II. Indications

III. Dosing: Hyperprolactinemia

  1. Bromocriptine (Parlodel)
    1. Larger safety database than Cabergoline (preferred in women trying to conceive)
    2. Start: 1.25 to 2.5 mg at bedtime
    3. Titrate: Increase by 2.5 mg every 3-7 days up to 15 mg daily
  2. Cabergoline (Dostinex)
    1. Fewer side effects than Bromocriptine
    2. Start: 0.25 orally twice weekly
    3. Titrate: Increase by 0.25 mg every month up to 1 mg twice daily

IV. Dosing: Diabetes Mellitus 2

  1. Bromocriptine QR or Cycloset
    1. Adjunctive with Metformin (and other Oral Hypoglycemic agents)
    2. 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
    3. Efficacy
      1. May lower Hemoglobin A1C 0.7 to 1.4%
    4. 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]

V. Adverse Effects

  1. Nausea or Vomiting
  2. Postural Hypotension
  3. Dizziness
  4. Headache
  5. Sedation
  6. Valvular disorders
    1. Reported with high dose Cabergoline (>4 mg daily)

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Related Studies

Cost: Medications

bromocriptine (on 5/17/2017 at Medicaid.Gov Survey of pharmacy drug pricing)
BROMOCRIPTINE 2.5 MG TABLET Generic $2.89 each
cabergoline (on 5/17/2017 at Medicaid.Gov Survey of pharmacy drug pricing)
CABERGOLINE 0.5 MG TABLET Generic $7.84 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
German BROMERGOCRYPTIN 02, 2-Bromergocryptin, Bromocriptin, Bromocryptin
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

Ontology: cabergoline (C0107994)

Definition (NCI) A synthetic ergoline derivative and a long-acting dopamine receptor agonist with high affinity for the dopamine D2 receptor. Cabergoline exerts an inhibitory effect on prolactin secretion by acting on dopamine receptors present in pituitary lactotrophs. This drug also binds to dopamine D2 receptors in the corpus striatum, thereby mimicking the actions of dopamine on motor control. Cabergoline also possesses antioxidant and neuroprotective properties due to its free radical scavenging activity. Cabergoline is used in the treatment of Parkinson's disease and in the treatment of hyperprolactinemia.
Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH C047047
SnomedCT 323191001, 109139002, 386979007
English cabergoline, 1-((6-Allylergolin-8beta-yl)carbonyl)-1-(3-(dimethylamino)propyl)-3-ethylurea, Cabergoline [parkinsons], cabergoline (medication), dopamine agonists cabergoline, 1-((6-allylergolin-8beta-yl)carbonyl)-1-(3-(dimethylamino)propyl)-3-ethylurea, CABERGOLINE, cabergoline [Chemical/Ingredient], cabergoline parkinsons, Cabergoline [parkinsons] (product), Cabergoline, Cabergoline (product), Cabergoline (substance), Cabergoline [parkinsons] (substance)
Spanish cabergolina [antiparkinsonianos] (producto), cabergolina [antiparkinsonianos], cabergolina (producto), cabergolina (sustancia), cabergolina

Ontology: Dostinex (C0526034)

Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH C047047
English Dostinex, Cabaseril, Pfizer brand of cabergoline, cabaser, dostinex, Cabaser