Bromocriptine

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Bromocriptine Brand Names

Cycloset | Parlodel

What is Bromocriptine

Bromocriptine is a synthetic dopamine agonist that is chemically related to ergot alkaloids and lysergic acid.

Bromocriptine is used in adult and pediatric patients 11 years and older with selected conditions.

It was the first dopamine agonist marketed for the treatment of Parkinson’s disease (PD) in adults as monotherapy or as an adjunct to levodopa-based treatment; however, newer dopamine agonists have largely replaced bromocriptine in the treatment of PD.

Bromocriptine is a versatile drug and is indicated for a variety of endocrine conditions including pituitary-secreting adenomas and hyperprolactinemia-related conditions (e.g., amenorrhea with or without galactorrhea, hypogonadism, or infertility).

Bromocriptine is also effective in patients with acromegaly, although newer agents directly targeting growth hormone have largely replaced bromocriptine in the treatment of patients with this condition.

A micronized tablet (Cycloset) has been approved for the treatment of type 2 diabetes mellitus in adults.

The American Diabetes Association (ADA) does not consider bromocriptine a common medication for use for type 2 diabetes; considerations include modest efficacy, potential for drug interactions, treatment cost, and frequent side effects, including nausea.

Bromocriptine is also used as monotherapy, or in combination with dantrolene, for the treatment of Neuroleptic Malignant Syndrome.

Bromocriptine interferes with proper lactation and should not be used during breast-feeding and should be avoided in the postpartum period in patients at potential cardiovascular risk.

Although bromocriptine was previously used for postpartum breast engorgement and lactation suppression, the indication for postpartum lactation suppression was voluntarily withdrawn by the manufacturer in 1994, following a prior determination by the FDA Fertility and Maternal Health Drugs Advisory Committee that safer and more conservative supportive measures were available.

Indications

  1. acromegaly
  2. amenorrhea
  3. hyperprolactinemia
  4. infertility
  5. mastalgia
  6. neuroleptic malignant syndrome
  7. Parkinson’s disease
  8. pituitary adenoma
  9. premenstrual syndrome (PMS)
  10. type 2 diabetes mellitus

For the treatment of idiopathic or postencephalitic Parkinson’s disease

Side Effects

  1. abdominal pain
  2. alopecia
  3. amblyopia
  4. anorexia
  5. anxiety
  6. asthenia
  7. ataxia
  8. blepharospasm
  9. blurred vision
  10. bradycardia
  11. cardiac valvulopathy
  12. confusion
  13. constipation
  14. depression
  15. diarrhea
  16. dizziness
  17. drowsiness
  18. dyskinesia
  19. dyspepsia
  20. dysphagia
  21. dyspnea
  22. fatigue
  23. GI bleeding
  24. hallucinations
  25. headache
  26. hypertension
  27. hypoglycemia
  28. hypotension
  29. impulse control symptoms
  30. increased urinary frequency
  31. infection
  32. influenza
  33. insomnia
  34. involuntary movements
  35. lethargy
  36. libido increase
  37. mania
  38. muscle cramps
  39. myocardial infarction
  40. nasal congestion
  41. nausea
  42. neuroleptic malignant syndrome-like symptoms
  43. nightmares
  44. orthostatic hypotension
  45. pallor
  46. paranoia
  47. paresthesias
  48. peptic ulcer
  49. pericardial effusion
  50. pericarditis
  51. peripheral edema
  52. peripheral vasoconstriction
  53. pleural effusion
  54. psychosis
  55. pulmonary fibrosis
  56. rash
  57. retroperitoneal fibrosis
  58. rhinitis
  59. rhinorrhea
  60. seizures
  61. sinus tachycardia
  62. sinusitis
  63. stroke
  64. sudden sleep onset
  65. syncope
  66. tinnitus
  67. urinary incontinence
  68. urinary retention
  69. ventricular tachycardia
  70. vertigo
  71. visual impairment
  72. vomiting
  73. xerostomia

Monitoring Parameters

  • blood glucose
  • glycosylated hemoglobin A1c (HbA1c)
  • neurologic function
  • pregnancy testing
  • serum growth hormone concentrations
  • serum prolactin

Contraindications

  • abrupt discontinuation
  • acute myocardial infarction
  • basilar/hemiplegic migraine
  • breast-feeding
  • cardiac disease
  • children
  • coadministration with other CNS depressants
  • contraception requirements
  • coronary artery disease
  • dementia
  • diabetic ketoacidosis
  • driving or operating machinery
  • eclampsia
  • ergot alkaloid hypersensitivity
  • ethanol ingestion
  • fever
  • geriatric
  • GI bleeding
  • hepatic disease
  • hypertension
  • hypotension
  • impulse control symptoms
  • infants
  • infection
  • lactase deficiency
  • melanoma
  • orthostatic hypotension
  • peptic ulcer disease
  • peripheral vascular disease
  • preeclampsia
  • pregnancy
  • pregnancy testing
  • psychosis
  • pulmonary fibrosis
  • Raynaud’s phenomenon
  • renal disease
  • retroperitoneal fibrosis
  • rhinorrhea
  • stroke
  • surgery
  • trauma
  • type 1 diabetes mellitus
  • visual impairment

Interactions

  • Acetaminophen; Aspirin, ASA; Caffeine
  • Acetaminophen; Butalbital
  • Acetaminophen; Butalbital; Caffeine
  • Acetaminophen; Butalbital; Caffeine; Codeine
  • Acetaminophen; Caffeine; Magnesium Salicylate; Phenyltoloxamine
  • Acetaminophen; Caffeine; Phenyltoloxamine; Salicylamide
  • Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine
  • Acetaminophen; Chlorpheniramine; Dextromethorphan; Pseudoephedrine
  • Acetaminophen; Chlorpheniramine; Phenylephrine; Phenyltoloxamine
  • Acetaminophen; Dextromethorphan; Guaifenesin; Phenylephrine
  • Acetaminophen; Dextromethorphan; Phenylephrine
  • Acetaminophen; Dextromethorphan; Pseudoephedrine
  • Acetaminophen; Dichloralphenazone; Isometheptene
  • Acetaminophen; Guaifenesin; Phenylephrine
  • Acetaminophen; Pseudoephedrine
  • Acrivastine; Pseudoephedrine
  • Almotriptan
  • Aminosalicylate sodium, Aminosalicylic acid
  • Amiodarone
  • Amoxicillin; Clarithromycin; Lansoprazole
  • Amoxicillin; Clarithromycin; Omeprazole
  • Amphetamine
  • Amphetamine; Dextroamphetamine
  • Amphetamine; Dextroamphetamine Salts
  • Apalutamide
  • Aprepitant, Fosaprepitant
  • Aripiprazole
  • Articaine; Epinephrine
  • Asenapine
  • Aspirin, ASA
  • Aspirin, ASA; Butalbital; Caffeine
  • Aspirin, ASA; Butalbital; Caffeine; Codeine
  • Aspirin, ASA; Caffeine; Dihydrocodeine
  • Aspirin, ASA; Caffeine; Orphenadrine
  • Aspirin, ASA; Carisoprodol
  • Aspirin, ASA; Carisoprodol; Codeine
  • Aspirin, ASA; Citric Acid; Sodium Bicarbonate
  • Aspirin, ASA; Dipyridamole
  • Aspirin, ASA; Omeprazole
  • Aspirin, ASA; Oxycodone
  • Aspirin, ASA; Pravastatin
  • Atazanavir
  • Atazanavir; Cobicistat
  • Atropine; Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
  • Atropine; Hyoscyamine; Phenobarbital; Scopolamine
  • atypical antipsychotic
  • Belladonna Alkaloids; Ergotamine; Phenobarbital
  • Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
  • Benzphetamine
  • Bexarotene
  • Bismuth Subsalicylate
  • Bismuth Subsalicylate; Metronidazole; Tetracycline
  • Boceprevir
  • Bosentan
  • Brexpiprazole
  • Brompheniramine; Carbetapentane; Phenylephrine
  • Brompheniramine; Hydrocodone; Pseudoephedrine
  • Brompheniramine; Pseudoephedrine
  • Butabarbital
  • Caffeine; Ergotamine
  • Carbamazepine
  • Carbetapentane; Chlorpheniramine; Phenylephrine
  • Carbetapentane; Diphenhydramine; Phenylephrine
  • Carbetapentane; Guaifenesin; Phenylephrine
  • Carbetapentane; Phenylephrine
  • Carbetapentane; Phenylephrine; Pyrilamine
  • Carbetapentane; Pseudoephedrine
  • Carbinoxamine; Dextromethorphan; Pseudoephedrine
  • Carbinoxamine; Hydrocodone; Phenylephrine
  • Carbinoxamine; Hydrocodone; Pseudoephedrine
  • Carbinoxamine; Phenylephrine
  • Carbinoxamine; Pseudoephedrine
  • Cariprazine
  • Cenobamate
  • Ceritinib
  • Cetirizine; Pseudoephedrine
  • Chlophedianol; Dexchlorpheniramine; Pseudoephedrine
  • Chlophedianol; Guaifenesin; Phenylephrine
  • Chloramphenicol
  • Chlorpheniramine; Dextromethorphan; Phenylephrine
  • Chlorpheniramine; Dihydrocodeine; Phenylephrine
  • Chlorpheniramine; Dihydrocodeine; Pseudoephedrine
  • Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine
  • Chlorpheniramine; Hydrocodone; Phenylephrine
  • Chlorpheniramine; Hydrocodone; Pseudoephedrine
  • Chlorpheniramine; Phenylephrine
  • Chlorpheniramine; Pseudoephedrine
  • Chlorpromazine
  • Choline Salicylate; Magnesium Salicylate
  • Ciprofloxacin
  • Clarithromycin
  • Clozapine
  • Cobicistat
  • Cocaine
  • Codeine; Phenylephrine; Promethazine
  • Codeine; Promethazine
  • Colchicine; Probenecid
  • Conivaptan
  • Conjugated Estrogens; Medroxyprogesterone
  • Crizotinib
  • Cyclosporine
  • Dabrafenib
  • Danazol
  • Darunavir
  • Darunavir; Cobicistat
  • Darunavir; Cobicistat; Emtricitabine; Tenofovir alafenamide
  • Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir
  • Deferasirox
  • Delavirdine
  • Desloratadine; Pseudoephedrine
  • Dexamethasone
  • Dexchlorpheniramine; Dextromethorphan; Pseudoephedrine
  • Dexmethylphenidate
  • Dextroamphetamine
  • Dextromethorphan; Diphenhydramine; Phenylephrine
  • Dextromethorphan; Guaifenesin; Phenylephrine
  • Dextromethorphan; Guaifenesin; Pseudoephedrine
  • Dextromethorphan; Promethazine
  • Dienogest; Estradiol valerate
  • Diethylpropion
  • Dihydrocodeine; Guaifenesin; Pseudoephedrine
  • Dihydroergotamine
  • Diltiazem
  • Diphenhydramine; Hydrocodone; Phenylephrine
  • Diphenhydramine; Phenylephrine
  • Donepezil; Memantine
  • Dopamine
  • Dronedarone
  • Droperidol
  • Drospirenone
  • Drospirenone; Estradiol
  • Drospirenone; Ethinyl Estradiol
  • Drospirenone; Ethinyl Estradiol; Levomefolate
  • Duvelisib
  • Efavirenz
  • Efavirenz; Emtricitabine; Tenofovir
  • Efavirenz; Lamivudine; Tenofovir Disoproxil Fumarate
  • Elagolix
  • Eletriptan
  • Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Alafenamide
  • Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate
  • Enzalutamide
  • Ephedrine
  • Epinephrine
  • Ergoloid Mesylates
  • Ergonovine
  • Ergot alkaloids
  • Ergotamine
  • Erythromycin
  • Erythromycin; Sulfisoxazole
  • Eslicarbazepine
  • Estradiol Cypionate; Medroxyprogesterone
  • Estradiol; Levonorgestrel
  • Estradiol; Norethindrone
  • Estradiol; Norgestimate
  • Estradiol; Progesterone
  • Estrogens
  • Ethanol
  • Ethinyl Estradiol; Desogestrel
  • Ethinyl Estradiol; Ethynodiol Diacetate
  • Ethinyl Estradiol; Etonogestrel
  • Ethinyl Estradiol; Levonorgestrel
  • Ethinyl Estradiol; Levonorgestrel; Ferrous bisglycinate
  • Ethinyl Estradiol; Levonorgestrel; Folic Acid; Levomefolate
  • Ethinyl Estradiol; Norelgestromin
  • Ethinyl Estradiol; Norethindrone
  • Ethinyl Estradiol; Norethindrone Acetate
  • Ethinyl Estradiol; Norethindrone Acetate; Ferrous fumarate
  • Ethinyl Estradiol; Norethindrone; Ferrous fumarate
  • Ethinyl Estradiol; Norgestimate
  • Ethinyl Estradiol; Norgestrel
  • Etonogestrel
  • Etravirine
  • Fedratinib
  • Fexofenadine; Pseudoephedrine
  • Fluconazole
  • Fluoxetine; Olanzapine
  • Fluphenazine
  • Flutamide
  • Fluvoxamine
  • Fosamprenavir
  • Fosphenytoin
  • Frovatriptan
  • grapefruit juice
  • Guaifenesin; Hydrocodone; Pseudoephedrine
  • Guaifenesin; Phenylephrine
  • Guaifenesin; Pseudoephedrine
  • Haloperidol
  • Hydrocodone; Phenylephrine
  • Hydrocodone; Potassium Guaiacolsulfonate; Pseudoephedrine
  • Hydrocodone; Pseudoephedrine
  • Hydroxyprogesterone
  • Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate; Sodium Biphosphate
  • Ibuprofen; Pseudoephedrine
  • Idelalisib
  • Iloperidone
  • Imatinib
  • Indinavir
  • Isavuconazonium
  • Isoniazid, INH; Pyrazinamide, PZA; Rifampin
  • Isoniazid, INH; Rifampin
  • Itraconazole
  • Ketoconazole
  • Lanreotide
  • Lefamulin
  • Letermovir
  • Leuprolide; Norethindrone
  • Levonorgestrel
  • Linezolid
  • Lisdexamfetamine
  • Lopinavir; Ritonavir
  • Loratadine; Pseudoephedrine
  • Loxapine
  • Lumacaftor; Ivacaftor
  • Lumacaftor; Ivacaftor
  • Lumateperone
  • Lurasidone
  • Magnesium Salicylate
  • Mecamylamine
  • Medroxyprogesterone
  • Memantine
  • Meperidine; Promethazine
  • Mepivacaine; Levonordefrin
  • Mesoridazine
  • Mestranol; Norethindrone
  • Methamphetamine
  • Methenamine; Sodium Acid Phosphate; Methylene Blue; Hyoscyamine
  • Methylene Blue
  • Methylergonovine
  • Methylphenidate
  • Methysergide
  • Metoclopramide
  • Metyrapone
  • Midodrine
  • Mifepristone
  • Mitotane
  • Modafinil
  • Molindone
  • Nafcillin
  • Naproxen; Pseudoephedrine
  • Naproxen; Sumatriptan
  • Naratriptan
  • Nefazodone
  • Nelfinavir
  • Netupitant, Fosnetupitant; Palonosetron
  • Nevirapine
  • Nicotine
  • Nilotinib
  • Norepinephrine
  • Norethindrone
  • Norgestrel
  • Octreotide
  • Olanzapine
  • Ombitasvir; Paritaprevir; Ritonavir
  • Omeprazole; Amoxicillin; Rifabutin
  • Paliperidone
  • Pasireotide
  • Pazopanib
  • Pegvisomant
  • Pergolide
  • Perphenazine
  • Perphenazine; Amitriptyline
  • Phendimetrazine
  • Phenobarbital
  • Phenothiazines
  • Phenoxybenzamine
  • Phentermine
  • Phentermine; Topiramate
  • Phentolamine
  • Phenylephrine
  • Phenylephrine; Promethazine
  • Phenytoin
  • Pimozide
  • Posaconazole
  • Prilocaine; Epinephrine
  • Primidone
  • Probenecid
  • Procaine
  • Prochlorperazine
  • Progesterone
  • Progestins
  • Promethazine
  • Pseudoephedrine
  • Pyrimethamine; Sulfadoxine
  • Quetiapine
  • Quinine
  • Ribociclib
  • Ribociclib; Letrozole
  • Rifabutin
  • Rifampin
  • Rifapentine
  • Risperidone
  • Ritodrine
  • Ritonavir
  • Rizatriptan
  • Salicylates
  • Salsalate
  • Saquinavir
  • Secobarbital
  • Segesterone Acetate; Ethinyl Estradiol
  • Serotonin-Receptor Agonists
  • Solriamfetol
  • St. John’s Wort, Hypericum perforatum
  • Sulfadiazine
  • Sulfamethoxazole; Trimethoprim, SMX-TMP, Cotrimoxazole
  • Sulfasalazine
  • Sulfisoxazole
  • Sulfonamides
  • Sumatriptan
  • Tacrolimus
  • Telithromycin
  • Thiethylperazine
  • Thioridazine
  • Thiothixene
  • Tipranavir
  • tobacco
  • Trandolapril; Verapamil
  • Trifluoperazine
  • Verapamil
  • Voriconazole
  • Zafirlukast
  • Zileuton
  • Ziprasidone
  • Zolmitriptan

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