BROMOCRIPTINE

Ergot derived dopamine receptor agonist which also inhibits release of prolactin and growth hormone by the pituitary

Dosage Forms

Tablet

2.5 mg

Uses

  • Parkinson’s disease
  • Galactorrhoea
  • Prolactinoma
  • Acromegaly
  • Hypogonadism
  • Menstrual cycle disorders and female infertility
  • Suppression or prevention of lactation

Dose and Duration

Parkinson’s disease
Adult:1–1.25 mg at night in the 1st week, 2–2.5 mg at night in the 2nd week, 2.5 mg every 12 hours for the 3rd week, 2.5 mg every 8 hours for the 4th week, then in creasing by 2.5mg every 3–14 days according to response to a usual range of 10–30 mg daily
Prevention or suppression of lactation
Adult:2.5 mg on the day of delivery (prevention)or 2.5 mg once a day for 2–3 days (suppression);

Then 2.5 mg every 12 hours for 14 days

Hypogonadism, galactorrhoea, infertility
Adult:initially 1–1.25 mg at bedtime, increased gradually to the usual dose of 7.5 mg (max 30 mg) daily in divided doses (usual dose 2.5 mg every 12 hours in infertility without hyperprolactinaemia)
Acromegaly
Adult: initially 1–1.25 mg at bedtime, increased gradually at 2 to 3 day intervals as follows: 2.5 mg every 8 hours to 2.5 mg every 6 hours to 5 mg every 6 hours
child 7 years and older: titrate initial dose according to growth hormone levels and increase dose gradually up to a maximum dose of 10 mg in children 7–12 years and 20 mg in children 13–17 years
Prolactinoma
Adult: initially 1–1.25 mg at bedtime, increased gradually at 2−3 day intervals as follows: 2.5 mg every 8 hours to 2.5 mg every 6 hours to 5 mg every 6 hours (max 30 mg daily)
child 7 years and older: 1 mg every 8–12 hours gradually increasing the dose to keep plasma prolactin adequately suppressed (max 7–12 years: 5 mg, 13–17 years: 20 mg)

Contraindications

  • Hypersensitivity to ergot alkaloids
  • Long term treatment in cardiac valvulopathy
  • Uncontrolled hypertension
  • Pre-eclampsia, eclampsia, pregnancy induced hypertension
  • Hypertension in postpartum women or in puerperium

Side Effects

  • Headache, drowsiness
  • Nausea, constipation
  • Nasal congestion

Patient Instructions

  • Take your medication during or immediately after a meal
  • Avoid driving or operating machinery cautiously since you might experience sudden onset of day time sleepiness

Pregnancy

  • Can be used (see caution)

Breastfeeding

  • Do not use (See caution)

⚠️ Caution

  • Use with caution in patients with Raynaud’s syndrome, cardiovascular disease or a history of mental disorder and peptic ulcer particularly in acromegalic patients; with draw treatment if gastro-intestinal bleeding occurs
  • Use with caution for lactation suppression in postpartum women on antihypertensive therapy and avoid other er got alkaloids
  • Exclude pituitary tumour before treating a patient with hyperprolactinaemia
  • Oral contraceptives may increase prolactin concentration
  • Discontinue medication immediately if hypertension, continuous headache, or signs of CNS toxicity develop
  • Breast feeding should be avoided for about 5 days if lactation prevention fails
  • It is advisable to withdraw bromocriptine after the first missed menstrual period if pregnancy occurs, but due to the risk of rapid expansion of pituitary tumors during pregnancy, monitor patients to detect signs of pituitary extension and reintroduce bromocriptine if necessary