Joy Pape, RN, BSN,
CDE, WOCN, CFNC
PRESENT Diabetes
Contributing Nursing Editor |
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A New Diabetes Drug, A New Class for The Treatment of Diabetes is Out. What Do You Know? What Will You Do?
Two weeks ago, on November 15th, I received an email that Cycloset® has hit the shelves. I know what Cycloset® is, since I was intrigued by it’s mechanism of action when I first heard about it two years ago. When I received word of it’s launch, I wondered, how many health care professionals (HCPs) know what Cycloset® is? How many of us will be ready for the questions that come? Questions that come from our patients, and questions from other HCPs.
I am reminded of the early days when Glucophage® (metformin) was released. At that time, I was living in a small town. I was not educated in detail about metformin. My first introduction to it was from a patient who reported that she had taken this new medication, Glucophage®. It made her nauseous and gave her diarrhea, so her doctor d/c’d it. She asked me what she should do now to manage her blood glucose level. I didn’t have a clue at the time, but I quickly started to look into it. At first, I had read and heard some bad stories about it, especially the lactic acidosis. I also read about the good--some patients told me it had changed their lives. Those who had switched from sulfonylureas to metformin were no longer having low blood glucose episodes -- and people with diabetes were losing weight and had improved blood glucose levels. How unusual!
Metformin is now one of the most prescribed medications worldwide. This is not to say there aren’t concerns, there are (and should be) concerns about every medication, but we have learned a lot over the years. See Dr. Tamler’s DiabeZine, Time to rethink metformin in heart failure and, Metformin: A New Shine on an Old Medication .
Cycloset® (bromocriptine mesylate)
So now we have a new class of medication, a centrally acting dopamine agonist to help people with diabetes. Although it is bromocriptine, it is not the same formulation of bromocriptine most think of to treat galactorrhoea, Parkinsons, and prolactinaemia.
Cycloset® has a newer quick release (QR) formulation, and the dosage used to treat diabetes (1.6–4.8mg/day) is a fraction of those used to treat Parkinson’s disease (30–140mg/day). When taken properly, once a day with food, within 2 hours after waking in the morning, , it is said to “reset” the circadian rhythm to those of healthy lean individuals.
When a new medication is released
This leaves us with a lot to think about. When a new medication is released, how do you find out about it? What are you concerned about? Are you one of the first to prescribe or recommend, or do you stand back and wait for the post marketing clinical trials?
Let us know what you do. See what your colleagues are saying and learn more about Cycloset®. Just follow this link, or click on the image below, to lauch theTalk:
Learn and share all your experiences on diabetes, and how diabetes education is changing as we know it, in our eTalk discussoin forum at presentdiabetes.com.
Until next time, EnJOY!
Joy Pape, RN, BSN, CDE WOCN, CFCN
PRESENT Diabetes Contributing Nursing Editor
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