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Ann Pharmacother. 2010 Nov;44(11):1777-85. doi: 10.1345/aph.1P271. Epub 2010 Oct 26.

Bromocriptine mesylate for glycemic management in type 2 diabetes mellitus.

Author information

1
Southern Illinois University, Edwardsville, IL, USA. jekerr@siue.edu

Abstract

OBJECTIVE:

To review the pharmacologic characteristics, safety, and efficacy of bromocriptine mesylate for glycemic control in patients with type 2 diabetes mellitus.

DATA SOURCES:

A Scopus and MEDLINE search (1950-June 2010) was conducted using the key words bromocriptine, diabetes, and circadian rhythm. Data were also received from the manufacturer.

STUDY SELECTION AND DATA EXTRACTION:

Available abstracts, studies, and review articles published in English with human data discussing bromocriptine treatment for type 2 diabetes mellitus were reviewed.

DATA SYNTHESIS:

Bromocriptine is an ergot derivative available for treatment of type 2 diabetes. The mechanism of action of this agent is unclear; however, activity as a dopamine D₂ receptor agonist seems to provide the primary mechanism for utility in resetting the circadian rhythm in patients with type 2 diabetes. Other mechanisms, including α-1 antagonist, α-2 agonist, and serotonin and prolactin modulator, may also help to explain bromocriptine's glucose-lowering effects. Studies with bromocriptine have included 4328 patients with type 2 diabetes. The majority of available trials conducted enrolled patients for a study duration of 6-24 weeks. One trial evaluating the safety and efficacy of bromocriptine concluded after 52 weeks of follow-up. Endpoints of hemoglobin A₁(c) (A1C) reduction and plasma glucose concentrations were the primary focus of all studies, with statistically significant differences found. Bromocriptine use resulted in a mean A1C reduction of 0.27% (range 0.1-0.6), while placebo resulted in a mean A1C increase of 0.48% (range 0.3-1.1). Incidence of adverse effects of nausea, vomiting, headache, and rhinitis was greater than that of placebo in clinical trials. Cardiovascular endpoints did not differ from those of placebo.

CONCLUSIONS:

Bromocriptine has demonstrated efficacy as an adjunctive agent in the management of type 2 diabetes. Caution may be warranted in the elderly population or patients at risk for suspected drug-drug interactions. Further studies of longer duration may help to define the role of bromocriptine in the management of diabetes.

PMID:
20978217
DOI:
10.1345/aph.1P271
[Indexed for MEDLINE]

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