title: Quick-release bromocriptine for treatment of type 2 diabetes.
abstract: Quick-release bromocriptine (bromocriptine-QR) (Cycloset) was approved in 2009 for treatment of type 2 diabetes. The exact anti-diabetic mechanism of action of bromocriptine-QR has not been elucidated, but the drug may help resetting the circadian dopamine signal. Randomized placebo-controlled trials showed that the mean reduction in hemoglobin A1c (HbA1c) levels by bromocriptine-QR was 0.0-0.2% when compared to baseline and 0.4-0.5% when compared with placebo after 24 weeks of therapy. Withdrawal rates due to adverse effects in patients receiving bromocriptine-QR and placebo were 24% and 11%, respectively. The most common adverse effect of bromocriptine-QR was nausea reported by 32% of patients compared with 7% of patients randomized to placebo. The advantages of bromocriptine-QR were minimal risk of hypoglycemia, neutral effect on weight, and reassuring cardiovascular safety over 1 year of use. However, the drug had multiple drawbacks including modest efficacy, high rates of nausea, lack of long-term efficacy and safety data, and considerable cost. Bromocriptine-QR may be used in patients with type 2 diabetes with mild hyperglycemia (HbA1c close to 7.5%) either as adjunctive treatment to metformin and sulfonylurea (SU) or as monotherapy in patients who are intolerant to both agents.
authors.affiliation: Endocrinology Division, Department of Medicine, Olive-View-UCLA Medical Center, Sylmar, CA 91342, USA. nmikhail@dhs.lacounty.gov
authors.forename: Nasser
authors.initials: N
authors.lastname: Mikhail
mesh_terms: D001786:Blood Glucose / Q000032:analysis; D001971:Bromocriptine / Q000008:administration & dosage / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D005215:Fasting; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D010919:Placebos; D019518:Postprandial Period
chemical_list: D001786:Blood Glucose; D007004:Hypoglycemic Agents; D010919:Placebos; D001971:Bromocriptine