It's a means of reducing prolactin levels. Dopamine receptor stimulator. Suppresses the secretion of prolactin, the hormone of the anterior pituitary gland, without altering the levels of other pituitary hormones. Parlodel inhibits the secretion of the anterior pituitary hormone - prolactin - without affecting normal levels of other pituitary hormones. However, it can reduce elevated levels of somatotropic hormone (STH) in acromegaly patients. This action is due to the stimulation of dopamine receptors. In the postpartum period, prolactin is necessary to start and maintain lactation. In other life periods, increased prolactin secretion leads to pathological lactation (galactorrhea) and/or ovulation and menstrual disorders. Parlodel, as a specific prolactin secretion inhibitor, can be used to prevent or suppress physiological lactation, as well as to treat pathological conditions caused by prolactin hyper-secretion. In amenorrhoea and/or anovulatory menstrual cycles (accompanied or not accompanied by galactorrhea) Parlodel can be used to restore menstrual cycle and ovulation. When using Parlodel to suppress lactation, there is no need to limit fluid intake. Besides, Parlodel does not disturb the postpartum involution of the uterus and does not increase the risk of thromboembolism.
Menstrual irregularities, female infertility:
Prolactin-dependent diseases and conditions, accompanied or not accompanied by hyperprolactinemia: amenorrhea (accompanied or not accompanied by galactorrhea); oligomenorrhea; luteal insufficiency; secondary hyperprolactinemia on the background of medication (for example, some psychoactive or hypotensive drugs);
Prolactine-independent female infertility: polycystic ovarian syndrome; anovulatory cycles (in addition to antiestrogens such as clomiphene). Premenstrual syndrome - mammary glands soreness; swelling associated with the cycle phase; meteorism; mood disorders. Hyperprolactinemia in men: prolactin-dependent hypogonadism (oligospermia, loss of libido, impotence).
Prolactinoma: conservative treatment of prolactinsecreting micro- and macroadenes of the pituitary gland; preoperative preparation to reduce the volume of the tumor and facilitate its removal; postoperative treatment, if the level of prolactin remains elevated.
Acromegaly: as an additional medication in combination with radiation therapy and surgical treatment or, in special cases, as an alternative to surgical or radiation treatment.
Suppression of lactation: prevention or cessation of postpartum lactation for medical reasons: prevention of lactation after abortion; postpartum breast congestion; onset of postpartum mastitis.
Benign breast diseases: mastalgia (isolated or combined with premenstrual syndrome or benign nodal or cystic changes); benign nodal and/or cystic changes, especially fibrous cystic mastopathy.
Parkinson's disease: all stages of Parkinson's idiopathic disease and post-encephalytic parkinsonism (in the form of monotherapy or in combination with other anti-Parkinson's medications).
Stimulator for central and peripheral D2-dopamine receptors (ergot alkaloid derivative). Inhibiting prolactin secretion, inhibits physiological lactation, helps to normalize menstrual function, inhibits increased secretion of growth hormone, reduces the size and number of cysts in the breast (by eliminating imbalance between progesterone and estrogens). In high doses it stimulates dopamine receptors of striped body, black core of brain, hypothalamus and mesolimbic system. Has antiparking effect, inhibits the secretion of STG and ACTH. After taking a single dose of a decrease in the level of prolactin of blood plasma occurs in 2 hours, the maximum effect - in 8 hours, the antiparking effect - in 30-90 minutes, the maximum - in 2 hours, a decrease in the level of STG - in 1-2 hours, the macimal effect is achieved in 4-8 weeks of therapy.
To prevent nausea and vomiting at the beginning of treatment, it is advisable to prescribe antiemetic medications 1 hour before taking the drug. Periodic blood pressure monitoring, liver and kidney functions are recommended. Patients taking the drug should refrain from engaging in activities that require increased attention and rapid physical and mental reactions. Treatment may cause an accelerated return to ovarian function after delivery, and women should be warned about the possibility of early postpartum conception. In women taking bromocriptine, treatment is discontinued upon pregnancy unless the potential benefits of treatment outweigh the potential risks to the fetus. During therapy, non-hormonal contraception is appropriate. In case of pregnancy against the background of pituitary adenoma, a systematic control of the adenoma, including the examination of the visual fields, is necessary after cancellation. Before starting treatment of benign breast diseases, it is necessary to exclude the presence of a malignant tumor of the same localization. In the treatment of acromegaly, if there is an indication of the presence of gastric ulcer in the history, it is better to refuse treatment. If treatment is necessary, to draw the attention of patients to the need to notify the doctor in case of disorders of the gastrointestinal tract.
Inside, during meals, the maximum daily dose is 100 mg. Menses of the menstrual cycle, female infertility - 1.25 mg 2-3 times a day; if the effect is insufficient, the dose is gradually increased to 5-7.5 mg/day (the frequency of intake 2-3 times a day). Treatment continues until the menstrual cycle is normalized and/or ovulation is restored. If necessary, treatment can be continued for several cycles to prevent relapses. Premenstrual syndrome - treatment begins on the 14th day of the cycle with 1.25 mg/day. Gradually increase the dose by 1.25 mg/day to 5 mg/day (before menstruation). Hyperprolactinemia in men - 1.25 mg 2-3 times a day, gradually increasing the dose to 5-10 mg/day. Prolactinomas - 1.25 mg 2-3 times a day, with a gradual increase in dose to several tablets per day, necessary to maintain an adequate decrease in the concentration of prolactin in the plasma. Acromegaly - the initial dose is 1.25 mg 2-3 times a day, then, depending on the clinical effect and side effects, the daily dose is gradually increased to 10-20 mg. Suppression of lactation - 1.25 mg 2 times a day (during meals at breakfast and dinner), then for 14 days - 2.5 mg 2 times a day. To prevent the start of lactation, the medication should be started a few hours after delivery or abortion (after stabilizing vital functions). Sometimes there is a slight secretion of milk 2-3 days after withdrawal. It can be eliminated by resuming the drug in the same dose for another 1 week. Postpartum loading of mammary glands - prescribed once in a dose of 2.5 mg, after 6-12 hours if necessary, repeat the use (this is not accompanied by undesirable suppression of lactation). Starting postpartum mastitis - dosing mode is the same as in the case of suppression of lactation. If necessary, an antibiotic is added to the treatment. Benign breast diseases - 1.25 mg 2-3 times a day. The daily dose is gradually increased up to 5-7.5 mg. Parkinson's disease - to ensure optimal tolerability, treatment should start with a small dose of the drug: 1.25 mg once a day (preferably in the evening) for 1 week. The daily dose of the drug is increased gradually, every week by 1.25 mg; the daily dose is divided into 2-3 doses. An adequate therapeutic outcome can be achieved within 6-8 weeks of treatment. If this is not the case, the daily dose can be increased further by 2.5 mg/day per week. Average therapeutic doses of bromocriptine for mono or combination therapy are 10-40 mg/day, but some patients may require higher doses. If side effects occur in dose selection, the daily dose should be reduced and maintained at a lower level for at least 1 week. If the side effects disappear, the dose can be increased again. Patients with motor disorders occurring during levodopa administration should reduce the levodopa dose before using bromocriptine. Once a satisfactory effect has been achieved, a further gradual reduction of the levodopa dose can be undertaken. Some patients may have a complete abolition of levodopa.