Mirkou A, Suchovsky D, Gouraud A, Gillet A, Bernard N, Descotes J, Vial T
Centre antipoison - centre de pharmacovigilance, hospices civils de Lyon, 162, avenue Lacassagne, 69003 Lyon, France.
J Gynecol Obstet Biol Reprod (Paris). 2012 Apr;41(2):167-73. doi: 10.1016/j.jgyn.2011.06.002. Epub 2011 Oct 14.
To provide an overview of ergot derivatives prescription for lactation inhibition in France, either label (bromocriptine 2.5mg and lisuride 0.2mg) or off-label prescription (dihydroergocryptine and cabergoline).
Analysis based on a questionnaire sent to all 618 French maternity wards in 2009, and prescription modalities from social security reimbursement data in the Rhône-Alpes region.
The mean response rate to the questionnaire was 43% and main characteristics of respondents in this sample were very close to those found at the national level. The use of bromocriptine (89%) was the most frequently proposed. Dihydroergocryptine and cabergoline were mentioned as first or second alternatives in 39 and 24% of cases, respectively. Lisuride, homeopathy and phytotherapy were very rarely mentioned. The analysis of social security reimbursement data in the Rhône-Alpes region between 2008 and 2009 evidenced an increase in the rate of dihydroergocryptine prescriptions (from 37 to 46%), which were more frequent in women also treated with cardiovascular or psychotropic drugs, while that of bromocriptine decreased.
This study shows that, in France, the main alternative to bromocriptine for lactation inhibition is the off-label use of dihydroergocryptine followed by cabergoline, which seems to be safer.
概述法国用于抑制泌乳的麦角衍生物处方情况，包括标签注明的处方（2.5毫克溴隐亭和0.2毫克利苏瑞肽）及未标注的处方（二氢麦角隐亭和卡麦角林）。
基于2009年向法国所有618家产科病房发放的问卷进行分析，并根据罗纳-阿尔卑斯地区社会保险报销数据得出处方方式。
问卷的平均回复率为43%，该样本中受访者的主要特征与全国水平非常接近。溴隐亭的使用最为常见（89%）。二氢麦角隐亭和卡麦角林分别在39%和24%的病例中被提及为首选或次选。利苏瑞肽、顺势疗法和植物疗法很少被提及。对罗纳-阿尔卑斯地区2008年至2009年社会保险报销数据的分析表明，二氢麦角隐亭处方率有所上升（从37%升至46%），在同时接受心血管药物或精神药物治疗的女性中更为常见，而溴隐亭的处方率则下降了。
本研究表明，在法国，用于抑制泌乳的溴隐亭的主要替代药物是未标注的二氢麦角隐亭，其次是卡麦角林，后者似乎更安全。
