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Bromocriptine information from DrugsUpdate  

See Available Brands of Bromocriptine in India

P - Contraindicated in pregnancy
L - Contraindicated in lactation

Bromocriptine (Parlodel), an ergoline derivative, is a dopamine agonist that is used in the treatment of pituitary tumors, Parkinson's disease (PD) and neuroleptic malignant syndrome.

Pharmacodynamics

Pharmacokinetics

Bromocriptine is a dopamine D2 and D3-agonist which works by activating postsynaptic dopamine receptors in the tuberoinfundibular and nigrostriatal pathways. It also inhibits the secretion of prolactin from the anterior pituitary and is used in the treatment of prolactinoma and in endocrinological disorders.
Absorption: 30% absorbed from the GIT (oral).
Distribution: Protein-binding: 90-96%
Metabolism: Extensive hepatic first-pass metabolism by hydrolysis to lysergic acid and peptides.
Excretion: Mainly via faeces, via urine (minimal amounts).

Bromocriptine Indications / Bromocriptine Uses

Information Not Available

Bromocriptine Adverse Reactions / Bromocriptine Side Effects

Nausea, vomiting, gastric haemorrhage (acromegaly), dizziness, headache, drowsiness, depression, postural hypotension, nasal congestion, pleural effusion, mania, ataxia. High doses produce confusion, hallucinations, delirium, psychosis.

Precautions

Information Not Available

Special Precautions

Increased risk of conception, patients with peptic ulcer, diabetes, diabetic retinopathy, impaired hepatic or renal function, pleuropulmonary signs and symptoms, history of psychosis, CV disease, dementia or concurrent antihypertensive therapy, ability to drive vehicles or operating machinery may be impaired.

Other Drug Interactions

Bioavailability increased if given along with erythromycin. Alcohol reduces tolerance to bromocriptine and vice-versa. Effects of antihypertensives may be potentiated. Avoid concurrent psychotropics.

Other Interactions

Food Interactions: Food reduces nausea caused by bromocriptine

Dosage

Oral
Parkinson's disease
Adult: As adjunct to levodopa: 1st wk: Initially, 1-1.25 mg at night; 2nd wk: 2-2.5 mg at night; 3rd wk: 2.5 mg bid; 4th wk: 2.5 mg tid, then increased by 2.5 mg every 3-14 days as required. Maintenance: 10-40 mg daily.
Oral
Hypogonadism
Adult: 1-1.25 mg at bedtime increased to 2-2.5 mg at bedtime after 2-3 days and subsequently increased by 1 mg at 2-3 days intervals, up to 2.5 mg bid or more if necessary. Max: 30 mg daily.
Oral
Galactorrhoea
Adult: 1-1.25 mg at bedtime increased to 2-2.5 mg at bedtime after 2-3 days and subsequently increased by 1 mg at 2-3 days intervals, up to 2.5 mg bid or more if necessary. Max: 30 mg daily.
Oral
Infertility
Adult: 1-1.25 mg at bedtime increased to 2-2.5 mg at bedtime after 2-3 days and subsequently increased by 1 mg at 2-3 days intervals, up to 2.5 mg bid or more if necessary. Max: 30 mg daily.
Oral
Adjunct to surgery and radiotherapy in patients with acromegaly
Adult: Initially, 2.5 mg bid, may increase further by 2.5 mg every 2-3 days, if necessary up to 5 mg every 6 hr depending on response.
Oral
Suppression of lactation
Adult: 2.5 mg daily for 2-3 days, increased gradually to 2.5 mg bid for 14 days.
Oral
Prevention of puerperal lactation
Adult: 2.5 mg on the day of delivery followed by 2.5 mg bid for 14 days.
Oral
Cyclical benign breast and menstrual disorders
Adult: 2.5 mg bid.

Food(before/after)

Should be taken with food

List of Contraindications

Bromocriptine and Pregnancy

Contraindicated in pregnancy
Category B: Either animal-reproduction studies have not demonstrated a foetal risk but there are no controlled studies in pregnant women or animal-reproduction studies have shown an adverse effect (other than a decrease in fertility) that was not confirmed in controlled studies in women in the 1st trimester (and there is no evidence of a risk in later trimesters).

Bromocriptine and Lactation

Contraindicated in lactation

Bromocriptine and Children

The safety and effectiveness of Bromocriptine for the treatment of prolactin-secreting pituitary adenomas have been established in patients age 16 to adult. No data are available for Bromocriptine use in pediatric patients under the age of 8 years. A single 8-year old patient treated with Bromocriptine for a prolactin-secreting pituitary macroadenoma has been reported without therapeutic response.
The use of Bromocriptine for the treatment of prolactin-secreting adenomas in pediatric patients in the age group 11 to under 16 years is supported by evidence from well-controlled trials in adults, with additional data in a limited number (n=14) of children and adolescents 11 to 15 years of age with prolactin-secreting pituitary macro- and microadenomas who have been treated with Bromocriptine. Of the 14 reported patients, 9 had successful outcomes, 3 partial responses, and 2 failed to respond to Bromocriptine treatment. Chronic hypopituitarism complicated macroadenoma treatment in 5 of the responders, both in patients receiving Bromocriptine alone and in those who received Bromocriptine in combination with surgical treatment and/or pituitary irradiation.

Bromocriptine and Geriatic

Clinical studies for Bromocriptine did not include sufficient numbers of subjects aged 65 and over to determine whether the elderly respond differently from younger subjects. However, other reported clinical experiences, including post-marketing reporting of adverse events, have not identified differences in response or tolerability between elderly and younger patients.
Even though no variation in efficacy or adverse reaction profile in geriatric patients taking Bromocriptine has been observed, greater sensitivity of some elderly individuals cannot be categorically ruled out. In general, dose selection for an elderly patient should be cautious, starting at the lower end of the dose range, reflecting the greater frequency of decreased hepatic, renal or cardiac function, and of concomitant disease or other drug therapy in this population.

Bromocriptine and Other Contraindications

Breast carcinoma, hypersensitivity to ergot alkaloids, uncontrolled hypertension, severe ischaemic heart disease. Pregnancy and lactation.

Storage

Information Not Available

Lab interference

Information Not Available

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