Skip to main content
Log in

Bromocriptine in the Treatment of Acromegaly

  • Evaluations on New Drug
  • Published:
Drugs Aims and scope Submit manuscript

Summary

Bromocriptine is a dopamine agonist which suppresses prolactin secretion in healthy people and in patients with prolactin secreting tumours. It increases growth hormone secretion in some normal subjects but paradoxically lowers growth hormone secretion in up to 70% of patients with acromegaly.

Reports on the efficacy of bromocriptine therapy in acromegaly vary widely. Growth hormone levels are reduced in the majority of patients but are rarely completely suppressed. Greater remission of the soft tissue features of acromegaly may occur in some patients than would be expected from changes in growth hormone levels as determined by immunoassay.

The major advantage of bromocriptine therapy in acromegaly is its lack of effect on pituitary function, other than growth hormone and prolactin secretion, and avoidance of the complications of surgical or radiation treatment. Its major disadvantages are that the majority of patients only show a partial response, and the degree of compliance required with long term therapy. It is a useful adjunct to surgical and radiation treatment. In the few large studies of bromocriptine treatment used alone the results obtained over a limited period compare favourably with those obtained by radiotherapy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  • Belforte, L.; Cammani, F.; Chiodini, P.G.; Liuzzi, A.; Massara, F.; Molinatti, G.M.; Muller, E.E. and Silvertrini, F.: Long-term treatment with 2-Br-alpha-ergocryptine in acromegaly. Acta Endocrinologica 85: 235 (1977)

    PubMed  CAS  Google Scholar 

  • Besser, G.M.; Parke, Lynne; Edwards, C.R.W.; Forsyth, I.A. and McNeilly, A.S.: Galactorrhoea: successful treatment with reduction of plasma prolactin levels by brom-ergocryptine. British Medical Journal 3: 669 (1972)

    Article  PubMed  CAS  Google Scholar 

  • Besser, G.M.; Thorner, M.O. and Wass, J.A.H.: Bromocriptine treatment of acromegaly; in Proceedings of a Symposium of Royal College of Physicians, London (Sandoz, 1976)

  • Boyd, A.E.; Lebowitz, H.E. and Pfeiffer, J.B.: Stimulation of human-growth-hormone secretion by L-dopa. New England Journal of Medicine 23: 1425 (1970)

    Article  Google Scholar 

  • Calne, D.B., Leigh, P.N.; Teycheene, P.F. and Bamji, A.N.: Treatment of parkinsonism with bromocriptine. Lancet 2: 1355 (1974)

    Article  PubMed  CAS  Google Scholar 

  • Cammani, F.; Massara, F.; Belforte, L. and Molinatti, G.M.: Changes in plasma growth hormone levels in normal and acromegalic subjects following administration of 2-bromo-α-ergocryptine. Journal of Clinical Endocrinology and Metabolism 40: 363 (1975)

    Article  Google Scholar 

  • Cassar, J.; Mashiter, K. and Joplin, G.F.: Bromocriptine treatment of acromegaly. Metabolism 26: 239 (1977)

    Article  Google Scholar 

  • Corrodi, H.; Fuxe, K.; Hokfelt, T.; Lidbrink, P. and Ungerstedt, V.: Effect of ergot drugs on central catecholamine neurons: evidence for a stimulation of central dopamine neurons. Journal of Pharmacy and Pharmacology 25: 409 (1973)

    Article  PubMed  CAS  Google Scholar 

  • Clark, B.J.; Fluckiger, E.; Loew, D.M. and Vigouret, J.M.: How does bromocriptine work? Triangle 17: 21 (1978)

    CAS  Google Scholar 

  • Eddy, R.L.; Jones, A.L.; Chakmakjian, Z.H. and Silverthorne, M.C.: Effect of levodopa (L-dopa) on human hypophyseal tropic hormone release. Journal of Clinical Endocrinology and Metabolism 33: 709 (1971)

    Article  PubMed  CAS  Google Scholar 

  • Faglis, G.; Paracchi, A.; Beck-Peccoz, P. and Ferrari, C.: An explanatory hypothesis for plasia GH response to non-specific releasing hormones and pr ‘paradoxical’ GH inhibition after dopaminergic drugs in acromegaly. Acta Endocrinologica Suppl. 199: 323 (1975)

    Google Scholar 

  • Fluckiger, E.; Doepfner, W.; Marko, M. and Niederer, W.: Effects of ergot alkaloids on the hypothalmic-pituitary axis. Postgraduate Medical Journal 52(Suppl. 1): 57 (1976)

    PubMed  Google Scholar 

  • Fraser, R.: The assessment of the endocrine effects and the effectiveness of ablative pituitary treatment by 90Y and 198Au implantation; in Kohler and Ross (Eds) Diagnosis and Treatment of Pituitary Tumours, p.35 (Excerpta Medica, Amsterdam 1973)

    Google Scholar 

  • Gordon, P.; Lesniak, M.A.; Eastman, R.; Hendricks, C.M. and Roth, J.: Evidence for higher proportion of ‘Little’ growth hormone with increased radioreceptor activity in acromegalic plasma. Journal of Clinical Endocrinology and Metabolism 43: 364 (1976)

    Article  Google Scholar 

  • Gordon, P. and Roth, J.: The treatment of acromegaly by conventional pituitary irradiation; in Kohler and Ross (Eds) Diagnosis and Treatment of Pituitary Tumours p.230 (Excerpta Medica, Amsterdam 1973)

    Google Scholar 

  • Halse, J.; Haughen, H.N. and Gohmer, T.: Bromocriptine treatment in acromegaly: clinical and biochemical effects. Acta Endocrinologica 86: 464 (1977)

    PubMed  CAS  Google Scholar 

  • Holdaway, I.M.; Fregley, P.A.; Scott, D.J. and Ibbertsen, H.K.: Bromoergocryptine treatment of acromegaly persisting following conventional therapy. Clinical Endocrinology 8: 45 (1978)

    Article  PubMed  CAS  Google Scholar 

  • Kjellberg, R.N. and Kliman, B.: A system for therapy of pituitary tumours; in Kohler and Ross (Eds) Diagnosis and Treatment of Pituitary Tumours p.234 (Excerpta Medica, Amsterdam 1973)

    Google Scholar 

  • Lal, S.; Vega, C.E.; Saukes, T.L. and Friesen, H.G.: Effect of apomorphine on human-growth-hormone secretion. Lancet 2: 661 (1972)

    Article  PubMed  CAS  Google Scholar 

  • Liuzzi, A.; Chiodini, P.G.; Botalla, L.; Cremascoli, G. and Silvestrini, F.: Inhibitory effect of L-dopa on GH release in acromegalic patients. Journal of Clinical Endocrinology and Metabolism 35: 941 (1972)

    Article  PubMed  CAS  Google Scholar 

  • Liuzzi, A.; Chiodini, P.G.; Botalla, L.; Cremascoli, G.; Muller, E.E. and Silvestrini, F.: Decreased plasma growth hormone (GH) levels in acromegalics following CB-154(2-Br-alpha-ergocryptine) administration. Journal of Clinical Endocrimgy and Metabolism 38: 910 (1974)a

    Article  CAS  Google Scholar 

  • Liuzzi, A.; Chiodini, P.G.; Botalla, L.; Silvestrini, F. and Muller, E.E.: Growth hormone (GH) — releasing activity of TRH and GH-lowering effect of dopaminergic drugs in acromegaly: homogenecity in the two responses. Journal of Clinical Endocrinology and Metabolism 39: 871 (1974)b

    Article  PubMed  CAS  Google Scholar 

  • Liuzzi, A.; Verde, G. and Chiodini, P.G.: Dopaminergic control of growth hormone secretion in acromegaly. Triangle 17: 41 (1978)

    Google Scholar 

  • Loew, D.; Vigouret, J. and Jaton, A.: Neuropharmacological investigations with two ergot alkaloids, hydergine and bromocriptine. Postgraduate Medical Journal 52(Suppl. 1): 40 (1976)

    PubMed  CAS  Google Scholar 

  • Macleod, R.M. and Lehymeyer, J.E.: Studies on the mechanism of the dopamine-mediated inhibition of prolactin secretion. Endocrinology 94: 1077 (1974)

    Article  PubMed  CAS  Google Scholar 

  • Mashiter, K.; Adams, E.; Brand, M. and Holly, A.: Bromocriptine inhibits prolactin and growth-hormone release by human pituitary tumours in culture. Lancet 2: 197 (1977)

    Article  PubMed  CAS  Google Scholar 

  • Sachdev, Y.; Gomez-Pan, A.; Tunbridge, W.M.G.; Weightman, D.K.; Duns, A. and Hall, R.: Bromocriptine therapy in acromegaly. Lancet 2: 1164 (1975)

    Article  PubMed  CAS  Google Scholar 

  • Schwinn, G.; Dirks, H.; Mclntosh, C. and Kobberling, J.: Metabolic and clinical studies on patients with acromegaly treated with bromocriptine over 22 months. European Journal of Clinical Investigation 7: 101 (1977)

    Article  PubMed  CAS  Google Scholar 

  • Sobrinho, L.G.; Nunes, M.C.P.; Santos, M.A. and Mauricio, J.L.: Radiological evidence for regression of prolactinoma after treatment with bromocriptine. Lancet 2: 257 (1978)

    Article  PubMed  CAS  Google Scholar 

  • Summers, V.K.; Hipkin, L.J.; Diver, M.J. and Davis, J.L.: Treatment of acromegaly with bromocriptine. Journal of Clinical Endocrinology and Metabolism 40: 904 (1975)

    Article  PubMed  CAS  Google Scholar 

  • Takahara, J.; Akimura, A. and Schally, A.V.: Suppression of prolactin release by a purified porcine PIF preparation and catecholamines infused into a rat hypophysial portal vessel. Endocrinology 96: 462 (1974)

    Article  Google Scholar 

  • Thorner, M.O.; Chait, A.; Aitken, M.; Benker, G.; Bloom, S.R.; Mortimer, C.H., Sanders, R.; Stuart Mason, A. and Besser, G.M.: Bromocriptine treatment of acromegaly. British Medical Journal 1: 299 (1975)

    Article  PubMed  CAS  Google Scholar 

  • Thorner, M.O.: Dopamine is an important neurotransmitter in the autonomic nervous system. Lancet 1: 662 (1975)

    Article  PubMed  CAS  Google Scholar 

  • Vaidya, R.; Alookar, S. and Sheth, A.: Therapeutic regression of putative pituitary hyperplasia and/or microadenoma with CB-154. Fertility and Sterility 28: 363 (1977)

    Google Scholar 

  • Wass, J.A.H.; Thorner, M.O.; Morris, D.V.; Rees, L.H.; Stuart Mason, A.; Jones, A.E. and Besser, G.M.: Long-term treatment of acromegaly with bromocriptine. British Medical Journal 1: 875 (1977)

    Article  PubMed  CAS  Google Scholar 

  • Williams, R.A.; Jacobs, H.S.; Kurtz, A.B.; Millar, J.G.B.; Oakley, N.W.; Spathis, G.S.; Sulway, M.J. and Nabarro, J.D.N.: The treatment of acromegaly with special reference to transsphenoidal hypophysectomy. Quarterly Journal of Medicine 44: 79 (1975)

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Bateman, D.E., Tunbridge, W.M.G. Bromocriptine in the Treatment of Acromegaly. Drugs 17, 359–364 (1979). https://doi.org/10.2165/00003495-197917050-00005

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.2165/00003495-197917050-00005

Keywords

Navigation