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Bromocriptine

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Bromocriptine, Bromocriptine QR, Parlodel, Cycloset

  • See Also
  1. Dopamine Agonist in Hyperprolactinemia
  2. Cabergoline
  3. Dopamine Agonist
  4. Hyperprolactinemia
  5. Galactorrhea
  • Indications
  1. Acromegaly
  2. Hyperprolactinemia
    1. Adjunctive management of pituitary tumors
  3. Parkinsonism (listed for historical reasons)
    1. Replaced by non-ergot derived Dopamine Agonists
    2. Dopamine Agonists are used for late Parkinsonism following tolerance to Levodopa
  4. Neuroleptic Malignant Syndrome (not FDA approved)
  • Contraindications
  1. Raynaud's Syndrome
  • Mechanism
  1. Ergot derived Dopamine receptor Agonist (esp. D2 receptors)
  1. Preparations: Bromocriptine (Parlodel)
  2. Indications
    1. Larger safety database than Cabergoline (preferred in women trying to conceive)
  3. Oral Dosing
    1. Start: 1.25 to 2.5 mg orally at bedtime
    2. Titrate: Increase by 2.5 mg/dose every 3-7 days up to 15 mg daily
    3. Maximum: 40 mg/day
  4. Alternative: Vaginal Dosing (not FDA approved)
    1. Dose: 2.5 to 7.5 mg intravaginally (if gastrointestinal symptoms prevent oral dosing)
  1. Target dose: 20-30 mg/day (divided twice daily if total dose >20 mg)
  2. Maximum: 100 mg/day
  1. Take 2.5 to 5 mg orally 2 to 6 times daily
  1. Preparations: Bromocriptine QR or Cycloset
  2. Indications (historical)
    1. Adjunctive with Metformin (and other Oral Hypoglycemic agents)
  3. Dosing
    1. Start 0.8 mg each am
    2. May increase up to weekly by 0.8 mg/day, to a maximum of 4.8 mg daily
  4. Efficacy
    1. May lower Hemoglobin A1C 0.7 to 1.4%
  5. References
    1. Joe Weidner, MD (2018) email communication, received 11/10/2018
    2. Gardner (2013) Endocr Pract 19(1):100-6 +PMID:23337160 [PubMed]
    3. Chamarthi (2017) Postgrad Med 129(4):446-455 +PMID:28374645 [PubMed]
  • Adverse Effects
  1. Take with food to reduce adverse effects (Nausea, Dizziness)
  2. Safety
    1. Pregnancy Category B
    2. Avoid in Lactation
  3. Cardiovascular Events (CVA, MI, Arrhythmias)
  4. Nausea
  5. Hallucinations
  6. Confusion
  7. CNS Activation
  • Resources
  1. Bromocriptine (DailyMed)
    1. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=93a0696b-b261-4262-9e06-f3180b419f8f
  • References
  1. Olson (2020) Clinical Pharmacology, Medmaster Miami, p. 46-7
  2. Hamilton (2020) Tarascon Pocket Pharmacopoeia
  3. Huang (2012) Am Fam Physician 85(11): 1073-80 [PubMed]