Bromocriptine-Richter
Bromocriptine-Richter: instructions for use and reviews
- 1. Release form and composition
- 2. Pharmacological properties
- 3. Indications for use
- 4. Contraindications
- 5. Method of application and dosage
- 6. Side effects
- 7. Overdose
- 8. Special instructions
- 9. Application during pregnancy and lactation
- 10. Use in childhood
- 11. For violations of liver function
- 12. Drug interactions
- 13. Analogs
- 14. Terms and conditions of storage
- 15. Terms of dispensing from pharmacies
- 16. Reviews
- 17. Price in pharmacies
Latin name: Bromocriptin-Richter
ATX code: N04BC01
Active ingredient: bromocriptine (Bromocriptine)
Manufacturer: Gedeon Richter (Hungary); Gedeon Richter-Rus (Russia)
Description and photo updated: 2018-29-11
Prices in pharmacies: from 270 rubles.
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Bromocriptine-Richter is a drug with dopaminergic, antiparkinsonian action.
Release form and composition
Dosage form - tablets: almost white, round flat shape, with a chamfer, on one side there is a risk, on the other - engraving "2.5" (in a cardboard box 1 bottle of dark glass containing 30 tablets, and instructions for use of Bromocriptine- Richter).
Composition of 1 tablet:
- active substance: bromocriptine - 2.5 mg (bromocriptine mesylate - 2.87 mg);
- auxiliary components: lactose monohydrate - 41 mg; colloidal silicon dioxide - 0.65 mg; povidone K30 - 5.2 mg; corn starch - 35.08 mg; magnesium stearate - 1.3 mg; microcrystalline cellulose - 40 mg; talc - 3.9 mg.
Pharmacological properties
Pharmacodynamics
Bromocriptine is an ergot derivative, a stimulant of central and peripheral dopamine D 2 receptors. Due to the inhibition of prolactin secretion, physiological lactation is suppressed, the normalization of menstrual function is stimulated, the size and number of cysts in the mammary gland is reduced, which is associated with the elimination of the imbalance in the levels of hormones - estrogen and progesterone.
Bromocriptine does not affect postpartum involution of the uterus, the risk of thromboembolism does not increase. Other effects of the substance:
- normalization of LH (luteinizing hormone) secretion;
- a decrease in the severity of polycystic ovary syndrome;
- promotion of growth arrest and reduction in the size of prolactin-secreting pituitary adenomas.
When used in high doses, the dopamine receptors of the black nucleus and striatum of the brain, the mesolimbic system and the hypothalamus are stimulated, as well as the restoration of neurochemical balance in these structures.
Bromocriptine has an antiparkinsonian effect, which is manifested in a decrease in tremor, rigidity and slowness of movement at all stages of Parkinson's disease. There is also a decrease in the severity of concomitant depression, while the effectiveness persists for many years.
The substance suppresses the secretion of growth hormone and ACTH (somatotropic and adrenocorticotropic hormones) of the pituitary gland, at the same time, it does not have an effect on other hormones of the pituitary gland, if their concentration does not go beyond the normal range.
A decrease in the level of prolactin in the blood after taking a single dose is noted after 2 hours, the development of the maximum effect is observed after 8 hours. The antiparkinsonian effect develops in 30–90 minutes, it reaches its maximum in 2 hours. A decrease in the level of growth hormone is observed 1-2 hours after taking the drug.
The maximum effect of the use of Bromocriptine-Richter is achieved within 4-8 weeks of therapy.
Pharmacokinetics
The absorption of bromocriptine from the gastrointestinal tract is 30%, the half-absorption period is 20 minutes. The biological availability of the substance is 6% (associated with the effect of the first passage through the liver). The time to reach C max (maximum concentration) in the blood varies from 1 to 3 hours.
Bromocriptine binds to plasma proteins (albumin) at a level of 90–96%; passes into breast milk.
In T 1/2 (half-life) of bromocriptine, two phases are distinguished: α-phase - in the range from 4 to 4.5 hours; the final phase is 15 hours.
The substance is excreted in the form of metabolites: 6% - by the kidneys, most of the dose - with bile.
Indications for use
- idiopathic Parkinson's disease and post-encephalitis parkinsonism at all stages (as monotherapy or in addition to other anti-Parkinsonian drugs);
- prolactin-independent female infertility: anovulatory cycles (Bromocriptine-Richter is prescribed as an adjunct to the use of antiestrogens, such as clomiphene); polycystic ovary syndrome;
- female infertility, menstrual irregularities: prolactin-dependent conditions / diseases with / without hyperprolactinemia (amenorrhea with / without galactorrhea); insufficiency of the luteal phase; oligomenorrhea; secondary hyperprolactinemia, which is associated with the use of certain drugs (antihypertensive drugs, psychostimulants);
- premenstrual syndrome (manifested by breast tenderness, edema, mood disorders, flatulence);
- prolactinomas: prolactin-secreting micro- and macroadenomas of the pituitary gland (conservative therapy); postoperative treatment in cases where the level of prolactin remains elevated; preoperative preparation to reduce tumor volume;
- benign diseases of the mammary glands: mastalgia with or without premenstrual syndrome; benign cystic or nodular changes, especially fibrocystic breast disease; mastalgia in combination with benign cystic or nodular changes in the gland;
- suppression of lactation: prevention or suppression of postpartum lactation (if medically indicated) after an abortion; incipient postpartum mastitis; postpartum engorgement of the mammary glands;
- acromegaly (Bromocriptine-Richter is prescribed as an adjunct to radiation and surgical treatment or, in special cases, as an alternative to radiation therapy or surgery);
- hyperprolactinemia in men: prolactin-dependent hypogonadism, including oligospermia, decreased libido, impotence.
Contraindications
Absolute:
- gestosis;
- heart valve disease;
- arterial hypertension in the postpartum period;
- essential and familial tremor;
- chorea of Huntington;
- psychosis;
- cardiovascular diseases, including arterial hyper- and hypotension;
- liver failure;
- ulcerative lesions of the gastrointestinal tract;
- age up to 15 years;
- individual intolerance to the components of the drug, as well as other ergot alkaloids.
Relative (Bromocriptine-Richter tablets are prescribed under medical supervision):
- parkinsonism, accompanied by symptoms of dementia;
- combined use with drugs prescribed for antihypertensive therapy;
- pregnancy and lactation.
Bromocriptine-Richter, instructions for use: method and dosage
Bromocriptine-Richter tablets are taken orally, with meals.
Premenstrual syndrome
The use of Bromocriptine-Richter begins on the 14th day of the menstrual cycle with a daily dose of 1.25 mg, gradually increasing the dose to 5 mg (in increments of 1.25 mg), therapy is carried out before the onset of menstruation.
Other diseases caused by imbalances in hormone levels
Reception of Bromocriptine-Richter begins with a single dose of 1.25 mg, taken 2-3 times a day.
Gradually, the daily dose should be increased:
- hyperprolactinemia in men: up to 5-10 mg;
- prolactinomas: up to several tablets that allow to provide the desired level of prolactin in the blood;
- acromegaly: up to 10–20 mg, depending on the therapeutic effect and side effects;
- benign diseases of the mammary glands: up to 5-7.5 mg;
- female infertility, menstrual irregularities: up to 5-7.5 mg. Treatment should be carried out until ovulation is restored and / or the menstrual cycle normalizes. In order to prevent relapses, the drug can be continued for several menstrual cycles.
Cessation of lactation, incipient postpartum mastitis
To stop lactation on the first day, 1.25 mg of Bromocriptine-Richter is taken 2 times a day (morning and evening), after that, for 14 days, the drug is taken 2.5 mg 2 times a day. Treatment begins no earlier than 4 hours after childbirth or abortion after the vital functions of the body have stabilized.
2–3 days after discontinuation of Bromocriptine-Richter, insignificant milk secretion may occur, resumption of therapy for another 7 days in compliance with the indicated dosage regimen leads to cessation of secretion.
With the onset of postpartum mastitis, treatment is carried out in the same way, if necessary, antibiotics are prescribed.
In the case of postpartum engorgement of the mammary glands, Bromocriptine-Richter is taken once in a dose of 2.5 mg, after 6-12 hours, the drug can be taken in the same dose, and there is no unwanted stop of lactation.
Parkinson's disease
In order to ensure optimal tolerability, the use of Bromocriptine-Richter is started with a small dose: once a day, preferably in the evening, 1.25 mg for one week. The daily dose is increased weekly in increments of 1.25 mg, divided into 2-3 doses.
The development of the therapeutic effect is noted in 6-8 weeks, if this does not happen, the dose increase can be continued by increasing the step to 2.5 mg.
The average therapeutic dose used for mono- and combined treatment is from 10 to 30 mg (maximum) per day.
In cases where side effects develop against the background of therapy, the daily dose is reduced, while the interval between such reductions must be observed at least one week. After the undesirable reactions disappear, the dose can be increased again.
Patients who have experienced movement disorders while taking levodopa are advised to reduce the dose of levodopa before taking Bromocriptine-Richter. With a satisfactory therapeutic effect, a further gradual decrease in the dose of levodopa can be continued, in some cases - up to its complete cancellation.
The use of Bromocriptine-Richter should begin simultaneously with the development of side reactions of levodopa, including dyskinesia, worsening of the condition by the end of the action of levodopa, which is associated with a decrease in the duration of the effect of a single dose (the "end of dose" effect), starting with the minimum effective dose of Bromocriptine-Richter. Higher doses should only be used in exceptional cases.
Side effects
Possible adverse reactions (> 10% - very common;> 1% and 0.1% and 0.01% and <0.1% - rarely; <0.01% - very rare):
- cardiovascular system: rarely - myocardial infarction, orthostatic hypotension *;
- nervous system: dizziness *, headache *; rarely - drowsiness, dyskinesia, stroke, psychomotor agitation, sudden falling asleep, psychosis, hallucinations;
- digestive system: vomiting *, nausea *; rarely - oral candidiasis, caries, constipation, dry mouth, periodontal disease;
- organ of vision: rarely - decreased visual acuity;
- others: rarely - cramps in the calf muscles, nasal congestion, fatigue *, allergic skin rash.
* - violations that do not require termination of treatment.
With long-term therapy, Raynaud's syndrome may develop. In the case of the use of high doses for the treatment of parkinsonism, side reactions such as fainting, confusion, gastrointestinal bleeding, release of cerebrospinal fluid from the nasal passages, peptic ulcer, retroperitoneal fibrosis (manifested as pain in the back and abdomen, loss of appetite, nausea, vomiting, frequent urination).
Overdose
The main symptoms: arterial hypotension, headache, hallucinations.
Therapy: metoclopramide (parenteral).
special instructions
At the beginning of treatment, in order to prevent dizziness, vomiting and nausea 1 hour before taking Bromocriptine-Richter, it is advisable to use antiemetics.
It is recommended to periodically monitor blood pressure, kidney / liver function; additionally with parkinsonism - blood picture, functional state of the cardiovascular system.
Against the background of the use of Bromocriptine-Richter, it is necessary to take into account the possibility of pregnancy after childbirth, which is associated with the rapid recovery of ovulatory cycles. It is advisable for women of childbearing age to use non-hormonal methods of contraception.
If pregnancy occurs against the background of a pituitary adenoma, after the cancellation of Bromocriptine-Richter, it is necessary to regularly monitor the condition of the adenoma, including conducting a study of the visual fields.
When using the drug to suppress postpartum lactation, it is necessary to regularly monitor blood pressure, especially during the first week of treatment with bromocriptine.
Before starting the use of Bromocriptine-Richter for benign diseases of the mammary glands, malignant tumors of the same localization should be excluded.
In cases where such disorders as arterial hypertension, sharp persistent headache with / without visual acuity disorders are noted during therapy, it is necessary to cancel the reception of Bromocriptine-Richter and examine the patient.
When treating acromegaly in patients with a history of gastric ulcer, it is advisable to use not Bromocriptine-Richter, but another drug. If this cannot be avoided, the risk of gastrointestinal disturbances must be considered. Such cases should be reported to the attending physician.
Careful oral hygiene is required. If your dry mouth persists for more than two weeks, you should consult your doctor.
Patients with psychiatric disorders require extra caution when administering large doses.
In cases of a pronounced increase in the size of prolactinoma, treatment should be resumed.
In the treatment of diseases that are not accompanied by hyperprolactinemia, the lowest effective dose of bromocriptine should be prescribed.
If pleuropulmonary symptoms develop during therapy (infiltration in the lungs, pleural effusion), Bromocriptine-Richter is canceled and a thorough medical examination of the patient is performed.
Influence on the ability to drive vehicles and complex mechanisms
The question of the possibility of driving vehicles during the period of therapy should be approached individually, since the development of such adverse reactions as decreased visual acuity and sudden falling asleep has wide variability.
Application during pregnancy and lactation
During treatment with Bromocriptine-Richter, women of childbearing age should be provided with reliable, if possible non-hormonal contraception.
If the patient wants to maintain the pregnancy, Bromocriptine-Richter is recommended to be canceled, unless the benefits of bromocriptine for a woman outweigh the possible harm to the fetus.
Therapy in the first eight weeks of gestation has no harmful effect on the course and outcome of pregnancy. After the abolition of Bromocriptine-Richter, abortions do not increase.
The use of the drug during lactation is possible only if indicated.
Pediatric use
The safety profile for patients under 15 years of age has not been studied, therefore Bromocriptine-Richter is not prescribed.
For violations of liver function
In hepatic failure, Bromocriptine-Richter is contraindicated.
Drug interactions
- levodopa, drugs with antihypertensive effects: their effects are enhanced;
- oral contraceptives: their effectiveness decreases;
- ritonavir: the dose is recommended to be reduced by 50%;
- drugs that have an antidopamine effect (phenothiazines, butyrophenones): the effect of bromocriptine may be weakened;
- clarithromycin, erythromycin, troleandomycin: the bioavailability and C max of bromocriptine in plasma increase;
- ergot alkaloids: the plasma concentration of bromocriptine increases, which contributes to the occurrence of side effects; you cannot use drugs together;
- furazolidone, monoamine oxidase inhibitors, selegiline, procarbazine, loxapine, methyldopa, metoclopramide, reserpine, molindone, thioxanthines: the plasma concentration of bromocriptine increases, which contributes to the occurrence of side effects;
- ethanol: the development of disulfiram-like reactions, manifested in the form of throbbing headache, chest pain, hyperemia, tachycardia, decreased visual acuity, seizures, weakness, nausea, vomiting, reflex cough.
Analogs
Analogues of Bromocriptine-Richter are: Abergin, Bromocriptine-KB, Bromocriptine, Apo-Bromocriptine, Bromergon, Parlodel, Serocriptine.
Terms and conditions of storage
Store in a place protected from light at temperatures up to 30 ° C. Keep out of the reach of children.
The shelf life is 3 years.
Terms of dispensing from pharmacies
Dispensed by prescription.
Reviews about Bromocriptine-Richter
On specialized forums and sites, there are mainly positive reviews about Bromocriptine-Richter. Most often it is recommended by women for whom the drug has helped suppress lactation. It is noted that therapy avoids the development of mastopathy. However, in many cases, taking pills is accompanied by the development of side effects of varying severity.
Price for Bromocriptine-Richter in pharmacies
The approximate price for Bromocriptine-Richter (30 tablets) is 271–377 rubles.
Bromocriptine-Richter: prices in online pharmacies
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Drug name Price Pharmacy |
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Bromocriptine-Richter 2.5 mg tablets 30 pcs. 270 RUB Buy |
Anna Kozlova Medical journalist About the author
Education: Rostov State Medical University, specialty "General Medicine".
Information about the drug is generalized, provided for informational purposes only and does not replace the official instructions. Self-medication is hazardous to health!
