II. 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)

III. Contraindications

IV. Mechanism

  1. Ergot derived Dopamine receptor Agonist (esp. D2 receptors)

V. Dosing: Hyperprolactinemia

  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)

VI. Dosing: Acromegaly

  1. Target dose: 20-30 mg/day (divided twice daily if total dose >20 mg)
  2. Maximum: 100 mg/day

VII. Dosing: Neuroleptic Malignant Syndrome

  1. Take 2.5 to 5 mg orally 2 to 6 times daily

VIII. Dosing: Diabetes Mellitus 2

  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]

IX. 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

XI. 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]

Images: Related links to external sites (from Bing)

Related Studies

Cost: Medications

bromocriptine (on 12/21/2022 at Medicaid.Gov Survey of pharmacy drug pricing)
BROMOCRIPTINE 2.5 MG TABLET Generic $1.43 each
BROMOCRIPTINE 5 MG CAPSULE Generic $4.34 each
cycloset (on 1/1/2022 at Medicaid.Gov Survey of pharmacy drug pricing)
CYCLOSET 0.8 MG TABLET $5.00 each

Ontology: Parlodel (C0000266)

Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH D001971
English parlodel, Parlodel

Ontology: Bromocriptine (C0006230)

Definition (NCI) A semisynthetic, ergot alkaloid with antiparkinson and lactation inhibitory activities. Bromocriptine selectively binds to and activates the postsynaptic dopamine D2-like receptors in the corpus striatum of the central nervous system (CNS). D2-like receptors are coupled to inhibitory G-proteins, which inhibit adenylyl cyclase, thereby preventing signal transduction mediated via cAMP and leading to an inhibitory effect on neurotransmission. This improves Parkinson symptoms, such as dyskinesia. Bromocriptine also has an inhibitory effect on the anterior pituitary gland, which results in blockage of prolactin secretion, thereby suppressing lactation.
Definition (CSP) D2 dopamine agonist used as a prolactin inhibitor.
Definition (MSH) A semisynthetic ergotamine alkaloid that is a dopamine D2 agonist. It suppresses prolactin secretion.
Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH D001971
SnomedCT 323134006, 325986001, 325985002, 116656002, 387039007, 46293006
LNC LP15165-1, MTHU002554
English 2 Bromoergocryptine, 2-Bromoergocryptine, 2-Bromoergokryptine, Bromocriptin, Bromocriptine, Bromocryptin, 2 Bromoergokryptine, 2 Bromo alpha ergocryptine, 2 Bromo alpha ergokryptine, 2-Bromo-alpha-ergocryptine, 2-Bromo-alpha-ergokryptine, Bromocriptine [endocrine], BROMOERGOCRYPTINE 02, Bromocriptine [endocrine use], Bromocriptine [parkinsons], Ergotaman-3',6',18-trione, 2-bromo-12'-hydroxy-2'-(1-methylethyl)-5'-(2-methylpropyl)-, (5'alpha)-, BROMOCRIPTINE, Bromocriptine [Chemical/Ingredient], bromocriptin, bromocryptin, bromocryptine, Ergotaman-3',6',18-trione, 2-bromo-12'-hydroxy-2'-(1-methylethyl)-5'alpha-(2-methylpropyl)-, Bromocriptine [parkinsons] (product), Bromocriptine [endocrine use] (product), Bromocriptine [endocrine] (product), bromocriptine, 2-Br-alpha-ergocryptine, Brom-ergocryptine, Bromocryptine, Bromocriptine (product), Bromocriptine (substance), BRCR, Bromocriptine [endocrine use] (substance), Bromocriptine [endocrine] (substance), Bromocriptine [parkinsons] (substance)
Swedish Bromokriptin
Czech bromokriptin
Finnish Bromokryptiini
Italian 2-Bromoergocriptina, 2-Bromo-alfa-ergocriptina, Bromocriptina
Russian 2-BROMOERGOKRIPTIN, BROMOKRIPTIN, PARLODEL, 2-БРОМОЭРГОКРИПТИН, БРОМОКРИПТИН, ПАРЛОДЕЛ
German BROMERGOCRYPTIN 02, 2-Bromergocryptin, Bromocriptin, Bromocryptin
Croatian BROMOKRIPTIN
Polish Bromokryptyna
Japanese ブロモクリプチン, 2-ブロモエルゴクリプチン
Spanish bromocriptina [endocrina] (producto), bromocriptina [uso endocrino], bromocriptina [endocrina], bromocriptina [antiparkinsoniano], bromocriptina [uso endocrino] (producto), bromocriptina [antiparkinsoniano] (producto), 2-br-alfa-ergocriptina, 2-bromoergocriptina, brom-ergocriptina, bromocriptina (producto), bromocriptina (sustancia), bromocriptina, 2-Bromoergocriptina, Bromocriptina
French Bromocriptine
Portuguese 2-Bromoergocriptina, Bromocriptina