Dopamine D2 receptor agonists
Bromocriptine quick release (QR) is a dopamine D2 receptor agonist licensed in some countries outside Europe for treatment of T2DM as an adjunct to lifestyle changes . The effect of bromocriptine on glycaemic parameters has been noted since 1980. The drug provides a morning boost to hypo¬thalamic dopamine levels, consistent with normal diur¬nal glucoregulation, and contributing to a reduction of sympathetic tone, neural suppression of hepatic glucose production and improvement in peripheral glucose disposal, without affecting insulin levels.
10.1 Bromocriptine as monotherapy
In two 6-month trials, overweight or obese individuals with type 2 diabetes were randomized to receive bromocriptine monotherapy or diet. Compared with diet alone, the average change in HbA1c and FPG from placebo was −0.4% and −27 mg/dl, respectively, in a population with an average baseline HbA1c of 8 – 9%. Bromocriptine treated patients were more likely to achieve a 1% decline in HbA1c (28%) from baseline compared with diet alone (8%) and to have a reduction in PPG compared with diet (p < 0.002).
10.2 Bromocriptine in combination
A meta-analysis showed that bromocriptine QR add on therapy, compared with placebo, reduced levels of HbA1c (−6.52 mmol/mol, …show more content…
Hypotension develops in about one in 50 patients. Persons treated concurrently with antihypertensive medications should be warned to report symptoms such as dizziness, nausea, or diaphoresis if they occur.1 It should not be used in patients who have a history of syncopal migraine. Hypoglycemia may occur in about 4 percent of patients when used alone, and in about 9 percent of patients when combined with a sulfonylurea. Severe hypoglycemia requiring medical treatment is uncommon. It has not been studied in children or patients with hepatic or renal insufficiency. It is a U.S. Food and Drug Administration pregnancy category B
Bromocriptine quick release (QR) is a dopamine D2 receptor agonist licensed in some countries outside Europe for treatment of T2DM as an adjunct to lifestyle changes . The effect of bromocriptine on glycaemic parameters has been noted since 1980. The drug provides a morning boost to hypo¬thalamic dopamine levels, consistent with normal diur¬nal glucoregulation, and contributing to a reduction of sympathetic tone, neural suppression of hepatic glucose production and improvement in peripheral glucose disposal, without affecting insulin levels.
10.1 Bromocriptine as monotherapy
In two 6-month trials, overweight or obese individuals with type 2 diabetes were randomized to receive bromocriptine monotherapy or diet. Compared with diet alone, the average change in HbA1c and FPG from placebo was −0.4% and −27 mg/dl, respectively, in a population with an average baseline HbA1c of 8 – 9%. Bromocriptine treated patients were more likely to achieve a 1% decline in HbA1c (28%) from baseline compared with diet alone (8%) and to have a reduction in PPG compared with diet (p < 0.002).
10.2 Bromocriptine in combination
A meta-analysis showed that bromocriptine QR add on therapy, compared with placebo, reduced levels of HbA1c (−6.52 mmol/mol, …show more content…
Hypotension develops in about one in 50 patients. Persons treated concurrently with antihypertensive medications should be warned to report symptoms such as dizziness, nausea, or diaphoresis if they occur.1 It should not be used in patients who have a history of syncopal migraine. Hypoglycemia may occur in about 4 percent of patients when used alone, and in about 9 percent of patients when combined with a sulfonylurea. Severe hypoglycemia requiring medical treatment is uncommon. It has not been studied in children or patients with hepatic or renal insufficiency. It is a U.S. Food and Drug Administration pregnancy category B