📋 Indications & Clinical Dosage
*Parkinsons disease:*
Adult: Initially 1-1.25 mg daily at night, for 1 week, then 2-2.5 mg daily for at night, for 1 week, then 2.5 mg twice daily for 1 week, then 2.5 mg 3 times a day for 1 week, then increased in steps of 2.5 mg every 3-14 days, adjusted according to response; maintenance 10-30 mg daily.
*Hypogonadism, Galactorrhoea, Endocrine based Infertility:*
Adult: Initially 1-1.25 mg daily at bedtime, increase dose gradually; usual dose 7.5 mg daily in divided doses, increased if necessary up to 30 mg daily, usual dose in infertility without hyperprolactinaemia is 2.5mg twice daily.
*Acromegaly:*
Adult: Initially 1-1.25 mg daily at bedtime, then increased to 5 mg every 6 hours, increase dose gradually.
*Prolactinoma:*
Adult: Initially 1-1.25 mg daily at bed time, then increased to 5 mg every 6 hours, increase dose gradually. Occasionally patients may require up to 30mg daily.
*Prevention of lactation:*
Adult: Initially 2.5 mg daily for 1 day, then 2.5 mg twice daily for 14 days.
*Suppression of lactation:*
Adult: Initially 2.5 mg daily for 2-3 days, then 2.5 mg twice daily for 14 days.
⛔ Contraindications
Pre-eclampsia, cardiacvalvulopathy, hypertension in postpartum women or in puerperium, toxaemia of pregnancy, puerperal hypertension, hypersensitivity to ergot alkaloids.
⚠️ Precautions & Warnings
Acute porphyrias, cardiovascular disease, history of peptic ulcer (particularly in acromegalic patients), history of serious mental disorders (especially psychotic disorders), Raynauds syndrome. Perform regular gynaecological assessment for women. Consider discontinuation in patients with unexplained pleura-pulmonary signs or symptoms.
🔄 Drug Interactions
Alcohol, erythromycin, metoclopramide, drugs effecting BP
⚠️ Adverse Reactions / Side Effects
Headache, nasalcongestion, constipation, nausea, confusion, dizziness, dry mouth, fatigue, hallucinations, postural hypotension, psychomotor, excitation, vomiting, allergic skin reactions, alopecia, cardiac valvulopathy, constrictive pericarditis, drowsiness, hyponatraemia, hypotension, leg cramps, leucopenia, pericardial effusion, peripheral oedema, pleural effusion, pleural fibrosis, pleuritis, pulmonary fibrosis, retroperitoneal fibrosis, thrombocytopenia, urinary incontinence. Rare: Arrhythmia, bradycardia, GI bleeding and ulcer, insomnia, paraesthesia, psychosis, tachycardia, tinnitus, visual disturbances
🤰 Pregnancy & Lactation Safety
Pregnancy Risk:
Use with caution; risk of toxicity
Lactation / Breastfeeding:
Contraindicated
📚 Official Regulatory & Clinical References
- Drug Regulatory Authority of Pakistan (DRAP): Drug Registration, S.R.O. Price Gazettes & National Essential Medicines List (NEML).
- World Health Organization (WHO): Collaborating Centre for Drug Statistics Methodology (ATC/DDD Index).
- Formulary Standards: British National Formulary (BNF) & Pakistan National Formulary (PNF) guidelines.