bromocriptina

Bromocriptine is an ergot-derived dopamine D2 receptor agonist used in medicine since the 1970s. It acts primarily by stimulating D2 receptors on lactotroph cells in the anterior pituitary, thereby reducing prolactin secretion. Clinically, it is employed to treat hyperprolactinemia and related conditions such as galactorrhea, amenorrhea, and infertility due to prolactin-secreting pituitary adenomas. It is also used to manage Parkinson's disease as an adjunct to levodopa and to treat acromegaly by lowering growth hormone levels in some patients. In several countries, a quick-release formulation is approved for type 2 diabetes, where it is believed to improve metabolic control by influencing hypothalamic pathways that regulate circadian rhythm and energy balance.

Pharmacology and mechanism: bromocriptine binds to dopamine D2 receptors and inhibits prolactin release from the pituitary; in the central nervous system, it stimulates dopaminergic signaling that can improve motor symptoms in parkinsonism.

Administration and dosing: typically given orally with gradual dose titration. Dosing is individualized and adjusted based on treatment indication, efficacy, and tolerability, with monitoring for adverse effects.

Adverse effects: common effects include nausea, vomiting, dizziness, orthostatic hypotension, fatigue, headache, and constipation. Other frequent effects are edema and abdominal discomfort. Long-term use of ergot derivatives carries a risk of valvular heart disease and less commonly retroperitoneal or pulmonary fibrosis. Psychiatric symptoms such as confusion or impulse control disorders may occur. Caution is advised when combining with other dopaminergic agents or in patients with cardiovascular or fibrotic disorders. Pregnancy and lactation require careful medical assessment, as bromocriptine is often avoided during pregnancy; it may be used to suppress lactation postpartum under supervision.