NASAL SPRAY VS ORAL-ADMINISTRATION OF BROMOCRIPTINE - PHARMACOLOGY AND EFFECT ON SERUM PROLACTIN IN PUERPERAL WOMEN

The oral administration of bromocriptine induces a variety of side-eff ects in about 50-70% of patients, the most common being nausea and vom iting, probably related to the local gastrointestinal effect of the dr ug. Nasal administration makes it possible to avoid intestinal and liv er metabolism, This study compared the serum concentrations of bromocr iptine and prolactin (PRL) in twenty puerperal women who had asked to discontinue breast feeding and were randomized to receive a single ora l (2.5 mg) or nasal spray dose (0.8 mg) of bromocriptine. Serum bromoc riptine and PRL concentrations were measured at various times before a nd after drug administration. At 15 min, the circulating concentration s of bromocriptine were about eight times higher after nasal than afte r oral administration; peak serum concentration (CMax) was reached res pectively 45 min and 60 min after administration, and was about three times higher after nasal administration (314+/-102 pg/ml vs 112.30+/-3 4.47 pg/ml), The I-eduction in serum PRL concentrations was also more rapid in the nasally-treated group reaching the normal assay range of <20 mu g/l within two as against five hours post-administration. Four orally-treated patients complained of nausea; in the nasally-treated g roup, six patients reported only a mild endonasal burning that disappe ared within a few minutes of administration. Our results suggest that the nasal administration of bromocriptine may lead to a reduction in t he required overall dose and fewer gastrointestinal side-effects, and may therefore Improve therapy compliance.