Oral prednisolone supplement abolishes the acute adverse effects following initiation of depot bromocriptine therapy.
OBJECTIVE: 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 bromocr...
| Main Authors: | , , , , |
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| Format: | Journal article |
| Language: | English |
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1996
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| _version_ | 1826261396620312576 |
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| author | Jenkins, P Jain, A Jones, S Besser, G Grossman, AB |
| author_facet | Jenkins, P Jain, A Jones, S Besser, G Grossman, AB |
| author_sort | Jenkins, P |
| collection | OXFORD |
| description | OBJECTIVE: 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. DESIGN: 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). PATIENTS: 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. MEASUREMENTS: Symptoms at 0, 16 and 40 hours after injection were assessed using visual linear analogue scales and both inter and intra-group scores were compared by non-parametric tests. RESULTS: Depot bromocriptine was associated with the significant occurrence of light-headedness and lethargy in the placebo-administered group by 16 hours, and also with nausea and nasal congestion by 40 hours. These symptoms did not occur in the prednisolone-administered group. CONCLUSIONS: Concurrent oral administration of prednisolone significantly reduces the incidence of acute adverse effects following depot bromocriptine. Two 20 mg doses of prednisolone given at 12-hour intervals may be used to avoid dopamine-agonist-induced adverse effects at the initiation of treatment with depot bromocriptine, and may also be of value in the treatment of side-effects associated with other dopamine agonist drugs. |
| first_indexed | 2024-03-06T19:20:46Z |
| format | Journal article |
| id | oxford-uuid:1a02d106-bb9f-4169-9319-a66c3e09c9b1 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-06T19:20:46Z |
| publishDate | 1996 |
| record_format | dspace |
| spelling | oxford-uuid:1a02d106-bb9f-4169-9319-a66c3e09c9b12022-03-26T10:52:18ZOral prednisolone supplement abolishes the acute adverse effects following initiation of depot bromocriptine therapy.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:1a02d106-bb9f-4169-9319-a66c3e09c9b1EnglishSymplectic Elements at Oxford1996Jenkins, PJain, AJones, SBesser, GGrossman, ABOBJECTIVE: 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. DESIGN: 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). PATIENTS: 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. MEASUREMENTS: Symptoms at 0, 16 and 40 hours after injection were assessed using visual linear analogue scales and both inter and intra-group scores were compared by non-parametric tests. RESULTS: Depot bromocriptine was associated with the significant occurrence of light-headedness and lethargy in the placebo-administered group by 16 hours, and also with nausea and nasal congestion by 40 hours. These symptoms did not occur in the prednisolone-administered group. CONCLUSIONS: Concurrent oral administration of prednisolone significantly reduces the incidence of acute adverse effects following depot bromocriptine. Two 20 mg doses of prednisolone given at 12-hour intervals may be used to avoid dopamine-agonist-induced adverse effects at the initiation of treatment with depot bromocriptine, and may also be of value in the treatment of side-effects associated with other dopamine agonist drugs. |
| spellingShingle | Jenkins, P Jain, A Jones, S Besser, G Grossman, AB Oral prednisolone supplement abolishes the acute adverse effects following initiation of depot bromocriptine therapy. |
| title | Oral prednisolone supplement abolishes the acute adverse effects following initiation of depot bromocriptine therapy. |
| title_full | Oral prednisolone supplement abolishes the acute adverse effects following initiation of depot bromocriptine therapy. |
| title_fullStr | Oral prednisolone supplement abolishes the acute adverse effects following initiation of depot bromocriptine therapy. |
| title_full_unstemmed | Oral prednisolone supplement abolishes the acute adverse effects following initiation of depot bromocriptine therapy. |
| title_short | Oral prednisolone supplement abolishes the acute adverse effects following initiation of depot bromocriptine therapy. |
| title_sort | oral prednisolone supplement abolishes the acute adverse effects following initiation of depot bromocriptine therapy |
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