created to improve how the body absorbs the medication and its effectiveness, guaranteeing a release of the drug and making it easier for patients to follow their treatment plan.

Bromocriptine works by imitating dopamine, a brain chemical that plays a key role in controlling movement and regulating hormones.

The way Bromocriptine is processed in the liver highlights its metabolism, which requires precise monitoring of dosage due to its bioavailability. In terms of how it works in the body, the medication affects dopamine receptors in the system, influencing both movement and hormone levels.

1. Hyperprolactinemia:

   • Bromocriptine Mesylate (brand name: Parlodel) is used to treat conditions caused by a hormone imbalance where there is excess prolactin in the blood.
   • High prolactin levels can lead to various symptoms:
     • Sexual Problems
     • Hot Flashes
     • Menstrual Problems
     • Infertility in Women
     • Muscle Loss in Men
     • Breast Enlargement in Men and Women
     • Lack of Sexual Development in Adolescents
   • It is also effective in treating these disorders when caused by a noncancerous tumor of the pituitary gland that overproduces prolactin¹².

2. Acromegaly:

   • Bromocriptine is sometimes used in conjunction with surgery or radiation to treat acromegaly.
   • Acromegaly results from a pituitary gland tumor that produces excessive growth hormone¹.

3. Parkinson’s Disease:

   • Parlodel is used to manage symptoms of Parkinson’s disease, including stiffness, tremors, muscle spasms, and poor muscle control¹.

4. Menstrual Problems and Milk Production:

   • Bromocriptine is used to treat certain menstrual problems (such as amenorrhea) in women.
   • It also stops milk production in some men and women who experience abnormal milk leakage².

5. Infertility:

   • Both men and women with infertility due to excessive prolactin production can benefit from bromocriptine treatment².

1. Restless Legs Syndrome (RLS):

   • Bromocriptine has been used off-label to manage restless legs syndrome (RLS).
   • RLS is characterized by uncomfortable sensations in the legs, often accompanied by an irresistible urge to move them¹.

2. Neuroleptic Malignant Syndrome (NMS):

   • Bromocriptine has been employed in the treatment of neuroleptic malignant syndrome (NMS).
   • NMS is a rare but serious condition associated with antipsychotic medications. It presents with hyperthermia, altered mental status, and autonomic dysregulation¹.

3. Type 2 Diabetes Mellitus:

   • Some studies suggest that bromocriptine may have a role in managing type 2 diabetes mellitus.
   • It may improve insulin sensitivity and glycemic control¹.

The amount of Bromocriptine needed differs greatly depending on the condition being addressed. It can range from as little as 1.25 mg to 20 mg per day, given in separate doses.

Bromocriptine is available in tablets and capsules, allowing for adaptable use based on individual patient requirements and particular medical situations.

It is important to make changes to the dosage for individuals and those with kidney or liver issues to minimize any adverse effects and improve the effectiveness of treatment.

Elderly individuals are usually advised to use amounts of Bromocriptine because they tend to be more sensitive to its effects and are more likely to have other health conditions.

During pregnancy and breastfeeding, it's typically not recommended to use Bromocriptine. In urgent situations, with careful medical oversight, it might be considered.

Bromocriptine Mesylate has the potential to interact with types of medications, impacting its effectiveness and possibly increasing the occurrence of side effects. Some significant interactions to be mindful of are as follows;

• Antipsychotics: When used together, antipsychotic drugs may counteract the intended effects of Bromocriptine, reducing its effectiveness in managing Parkinson's' disease.
• Antihypertensives: The combination could heighten Bromocriptine's blood pressure, lowering the impact and requiring adjustments in blood pressure management.
• Macrolide antibiotics: These antibiotics have the potential to elevate the levels of Bromocriptine in the bloodstream, which could result in toxicity. Patients must communicate all medications to their healthcare provider to prevent any potential conflicts during treatment.

Certain decisions about how you live and what you eat can impact how well Bromocriptine works.

• For example; Drinking alcohol; This can make the effects of Bromocriptine worse affecting thinking and movement.
• Grapefruit juice; It might raise the levels of Bromocriptine, in the blood increasing the chances of negative effects.
• Patients should talk to their healthcare provider about their eating habits and lifestyle to ensure they manage their condition effectively.

Bromocriptine Mesylate should not be used in patients with high blood pressure as it can worsen blood pressure levels.

• Its also not recommended for those with a history of heart attacks if there is remaining coronary artery disease.
• Avoid using it if you are allergic to ergot derivatives, as it could lead to allergic reactions.
• In cases of conditions, like ulcers or psychiatric disorders the risks and benefits need to be thoroughly assessed before considering its use.

It's crucial to keep a check on blood pressure, especially for patients at risk of low blood pressure.

• Additional precautions involve watching out for symptoms of heart valve issues, as Bromocriptine has been linked to valve problems in patients.
• Also, be vigilant for any changes, particularly in individuals with Parkinsons' disease, as treatment adjustments might be necessary.

Bromocriptine Mesylate should be stored away from light and moisture in a dry place to ensure its effectiveness. It's essential to keep the tablets and capsules in their packaging and dispose of the medication correctly once it reaches its expiration date to avoid any accidental consumption or misuse.

Taking much Bromocriptine Mesylate may show up as

• Feeling nauseous, throwing up, and experiencing extremely low blood pressure.
• Feeling confused seeing things that are not there and behaving in ways that seem strange.
• Having intense headaches and seizures. If you notice these signs, it's important to seek help immediately.

In case of an overdose, it is important to seek medical attention.

• Treatment options include Gastric lavage to get rid of any unabsorbed medication in the stomach.
• Administering activated charcoal to lessen drug absorption in the digestive system.
• Providing symptomatic treatment, like fluids for low blood pressure and anticonvulsants for seizures.
• There is no antidote for Bromocriptine overdose, so the focus is on supportive care and managing symptoms.