Bromocriptine

Aka: Bromocriptine, Bromocriptine QR, Parlodel, Cycloset

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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

  1. Raynaud's Syndrome

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

X. Resources

  1. Bromocriptine (DailyMed)
    1. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=93a0696b-b261-4262-9e06-f3180b419f8f

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]

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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
FPNotebook does not benefit financially from showing this medication data or their pharmacy links. This information is provided only to help medical providers and their patients see relative costs. Insurance plans negotiate lower medication prices with suppliers. Prices shown here are out of pocket, non-negotiated rates. See Needy Meds for financial assistance information. GoodRx is another tool for finding lower drug prices.

Related Topics in Pharmacology

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