Bromocriptine


Concise Prescribing Info
Indications/Uses
Listed in Dosage.
Dosage/Direction for Use
Adult : PO Parkinson's disease As adjunct to levodopa: 1st wk: Initial: 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, increased by 2.5 mg every 3-14 days as required. Maintenance: 10-30 mg/day. Galactorrhoea; Hypogonadism; Infertility Initial: 1-1.25 at night, increased to 2-2.5 mg at night after 2-3 days, subsequently increased by 1-2.5 mg every 2-3 days up to 2.5 mg bid, or more if needed. Max: 30 mg/day. Acromegaly; Prolactinoma Initial: 1-1.25 mg at night, increased gradually to 2-2.5 mg/day at 2-3 days interval, then 2.5 mg 8 hrly, 2.5 mg 6 hrly and 5 mg 6 hrly. Suppression of lactation 2.5 mg/day for 2-3 days, increased to 2.5 mg bid for 14 days. Prophylaxis of puerperal lactation 2.5 mg on the day of delivery, then 2.5 mg bid for 14 days.
Dosage Details
Oral
Prophylaxis of puerperal lactation
Adult: 2.5 mg on the day of delivery followed by 2.5 mg bid for 14 days.

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: 10-30 mg daily.

Oral
Hypogonadism, Galactorrhoea, Infertility
Adult: Initially, 1-1.25 mg at night, increased to 2-2.5 mg at night after 2-3 days, and subsequently increased by 1-2.5 mg every 2-3 days up to 2.5 mg bid or more if necessary. Max: 30 mg daily.

Oral
Prolactinoma (prolactin secreting adenoma)
Adult: Initially,1-1.25 mg at night, increased gradually to 2-2.5 mg daily at 2-3 days interval, then 2.5 mg 8 hrly, 2.5 mg 6 hrly and 5 mg 6 hrly. Max: 30 mg daily.
Child: 7-17 yr Initially, 1 mg bid or tid, may gradually increase according to response. Max: 7-12 yr 5 mg daily; ≥13 yr 20 mg daily.

Oral
Acromegaly
Adult: Initially, 1-1.25 mg at night, increased gradually to 2-2.5 mg daily at 2-3 days interval then 2.5 mg 8 hrly, 2.5 mg 6 hrly and 5 mg 6 hrly.
Child: 7-17 yr Initially, 1.25 mg bid or tid, may gradually increase according to response. Max: 7-12 yr 10 mg daily; ≥13 yr 20 mg daily.

Oral
Suppression of lactation
Adult: 2.5 mg daily for 2-3 days, increased to 2.5 mg bid for 14 days.
Administration
Should be taken with food.
Contraindications
Uncontrolled HTN, hypertensive disorders of pregnancy (including eclampsia, pre-eclampsia or pregnancy-induced HTN), HTN post-partum and in the puerperium. Coronary artery disease, other severe CV disorders, symptoms or history of severe psychiatric disorders when used for the suppression of lactation or other non-life-threatening indications. Evidence of cardiac valvulopathy (long-term therapy). Lactation.
Special Precautions
Patient w/ parkinsonian syndrome who manifest mild degrees of dementia or w/ history of MI and a residual atrial, nodal or ventricular arrhythmia, pleuropulmonary signs and symptoms, history of psychosis, CV disease, Raynaud’s syndrome, history of peptic ulcer. Renal or hepatic impairment. Childn. Pregnancy.
Adverse Reactions
Nausea, vomiting, drowsiness, orthostatic hypotension, Raynaud’s syndrome, erythromelalgia, arrhythmias, exacerbation of angina, headache, nasal congestion, dry mouth, constipation, diarrhoea, altered LFTs, dyskinaesia, GI bleeding, psychosis, hallucinations, delusions, confusion, pericarditis, pleural thickening and effusions, sudden sleep onset, hypersexuality, visual disturbance, tinnitus, hair loss. Very rarely, HTN, MI, seizures or stroke.
Patient Counseling Information
This drug may cause somnolence and/or sudden sleep onset, if affected, do not drive or operate machinery.
MonitoringParameters
Monitor for pituitary enlargement, visual field to detect secondary field loss in macroprolactinoma fibrotic disease; BP and heart rate (at baseline and periodically), GI bleeding and pregnancy test during amenorrheic period.
Overdosage
Symptoms: Vomiting, nausea, dizziness, hypotension, postural hypotension, tachycardia, drowsiness, somnolence, lethargy, confusion and hallucination. Management: Symptomatic and supportive treatment. Administer activated charcoal; may perform gastric lavage if intake is very recent. May give metoclopramide for emesis or hallucinations.
Drug Interactions
Increased plasma level w/ erythromycin and other macrolide antibiotics. Effects of antihypertensives may be potentiated. Diminished therapeutic effect w/ dopamine antagonists such as psychotropics (e.g. phenothiazines, butyrophenones, thioxanthenes). Additive neurologic effect w/ levodopa. Reduced prolactin-lowering effect w/ metoclopramide and domperidone. Potentially severe adverse effects may occur w/ concomitant use of other ergot alkaloids.
Food Interaction
Food reduces nausea caused by bromocriptine. Alcohol reduces tolerance to bromocriptine.
Action
Description: Bromocriptine is a dopamine D2 agonist which activates postsynaptic dopamine receptors in the tuberoinfundibular pathway that inhibits the secretion of prolactin from the anterior pituitary and may lower blood level of growth hormone. It also stimulates nigrostriatal pathways in the corpus striatum to enhance coordinated motor control.
Pharmacokinetics:
Absorption: Rapidly absorbed from the GI tract. Bioavailability: Approx 6%. Time to peak plasma concentration: W/in 1-3 hr.
Distribution: Plama protein-binding: 90-96%, mainly albumin.
Metabolism: Undergoes extensive hepatic first-pass metabolism; converted to lysergic acid and peptides via hydrolysis.
Excretion: Via faeces (approx 82%) and urine (approx 2-6%). Elimination half-life: Biphasic: Approx 4-4.5 hr; 15 hr.
Chemical Structure

Click on icon to see table/diagram/image
Storage
Store below 25°C. Protect from light.
ATC Classification
G02CB01 - bromocriptine ; Belongs to the class of prolactine inhibitors. Used to suppress lactation.
N04BC01 - bromocriptine ; Belongs to the class of dopamine agonist. Used in the management of Parkinson's disease.
Disclaimer: This information is independently developed by MIMS based on Bromocriptine from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to MIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, MIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2020 MIMS. All rights reserved. Powered by MIMS.com
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