Bromocriptine

Administration

• Type: Dopamine agonist
• Dosage Forms: 2.5, 5 mg
• Routes of Administration: Oral
• Common Trade Names: Parlodel, Cycloset

Adult Dosing

• Acromegaly
  • 20-30 mg PO qd
    • Start: 1.25-2.5 mg PO qhs x3 days
      • Increase by 1.25-2.5 mg per day q 3-7 days
    • Max: 100 mg per day
    • Give with food and taper dose to D/C
• Hyperprolactinemia
  • 2.5-15 mg PO qd
    • Start: 1.5-2.5 mg PO qd
      • Increase by 1.25-2.5 mg per day q 2-7 days
    • Give with food and taper dose to D/C
• Parkinson's disease
  • 10-30 mg PO tid
    • Max: 100 mg/day
    • Give with food and taper dose to D/C
• Neuroleptic malignant syndrome
  • 5-10 mg PO tid-qid
    • Start: 2.5 mg PO tid-qid
      • Increase dose as tolerated
    • Max: 20 mg PO qid
    • Continue x7-10 days, then taper dose over 3 days to D/C

Pediatric Dosing

• Adenoma, prolactin-secreting
  • 11-15 yo
    • 2.5-10 mg PO qd
      • Start: 1.25-2.5 mg PO qd
      • Give with food and taper dose to D/C
  • 16+ yo
    • 2.5-15 mg PO qd
      • Start: 1.25-2.5 mg PO qd
      • Give with food and taper dose to D/C

Special Populations

• Pregnancy Rating: B; No known risk of fetal harm based on human data. Monitor hyperprolactinemic pts closely for potential prolactin-secreting tumor enlargement.
• Lactation risk: L5; Contraindicated in postpartum lactation

Renal Dosing

• Adult: Not defined. Caution advised.
• Pediatric: Not defined. Caution advised.

Hepatic Dosing

• Adult: Not defined. Caution advised.
• Pediatric: Not defined. Caution advised.

Contraindications

• Allergy to class/drug
• Hypersensitivity to ergot derivatives
• Hypertension, uncontrolled
• Breastfeeding
• Avoid abrupt withdrawal

Adverse Reactions

Serious

• Seizure
• Stroke
• Hallucinations
• Syncope
• Hypotension
• Arrhythmia, MI
• Pericardial effusion, constrictive pericarditis
• Pleural effusion, pulmonary fibrosis
• Hypertension
• Raynaud phenomenon
• Retroperitoneal fibrosis
• GI bleeding
• Neuroleptic malignant syndrome-like symptoms if abrupt discontinuation

Common

• Nausea/vomiting, diarrhea, constipation, dyspepsia, anorexia, abdominal pain
• Headache, dizziness, fatigue
• Nasal congestion
• Orthostatic hypotension, orthostatic
• Involuntary movements, ataxia, visual disturbances
• Compulsive behaviors
• Digital vasospasm
• ALT, AST, alk phos elevation

Pharmacology

• Half-life: Biphasic 4-4.5 hr and 15 hr
• Metabolism: Liver; CYP450: 3A4 substrate
• Excretion: Bile 95%, urine 2.5-5.5%

Mechanism of Action

• Stimulates dopamine receptors
• Inhibits anterior pituitary prolactin secretion

See Also

• Neuroleptic malignant syndrome

References

Authors

Jonathan Warren, Claire