Bromocriptine Mesylate and Canakinumab Subcutaneous

• 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Used in the past for prevention of postpartum breast engorgement; FDA has withdrawn approval of bromocriptine for this indication because the risk of serious, potentially fatal adverse effects outweigh the limited benefits associated with this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: canakinumab
• Dosage Forms: n.a.
• Other Brand Names: Ilaris

Canakinumab injection is used to treat cryopyrin-associated periodic syndromes (CAPS). This also includes familial cold auto-inflammatory syndrome (FCAS) and Muckle-Wells syndrome (MWS). CAPS is a rare, inherited disease of the immune system. It occurs when the body produces too much of a chemical called interleukin-1 beta. This chemical causes inflammation, and patients with CAPS may have a fever, headache, skin rash, joint or muscle pain, or unusual tiredness or weakness.

Canakinumab helps prevent inflammation by keeping the interleukin-1 beta from working properly. Canakinumab also treats adults and children with other autoinflammatory periodic fever syndromes, such as tumor necrosis factor receptor associated periodic syndrome (TRAPS), hyperimmunoglobulin D syndrome (HIDS)/mevalonate kinase deficiency (MKD), and familial Mediterranean fever (FMF).

Canakinumab is also used to treat active systemic juvenile idiopathic arthritis (SJIA) in children 2 years of age and older.

Canakinumab is to be given only by or under the direct supervision of a doctor.