Bromocriptine

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Generic Name of Bromocriptine - Learn More

Bromocriptine

Bromocriptine Precaution - What You Need to Know

Before initiating treatment with Bromocriptine, it is essential to consult with a healthcare provider to ensure its suitability for your condition. The following precautions should be considered:

- Cardiovascular Conditions: Bromocriptine may cause hypotension (low blood pressure), particularly after the first dose. Patients with a history of heart disease, hypertension, or vascular disorders should be closely monitored during therapy. Sudden changes in posture or standing up quickly may lead to dizziness or fainting.
- Psychiatric Conditions: Bromocriptine can affect mood and mental health. Patients with a history of psychiatric disorders such as psychosis, depression, or schizophrenia should be monitored for exacerbation of symptoms. Some individuals may also experience impulse control disorders (e.g., compulsive gambling, hypersexuality).
- Pregnancy and Breastfeeding: Bromocriptine should be used with caution during pregnancy (Category B). It is contraindicated in women who are pregnant and have conditions such as high blood pressure or gestational hypertension. Bromocriptine is excreted in breast milk, so it is not recommended during breastfeeding unless the benefits outweigh the risks.
- Liver Impairment: Patients with liver dysfunction should be closely monitored, as bromocriptine is metabolized by the liver. Dose adjustments may be necessary.
- Diabetes: Bromocriptine may influence glucose metabolism. Diabetic patients should monitor their blood sugar levels more frequently, as adjustments to antidiabetic medications may be required.

Bromocriptine Indication - Uses and Benefits

Bromocriptine is used for the treatment of several conditions, primarily those related to dopamine deficiency or abnormal prolactin levels:

- Parkinson’s Disease: Bromocriptine is used to treat the symptoms of Parkinson’s disease, a neurodegenerative disorder characterized by tremors, rigidity, and bradykinesia (slow movement). It works by stimulating dopamine receptors in the brain, thereby improving motor function.
- Hyperprolactinemia: Bromocriptine is effective in treating hyperprolactinemia, a condition where the body produces too much prolactin. It is commonly used in conditions such as prolactinomas (pituitary tumors that secrete prolactin), infertility, amenorrhea, and galactorrhea (abnormal milk production).
- Acromegaly: Bromocriptine may be used in the treatment of acromegaly, a condition where excess growth hormone is produced, typically due to a pituitary tumor. Bromocriptine helps reduce growth hormone levels.
- Type 2 Diabetes: In some cases, bromocriptine is used off-label to manage type 2 diabetes. It can help regulate blood sugar by resetting the body's internal clock and enhancing insulin sensitivity.

Bromocriptine Contraindications - Important Warnings

Bromocriptine should not be used in certain situations, including:

- Hypersensitivity: Bromocriptine is contraindicated in individuals who have a known allergy or hypersensitivity to the drug or any of its components.
- Severe Cardiovascular Disease: The drug should be avoided in patients with severe coronary artery disease, uncontrolled hypertension, or those who have had a heart attack. Bromocriptine may worsen cardiovascular conditions.
- Severe Liver Impairment: In patients with severe liver disease, bromocriptine should be avoided due to the potential for increased systemic absorption and heightened risk of side effects.
- Pregnancy: Bromocriptine is contraindicated in pregnant women with hypertension or gestational hypertension, especially if used for the purpose of stopping lactation or for fertility-related issues.
- Postpartum Women: Bromocriptine should not be used to suppress lactation in women who have recently given birth unless there is a medical reason that justifies its use.

Bromocriptine Side Effects - What to Expect

Common and serious side effects associated with Bromocriptine include:

- Common Side Effects:
- Nausea and Vomiting: Gastrointestinal discomfort, including nausea and vomiting, is commonly reported, especially when treatment is initiated or dosages are increased.
- Dizziness or Light-headedness: Bromocriptine can cause dizziness, especially when standing up quickly, due to its effect on blood pressure.
- Headache: Some patients experience headaches as a side effect.
- Fatigue: Tiredness or drowsiness may occur, particularly during the initial stages of treatment.

- Serious Side Effects:
- Cardiovascular Issues: Bromocriptine can cause low blood pressure (hypotension), heart palpitations, or even more severe cardiovascular reactions such as arrhythmias in some individuals.
- Psychiatric Symptoms: There have been reports of severe mood disturbances, including hallucinations, delusions, and psychosis. Impulse control disorders, such as compulsive gambling or hypersexuality, can also occur.
- Severe GI Effects: Rarely, Bromocriptine can cause abdominal pain, constipation, or intestinal perforation.
- Raynaud’s Phenomenon: In some cases, bromocriptine may exacerbate Raynaud's disease, causing cold fingers or toes and vasospasm.

Bromocriptine Pregnancy Category ID - Safety Information

2

Bromocriptine Mode of Action - How It Works

Bromocriptine is a dopamine agonist, meaning it stimulates dopamine receptors in the brain. Specifically, it is a D2 receptor agonist, which helps to correct the dopamine deficiency seen in conditions like Parkinson’s disease. In Parkinson’s disease, dopamine-producing neurons in the brain are progressively lost, leading to the characteristic motor symptoms. By stimulating dopamine receptors, bromocriptine helps to improve motor function, reduce tremors, and alleviate rigidity.

In the treatment of hyperprolactinemia, bromocriptine works by acting on dopamine receptors in the pituitary gland, where it inhibits the secretion of prolactin, thus normalizing prolactin levels.

For acromegaly, bromocriptine reduces growth hormone levels by inhibiting its release from the pituitary gland, helping control the excess growth seen in this condition.

Bromocriptine Drug Interactions - What to Avoid

Bromocriptine may interact with various medications, potentially altering its effectiveness or increasing the risk of side effects:

- Antipsychotic Medications: Bromocriptine may interact with antipsychotic drugs (e.g., haloperidol) as they antagonize dopamine receptors. This may reduce the efficacy of bromocriptine in treating Parkinson's disease or hyperprolactinemia.
- Other Dopaminergic Drugs: Concurrent use of dopamine agonists (e.g., pramipexole, ropinirole) may result in excessive dopaminergic effects, increasing the risk of psychotic symptoms, delirium, or dizziness.
- Antihypertensives: Bromocriptine can lower blood pressure, and when taken with antihypertensive medications, it may increase the risk of hypotension. Close monitoring of blood pressure is essential.
- Cytochrome P450 Inhibitors/Inducers: Bromocriptine is metabolized by cytochrome P450 enzymes, particularly CYP3A4. Medications that inhibit or induce these enzymes may alter the drug's levels. Ketoconazole (a CYP3A4 inhibitor) can increase bromocriptine levels, while rifampicin (a CYP3A4 inducer) can decrease its effectiveness.
- Ergot Alkaloids: Concurrent use with ergotamine or other ergot-derived medications should be avoided, as it may increase the risk of vasoconstriction, leading to peripheral vascular ischemia.

Bromocriptine Adult Dose - Recommended Dosage

- Parkinson’s Disease: The typical starting dose is 1.25 mg daily, with gradual titration to 2.5–5 mg/day divided into multiple doses. In more severe cases, doses may go up to 10–30 mg/day.
- Hyperprolactinemia: The typical starting dose is 1.25–2.5 mg/day, which can be increased gradually to a maintenance dose of 2.5–15 mg/day depending on response.
- Acromegaly: The usual starting dose is 1.25 mg twice daily, with gradual increases based on clinical response. The typical maintenance dose ranges from 2.5–15 mg/day.
- Type 2 Diabetes: For diabetes, the dosage is usually 0.8 mg daily, with possible titration based on response.

Bromocriptine Child Dose - Dosage for Children

Bromocriptine is generally not recommended for use in children unless specifically directed by a healthcare provider, as its safety and efficacy in pediatric populations have not been well established. For pediatric patients, careful medical supervision is essential, particularly in those with conditions such as acromegaly or prolactinomas.

Bromocriptine Renal Dose - Dosage for Kidney Conditions

In patients with renal impairment, the dose of Bromocriptine should be adjusted carefully. Severe renal impairment (creatinine clearance <30 mL/min) requires caution, and the drug may need to be avoided in these patients. Monitoring of renal function is recommended during therapy.