Co-Dergocrine in Various Cardiovascular and Cerebral Indications

Abstract

The first major indication of co-dergocrine was arterial hypertension, the compound’s antihypertensive effect being thought to result from its sympatholytic and adrenolytic properties and resultant vasodilatation. In 1947, intravenous dihydroergocornine was shown to lower the blood pressure in normotensive and hypertensive subjects [52]; in 1948, also intravenous dihydroergokryptine and dihydroergocristine were seen to lower the blood pressure in hypertensive patients [158], and the combination of equal parts of these dihydrogenated alkaloids, i.e. co-dergocrine, proved to be effective by the intravenous and oral routes [257]. Co-dergocrine was launched in 1949 for the treatment mainly of arterial hypertension and peripheral circulatory disorders. The advent of newer and more potent antihypertensives and the realization from 1952 onwards [413] that co-dergocrine had favorable effects on symptoms of senile mental decline led to a gradual shift in the drug’s field of indication. However, there has been during recent years a revival of interest for the use of co-dergocrine in hypertension, particularly in elderly patients with isolated or predominantly systolic hypertension. Besides lowering the blood pressure in such patients, oral co-dergocrine has been seen to improve their subjective well-being markedly [54, 124, 184, 226]. Other advantages are a smooth lowering of blood pressure, the absence of reactive tachycardia or orthostatic hypotension and contraindications such as those of beta-blockers, and an excellent tolerability compared with other antihypertensive agents [33, 125,184, 350, 364]. Intravenous co-dergocrine has been shown to be a fast-acting, safe, and well-tolerated treatment of hypertensive crises, again particularly in the elderly [191,217, 533].