Universal reference book for medicines
Product name: ABERGIN (ABERGIN)

Active substance: bromocriptine

Type: Prolactin secretion inhibitor.
Antiparkinsonian preparation
Manufacturer: ФАРМЦЕНТР ВИЛАР (Russia)

Description of the active substance :.
This information is a reference and it is not enough that the drug was prescribed by a doctor.
.
PHARMACHOLOGIC EFFECT
Stimulator of central and peripheral dopamine D 2 receptors, derivative of alkaloid ergot.
Reduces the secretion of prolactin, as well as increased secretion of STH, without affecting normal levels of other pituitary hormones. 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 between progesterone and estrogens). At doses higher than those required to suppress prolactin secretion, bromocriptine causes marked stimulation of dopamine receptors, particularly in the striatum, black brain, hypothalamus, and mesolimbic system. Has antiparkinsonian action, inhibits the secretion of STH and ACTH.
After taking a single dose, a decrease in the level of prolactin in the blood comes in 2 hours, the maximum effect after 8 hours;
the anti-Parkinsonian effect develops after 30-90 minutes, the maximum effect after 2 hours; decrease in the level of STH occurs in 1-2 hours, the maximum effect - after 4-8 weeks of therapy.
PHARMACOKINETICS
After ingestion, absorption of bromocriptine from the gastrointestinal tract is 28%.
Exposed to the effect of "first passage" through the liver.Bioavailability - 6%. Time to reach the maximum concentration in blood plasma is 1-3 hours T 1/2 biphasic: 4-4.5 h in the? -phase, 1 h in the terminal phase.
Binding to plasma albumins is 90-96%.

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 hyperprolactinaemia (amenorrhea, accompanied and not accompanied by galactorrhea, oligomenorrhea, luteal phase insufficiency, secondary hyperprolactinemia induced by drugs);
Prolactin-independent female infertility (polycystic ovarian syndrome, anovulatory cycles - as an additional therapy for anti-estrogens).
Premenstrual syndrome: tenderness of the mammary glands;
edema associated with the phase of the cycle; flatulence; mood disorders.
Hyperprolactinemia in men: prolactin-dependent hypogonadism (oligospermia, loss of libido, impotence).

Prolactinomas: conservative treatment of prolactin secreting micro- and macroadenomas of the pituitary gland;
in the preoperative period to reduce the size of the tumor and facilitate its removal; Postoperative treatment if the level of prolactin remains elevated.
Suppression of lactation: prevention or cessation of postpartum lactation for medical reasons - prevention of lactation after abortion;postpartum engorgement of the mammary glands;
beginning postpartum mastitis.
Benign breast diseases: mastalgia in isolated form or in combination with premenstrual syndrome or benign nodal or cystic changes);benign nodular and / or cystic changes, especially fibrocystic mastopathy.

Parkinson's disease and Parkinson's syndrome, incl.
after encephalitis (in the form of monotherapy or in combination with other antiparkinsonian agents).
DOSING MODE
Individual.
Inside - in a dose of 1.25-2.5 mg 2-3 times / day. With male hypogonadism, prolactinoma, benign breast diseases, acromegaly, the dose is gradually increased to 5-20 mg / day; at parkinsonizme - up to 10-40 mg / sut. If adverse reactions develop during dose selection, the daily dose should be reduced and maintained at this level for a week; With the disappearance of side effects, the dose can be increased again.
SIDE EFFECT
On the part of the digestive system: nausea, vomiting, dry mouth, constipation, diarrhea, impaired liver function.

From the side of the central nervous system: dizziness (usually occur in the first week of treatment), headache, drowsiness, psychomotor agitation, dyskinesia, decreased visual acuity, hallucinations.

From the cardiovascular system: orthostatic hypotension, arrhythmia;
in some cases, with prolonged use - Raynaud's syndrome (especially in predisposed patients).
Allergic reactions: skin rash.

Other: nasal congestion, cramps in the calf muscles.

CONTRAINDICATIONS
Essential and family tremor, Huntington's chorea, severe forms of cardiovascular diseases, arterial hypertension, arterial hypotension, endogenous psychoses, postpartum arterial hypertension, pregnancy toxicity, hypersensitivity to ergot alkaloids.

PREGNANCY AND LACTATION
When pregnancy occurs, it is recommended that bromocriptine be withdrawn as soon as possible after conception, unless there is a medical indication for continuing therapy.

Possible application in the lactation period according to the indications.
It should be borne in mind that bromocriptine is excreted in breast milk.
SPECIAL INSTRUCTIONS
They are used with caution in Parkinsonism with signs of dementia, with simultaneous antihypertensive therapy, in patients with erosive and ulcerative gastrointestinal lesions, with a history of bleeding from the gastrointestinal tract.

Since during the first days of treatment, hypotensive reactions are possible, a state of anxiety, regular monitoring of blood pressure and the patient's condition is necessary.

Most of the side effects of bromocriptine usually decrease or disappear with a lower dose.
At the beginning of treatment, it is recommended to prescribe an anti-emetic for 1 h before taking bromocriptine.
Women with a regular menstrual cycle receiving bromocriptine for a long time are shown regular (once a year) gynecological examination, preferably with cytological examination of the tissues of the cervix and endometrium.
After the onset of menopause, such a survey is carried out monthly for six months.
With pituitary adenoma, which is accompanied by a significant increase in the size of the Turkish saddle and violation of the visual fields, bromocriptine is prescribed only in cases where surgical treatment and radiation therapy have proved ineffective.

Treatment with bromocriptine can restore normal reproductive function.
To prevent an unwanted pregnancy, you should use reliable contraceptives (with the exception of hormonal contraceptives).
When bromocriptine is prescribed for mastopathy, the presence of a malignant tumor should be excluded.

With Parkinson's disease and Parkinson's syndrome, the combined use of bromocriptine and levodopa leads to an increase in the clinical effect, which makes it possible to reduce the dose of levodopa up to complete cancellation.
This is especially important for patients who develop motor disorders against the background of levodopa treatment, and there is also no stable therapeutic effect.
Impact on the ability to drive vehicles and manage mechanisms

During the treatment period, one should refrain from potentially dangerous activities requiring increased attention and rapid psychomotor reactions.

DRUG INTERACTION
With simultaneous application with bromocriptine, the effectiveness of antipsychotic agents of dopamine receptor antagonists decreases.

When used simultaneously with derivatives of butyrofenone, phenothiazine, a decrease in the effects of bromocriptine is possible.

In patients who simultaneously received bromocriptine and sympathomimetics, there were cases of severe headache, arterial hypertension, seizures, cardiac dysfunction, psychosis.

With simultaneous application with domperidone, a decrease in the effect of bromocriptine in its administration with the aim of decreasing prolactin levels is possible.

With simultaneous use with levodopa, antiparkinsonian action is enhanced;
with antihypertensive drugs - increased hypotensive effect.
With simultaneous application with erythromycin, josamycin, other macrolide antibiotics, octreotide, an increase in the concentration of bromocriptine in the blood plasma is possible;
with ethanol - it is possible to increase the side effects of bromocriptine.
Bromocriptine reduces the effectiveness of oral contraceptives.


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