Adjunctive Management of Idiopathic Dementia
Action And Clinical Pharmacology: The possible mechanism of action of ergoloid mesylates has not been determined. There is no evidence that ergoloid mesylates affect cerebrovascular insufficiency or cerebral arteriosclerosis.
Ergoloid mesylates do not have the vasoconstrictor effects of the natural ergot alkaloids.
Indications And Clinical Uses: May be of some value in the adjunctive management of selective symptoms of elderly patients with cognitive decline and a moderate impairment of self care, when used as part of a comprehensive therapeutic program, including medical and psychosocial support.
Clinical trials with Hydergine have described a modest improvement in symptoms that reflect on the level of self care in some of these patients.
Contra-Indications: Hypersensitivity to the drug, severe bradycardia, and severe hypotension. It is also contraindicated in patients who have acute or chronic psychosis regardless of its etiology.
Manufacturers’ Warnings In Clinical States: Before using ergoloid mesylates, a careful diagnosis should be made to exclude treatable causes of dementia, including affective disorders, which may respond to specific therapy. Particular care should be taken to exclude delirium and dementiform illness secondary to systemic disease, primary neurological disease, or primary disturbance of mood.
Hydergine is not indicated in aged individuals with normal cognitive function.
Precautions: Hydergine should be kept out of the reach of children.
Adverse Reactions: Nausea and vomiting, headaches, dizziness, flushing, blurring of vision, rash, anorexia, nasal stuffiness, abdominal cramps, bradycardia and tachycardia have been noted.
Symptoms And Treatment Of Overdose: Symptoms: The symptoms of overdosage with Hydergine are nasal stuffiness, flushing of the face, headache, nausea and vomiting, tremulousness, spasticity, hypotension, circulatory collapse and coma.
Treatment: Symptomatic and supportive. Empty the stomach by emesis or lavage depending upon the level of consciousness of the patient, ensuring maintenance of an adequate airway. I.V. fluids should be administered with careful supervision of intake and output, but there is no evidence that forced diuresis accelerates the elimination of the drug. Circulatory collapse should be prevented by appropriate positioning of the patient, fluids and, if necessary, vasopressor agents.
Dosage And Administration: 1 tablet 3 to 4 times daily with food.
Since alleviation of symptoms is usually gradual, improvement may not be observed before several weeks. If no clinical improvement is seen at 3 to 4 weeks it is advisable to discontinue the drug. Full expression of the beneficial effects of Hydergine may take several weeks. In patients who have responded with clinical improvement, it is advisable to discontinue the drug from time to time, in order to assess the need for its continued administration.
Availability And Storage: Each round, white, compressed, 8 mm diameter, flat, beveled tablet, scored with “VJ” on one side and “SANDOZ” insignia on the other contains: ergoloid mesylates 1 mg. Nonmedicinal ingredients: alcohol anhydrous, cornstarch, lactose anhydrous, povidone, purified water, stearic acid and talc. Bottles of 100. (Shown in Product Recognition Section)
HYDERGINE® Novartis Ergoloid Mesylates Adjunctive Management of Idiopathic Dementia