Long-term treatment of acromegalic patients with repeatable parenteral depot-bromocriptine.
We studied the efficacy and tolerability of a repeatable long-acting parenteral depot-bromocriptine preparation (Parlodel LAR) in 14 acromegalic patients, 10 of whom had received oral bromocriptine therapy previously, 2 of them showing intolerance to oral bromocriptine. Patients received i.m. injections of 50-100 mg depot-bromocriptine at 4-week intervals for 3-24 months (median 6). Growth hormone profiles were assessed by four daily samples at 4-week intervals. Main daily growth hormone levels decreased from 52.1 +/- 12.3 micrograms/l (mean +/- SEM) to 19.4 +/- 4.7 micrograms/l on the day of injection. In 6 patients, growth hormone values were lowered by more than 50%, whereas IGF-I levels decreased only slightly and growth hormone values during the oral glucose tolerance test remained non-suppressible. Tumour sizes were not affected. Two women became pregnant and were delivered of healthy babies. Side-effects typical of bromocriptine occurred frequently on the days of injection and diminished in most patients after 2 months of therapy despite increasing dosage. Compared with previous oral bromocriptine therapy, 9 of 10 patients preferred the depot preparation, whereas the reduction of growth hormone levels was similar during both treatments. In conclusion, depot-bromocriptine should be considered for acromegalic patients intolerant to oral bromocriptine.
Abteilung für Klinische Endokrinologie, Medizinischen Universitätsklinik Essen.
C
C
Jaspers
R
R
Haase
H
H
Pfingsten
G
G
Benker
D
D
Reinwein
D000172:Acromegaly / Q000097:blood / Q000188:drug therapy* / Q000209:etiology; D000236:Adenoma / Q000097:blood / Q000150:complications; D000328:Adult; D000368:Aged; D001971:Bromocriptine / Q000008:administration & dosage* / Q000009:adverse effects; D003692:Delayed-Action Preparations; D005260:Female; D013006:Growth Hormone / Q000097:blood; D006801:Humans; D007273:Injections, Intramuscular; D008297:Male; D008875:Middle Aged; D010911:Pituitary Neoplasms / Q000097:blood / Q000150:complications; D011247:Pregnancy
D003692:Delayed-Action Preparations; D001971:Bromocriptine; D013006:Growth Hormone