Bromocriptine Mesylate and Busulfan

• Generic Name: bromocriptine
• Dosage Forms: n.a.
• Other Brand Names: Parlodel, Cycloset

Treatment of male and female dysfunctions associated with hyperprolactinemia, including amenorrhea and/or galactorrhea, hypogonadism, and infertility.

Used in patients with prolactin-secreting adenomas (e.g., prolactinoma), including macroadenomas, to decrease tumor size; may be used prior to surgery in patients undergoing excision of the tumor (adenectomy).

Treatment of female infertility associated with hyperprolactinemia; used to induce ovulation in appropriately selected anovulatory women.

Treatment of hypogonadism and galactorrhea that persist following radiation therapy or surgery in hyperprolactinemic males with prolactin-secreting adenomas and adequate testosterone concentrations. Some clinicians consider bromocriptine the treatment of choice for reduction of large tumors (macroadenomas).

Symptomatic management of idiopathic or postencephalitic parkinsonian syndrome.

Used as an adjunct to levodopa for the symptomatic management of parkinsonian syndrome in patients with advanced disease.

Has been used as monotherapy for initial symptomatic management of parkinsonian syndrome. Most clinicians would use levodopa for initial therapy in individuals >70 years of age (less likely than younger individuals to develop levodopa-related motor complications and because of concerns about cognitive dysfunction), in patients with cognitive impairment, and in those with severe disease. A dopamine receptor agonist may be preferred for initial therapy in patients ≤70 years of age.

Treatment of acromegaly, alone or as adjunctive therapy with pituitary irradiation or surgery.

Has been used to increase sperm counts and restore fertility in oligospermic men without hyperprolactinemia who are unresponsive to traditional drug therapy.

Has been used to relieve extrapyramidal reactions, hyperthermia, and hypertension of neuroleptic malignant syndrome (NMS) associated with neuroleptic drug therapy (e.g., haloperidol, fluphenazine).

Has been used in the management of chronic hepatic encephalopathy.

Used in the past for prevention of postpartum breast engorgement; FDA has withdrawn approval of bromocriptine for this indication because the risk of serious, potentially fatal adverse effects outweigh the limited benefits associated with this use. (See Cardiovascular Effects under Cautions.)

• Generic Name: busulfan
• Dosage Forms: n.a.
• Other Brand Names: Busulfex, Myleran

Used IV in combination with cyclophosphamide: as a conditioning regimen prior to allogeneic hematopoietic progenitor cell transplantation in patients with chronic myelogenous leukemia (CML) (designated an orphan drug by US FDA for this use).

Also administered orally as a component of a conditioning regimen prior to allogeneic transplantation.

Rarely, used as an alternative agent for palliative treatment of CML. Not curative, but approximately 90% of patients in the chronic phase of CML treated with the drug obtain remissions.

Component of pretransplant conditioning regimens in patients undergoing bone marrow transplantation for acute myeloid leukemia and nonmalignant diseases (e.g., sickle cell disease).