Indications for CYCLOSET:
Adjunct to diet and exercise, to improve glycemic control in type 2 diabetes.
Limitations of Use:
Not for treating type 1 diabetes or ketoacidosis. Limited efficacy data in combination with thiazolidinediones. Efficacy has not been confirmed in combination with insulin.
Take with food in the AM, within 2hrs of waking. Initially 0.8mg once daily; may increase by 0.8mg per week as tolerated until max 4.8mg/day. Usual range: 1.6–4.8mg/day. Concomitant moderate CYP3A4 inhibitors (eg, erythromycin): max 1.6mg once daily. Concomitant strong CYP3A4 inhibitors (eg, azole antimycotics, protease inhibitors): avoid.
Syncopal migraines. Postpartum or lactating patients. Allergy to ergot-related drugs.
Monitor orthostatic vital signs initially and periodically during therapy. Severe psychotic disorders: not recommended. Impulse control/compulsive behaviors. Renal or hepatic impairment. Postpartum patients with cardiovascular disease. Pregnancy.
Dopamine agonist (ergot deriv).
See Adult. Concomitant selective 5-HT1B agonists (eg, sumatriptan), sympathomimetic drugs >10 days, ergot-related drugs within 6hrs, other dopamine agonists and antagonists, including neuroleptics (eg, clozapine, olanzapine, ziprasidone) and metoclopramide: not recommended. Potentiated by CYP3A4 inhibitors and antagonized by CYP3A4 inducers (eg, rifampin, dexamethasone). Potentiates antihypertensives; caution. May potentiate highly protein bound drugs (eg, salicylates, sulfonamides, chloramphenicol, probenecid).
Nausea, vomiting, fatigue, dizziness, headache; hypotension, syncope, somnolence, hypoglycemia.