Oral prednisolone supplement abolishes the acute adverse effects following initiation of depot bromocriptine therapy

Clinical Endocrinology
P J JenkinsA B Grossman

Abstract

Although an effective treatment for hyper-prolactinaemia, initiation of bromocriptine therapy may be associated with significant acute side-effects in some patients, particularly nausea, vomiting and postural hypotension. These may be minimized by initial treatment with i.m. depot bromocriptine (Parlodel-LAR, Sandoz, Basel, Switzerland), but adverse effects following the first injection may still be a significant problem. Following the observation that cortisol deficient patients were subject to an increased incidence of severe side-effects on initiation of bromocriptine therapy, we have evaluated whether concurrent administration of oral prednisolone to patients without cortisol deficiency might reduce adverse effects. Double-blind placebo-controlled trial with prednisolone (20 mg) prior to, and 16 hours after, depot injection of i.m. bromocriptine (50 or 100 mg). Twenty-one consecutive patients with hyperprolactinaemia (serum prolactin > 1000 mU/l on 3 separate occasions) who were due to start depot bromocriptine and who had a normal cortisol response to insulin-induced hypoglycaemia. Symptoms at 0, 16 and 40 hours after injection were assessed using visual linear analogue scales and both inter and intra-group scores were com...Continue Reading

Citations

Nov 10, 1998·Lancet·A Colao, G Lombardi
Apr 20, 1999·Endocrinology and Metabolism Clinics of North America·M E Molitch
Sep 27, 2001·Endocrinology and Metabolism Clinics of North America·M E Molitch
Nov 14, 1998·Annals of Medicine·A ColaoG Lombardi

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