6.7 Other endocrine drugs


These preparations are specialist use only, where appropriate, treatment may be initiated in the community on the recommendation of a consultant/specialist.

Bromocriptine (tablets, capsules) inhibits the release of prolactin by the pituitary. It has a number of specialised indications.

Cabergoline (tablets) has actions and uses similar to those of bromocriptine. It may be suitable for patients who are unable to tolerate bromocriptine. It is taken once or twice weekly. Cabergoline is the recommended drug in those rare situations where suppression of lactation is undertaken, e.g. stillbirth, sudden infant death syndrome, dosing as BNF.

Buserelin (nasal spray, injection) is a gonadotrophin analogue which causes inhibition of ovarian steroid secretion. It is used in endometriosis, prostate cancer and the treatment of infertility.

Triptorelin 4.2mg vial (m/r triptorelin (as acetate), Decapeptyl® SR) is the first-choice gonadorelin analogue, administered by intramuscular injection 3mg every 4 weeks. Note: Each 4.2-mg vial includes an overage to allow administration of a 3-mg dose. It is used in the treatment of endometriosis and for reduction in size of uterine fibroids.
Triptorelin 15mg vial (m/r triptorelin (as acetate), Decapeptyl® SR) is the first-choice gonadorelin analogue, administered by intramuscular injection 11.25 mg every 3 months. Note: Each 15-mg vial includes an overage to allow administration of an 11.25mg dose. It is used under specialist supervision for the treatment of endometriosis who would benefit from reduced frequency of administration compared with triptorelin 3mg injection every 4 weeks. Maximum duration of treatment is 6 months (not to be repeated). 
See 8.3.4.2 for treatment of advanced prostate cancer.

Goserelin (3.6mg implant) is a gonadorelin analogue which is administered by subcutaneous injection into the anterior abdominal wall, administered every 28 days. It is used in the treatment of endometriosis, and for endometrial thinning prior to transcervical resection of the endometrium or laser ablation in patients with menorrhagia.

Metyrapone (250mg capsules) is used in the diagnosis and management of Cushing's syndrome.

PAEDIATRIC NOTES - OTHER ENDOCRINE DRUGS

Triptorelin 3.75mg prefilled syringe
as Gonapeptyl Depot® is used for the treatment of confirmed central precocious puberty in girls under nine years and boys under ten years. Triptorelin 15mg vial is used for the treatment of precociuos puberty (onset before 8 years in girls and 9 years in boys), as per SMC 331/06.  

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