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Prolactinoma
Published in Vincenzo Berghella, Maternal-Fetal Evidence Based Guidelines, 2022
The main potential risk to the fetus is from dopamine agonist treatment of hyperprolactinemia. As dopaminergic neurons form early in fetal development, dopamine represents a key component of motor and cognitive development, and both bromocriptine and cabergoline cross the placenta [7, 15, 16]. Administration of bromocriptine during the first months of pregnancy does not harm the fetus (over 6000 pregnancies reported) [7, 8, 17–19]. Data available about the use of bromocriptine later in pregnancy are less, but no adverse events have been reported. Cabergoline use in pregnancy is probably safe as well (over 1000 pregnancies reported), but less experience is reported in comparison to bromocriptine (see also preconception counseling) [7, 15, 16, 19–23]. Because of the long half-life of cabergoline, concerns were raised about use in pregnancy induction (i.e. achieving pregnancy in a previously infertile woman) [15], however use of cabergoline in early pregnancy has not been associated with negative outcomes and thus far, there is no evidence to suggest an increased risk of major malformations beyond the baseline risk [7, 15, 16, 19, 22, 23]. There are however, limited data available about use of cabergoline throughout pregnancy [5, 7, 15].
The twentieth century
Published in Michael J. O’Dowd, The History of Medications for Women, 2020
During the 1980s bromocriptine was used liberally to prevent lactation and breast engorgement in those mothers who chose not to breastfeed. Although the results of treatment were excellent there were some disturbing reports in the literature of side-effects, including myocardial infarction, hypertension, severe headache and seizures and routine use of the drug to prevent lactation was stopped, except in unusual circumstances such as stillbirth.
Principles of Pathophysiology of Infertility Assessment and Treatment*
Published in Asim Kurjak, Ultrasound and Infertility, 2020
Joseph G. Schenker, Aby Lewin, Menashe Ben-David
Apart from reducing prolactin secretion and release, bromocriptine also diminishes DNA synthesis and reduces mitotic activity in the pituitary tumor cells. Long-term treatment with bromocriptine in some patients with micro- or macroadenoma could reduce the volume of the tumor to the point of complete disappearance, Bromocriptine is effective in cases of transient hyperprolactinemia. It may be administered concomitantly with other agents like gonadotropin preparations and CC for induction of ovulation. The side effects of bromocriptine are hypotension, nausea, and vomiting due to the potent dopaminergic agonistic effect, especially in sensitive patients. It has been documented that induction of ovulation with bromocriptine is not associated with an increased rate of multiple gestation, abortions, or congenital malformations.
The role of anti-Mullerian hormone and other correlates in patients with polycystic ovary syndrome
Published in Gynecological Endocrinology, 2023
Moaz O. Moursi, Haya Salem, Ayman R. Ibrahim, Sandy Marzouk, Sara Al-Meraghi, Maha Al-Ajmi, Alreem Al-Naimi, Lolwa Alansari
Unlike the LH/FSH ratio, our study did not show a statistically significant correlation between the levels of prolactin and PCOS diagnosed women. This finding was not surprising as it was consistent with other studies [45,50]. In one study by Filho et al. [51], where bromocriptine was given to a 100 PCOS patients, there was a significant decrease in prolactin levels but no effect on LH, FSH, ovulation and fertility. Moreover, another study by Li et al. [52], revealed that the high levels of prolactin in women with PCOS, were explained by either exogenous medicinal intake or the presence of organic causes such as pituitary adenomas or macroprolactinomas. Similarly, another study by Parsanezhad et al. [50], showed that, out of all the recruited women with PCOS, 16% had elevated prolactin levels, and out of the 16%, all were found to have an identifiable underlying cause for this elevated prolactin. The findings of these articles, in addition to our findings, suggest that a high prolactin level is neither a manifestation nor an association of PCOS.
Pharmacotherapy for post-stroke aphasia: what are the options?
Published in Expert Opinion on Pharmacotherapy, 2023
Marcelo L. Berthier, Guadalupe Dávila
Drugs for Parkinson’s disease and stimulants are used to treat PSA. There is mixed evidence on the role of traditional dopaminergic agents (bromocriptine, levodopa, amantadine) on PSA, most likely due to variable effects on different language domains [73,74]. The most noticeable benefit of dopaminergic stimulation is increasing the drive to generate spontaneous speech [75] together with the enhanced motivation to resume everyday activities and mood [76], arguably by restoring dopaminergic activity in the medial frontal cortex and basal ganglia [44,76]. In contrast, no parallel improvement occurs in auditory comprehension deficits [75]. Bromocriptine has been widely investigated, but it is no longer recommended due to the increased risk of developing valvular heart disease [77] and neurological adverse events [78]. Levodopa accelerates and increases word learning in healthy subjects [79], yet its action in PSA is still controversial, with studies showing benefits [80] and others reporting no relevant improvements [81].
Malignant syndromes: current advances
Published in Expert Opinion on Drug Safety, 2021
Minghua Tao, Jiyuan Li, Xuefeng Wang, Xin Tian
Bromocriptine is an oral dopamine receptor agonist. Many reports have documented the successful treatment of NMS with bromocriptine. A retrospective study [89] showed that bromocriptine and dantrolene could accelerate clinical efficacy and shorten the course of NMS; the average clinical response time to supportive treatment alone was 6.8 days, and when dantrolene and bromocriptine were added, the response times were 1.15 days and 1.03 days, respectively. On average, 15 days were required for complete recovery with support therapy alone, but this period was shortened to 9 days with the addition of dantrolene and 10 days with the addition of bromocriptine. For patients with mild to moderate NMS, bromocriptine alone should be administered at a dose of 2.5–5 mg/injection, 3–4 times/day; its use should continue for 10 days after the symptoms are relieved, and then the dose should be slowly reduced to withdrawal to prevent relapse. For patients with severe NMS, the combination of bromocriptine and dantrolene has better efficacy [90].