6.5 Dopamine responsive conditions

First line drugs

Second line drugs

Specialist drugs

Secondary care drugs

Traffic light status (TLS) explained:

Green: Routine prescribing within licensed indication
Amber 1: specialist recommendation followed by GP initiation and continuation
Amber 2: specialist or GP initiation in line with local guideline after 1st line failure followed by GP continuation
Amber 3: specialist initiation and stabilisation followed by GP continuation
Amber SCG: specialist initiation and stabilisation followed by GP continuation in line with an agreed shared care guideline
Red: Hospital or specialist prescribing only

Dopamine-receptor agonists

Notes:

Bromocriptine and cabergoline are included in this section for their inhibition of prolactin release.
Bromocriptine has a known safety profile in pregnancy; further data is required to warrant prescribing cabergoline under such circumstances.
Cabergoline has an advantage of administration on a once weekly basis although it is more expensive than bromocriptine. Evidence suggests it is better tolerated.
CSM Advice:The ergot-derived dopamine-receptor agonists, bromocriptine, cabergoline, lisuride and pergolide have been associated with pulmonary, retroperitoneal and pericardial fibrotic reactions.
Before starting treatment with these ergot derivatives, investigations such as measurement of ESR, U&Es and a chest X-ray may be appropriate. If long-term treatment is expected, then lung function tests may be helpful. Patients should be monitored for progressive fibrotic disorders.
Excessive daytime sleepiness and sudden onset of sleep can occur with dopaminergic drugs. Patients starting treatment with these drugs should be warned of the possibility of these effects and of the need to exercise caution when driving or operating machinery.

Last updated by: on 05-07-2017 14:22