Risks of fibrotic reactions - moderate to severe cardiac valvulopathy and serosal fibrosis (pleural, pericardial and retroperitoneal)l. Needs monitoring. CXR, echo, ESR, U&E
- Check BNF or equivalent for UpToDate prescribing advice
Mode of action
- Ergot derived agonists
- Dopamine Agonist - stimulates dopamine receptors
- Parkinson's disease (Monotherapy): Pergolide 50 mcg Day 1 then 50 mcg BD for 2 days slowly increasing by 100-250 mcg/day until symptoms improve. 1.5 mg daily in 3 divided doses by day 28. Max 3 mg/day
- Parkinson's disease (with L-Dopa): Pergolide 50 mcg Day 1 then 50 mcg BD for 2 days slowly increasing by 100-150 mcg/day every 3 days until symptoms improve. Max 3 mg daily in 3 divided doses. May need to reduce L-Dopa
- Abrupt cessation can cause a neuroleptic malignant syndrome
- Care with hypotension, drowsiness.
- Driving may be an issue needing assessment.
- Acute porphyrias
- Abdominal pain, compulsive behaviour, ectopics, diarrhoea, diplopia, dizziness
- Drowsiness, dyskinesias, hallucinations, insomnia, hypotension
- Fibrotic reactions: Cardiac, Lung, retroperitoneal, pericardial. Echo and CXR. Measure ESR, U&E monitor and stop if any suggestion of active disease
- Impulse control disorders