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Bromocriptine

Also known as: Bromocriptine mesylate 2-Bromoergocriptine

Therapeutic Indications

Bromocriptine is indicated for:

Prolactinoma

Irrespective of gender only Children (1 year - 12 years old) , Adolescents (12 years - 18 years old)

To reduce tumour size, particularly in those at risk of optic nerve compression.

For this indication, the medical literature mentions below treatments (click for details):

Treatment 1: Oral - 2-20 mg in 2-4 divided doses daily

Gigantism

Irrespective of gender only Children (1 year - 12 years old) , Adolescents (12 years - 18 years old)

For this indication, the medical literature mentions below treatments (click for details):

Treatment 1: Oral - 1-20 mg in 1-4 divided doses daily

Premenstrual symptoms and benign breast disease

Irrespective of gender only Adults (18 - 65 years old)

For this indication, the medical literature mentions below treatments (click for details):

Treatment 1: Oral - 1.25-10 mg in 1-2 divided doses daily

Acromegaly

Irrespective of gender only Adults (18 - 65 years old)

Bromocriptine has been used in a number of specialised units, as an adjunct to surgery and/or radiotherapy to reduce circulating growth hormone in the management of acromegalic patients.

For this indication, the medical literature mentions below treatments (click for details):

Treatment 1: Oral - 2.5-20 mg in 2-4 divided doses daily

Prolactinoma

Irrespective of gender only Adults (18 years old or older)

To reduce tumour size, particularly in those at risk of optic nerve compression.

For this indication, the medical literature mentions below treatments (click for details):

Treatment 1: Oral - 5-30 mg in 2-4 divided doses daily

Hyperprolactinaemia

Irrespective of gender only Adults (18 years old or older)

The treatment of hyperprolactinaemia in men and women with hypogonadism and/or galactorrhoea.

For this indication, the medical literature mentions below treatments (click for details):

Treatment 1: Oral - 5-30 mg in 2-4 divided doses daily

Drug-induced hyperprolactinaemic disorders

Irrespective of gender only Adults (18 years old or older)

For this indication, the medical literature mentions below treatments (click for details):

Treatment 1: Oral - 1.25-10 mg in 1-2 divided doses daily

Parkinson’s Disease

Irrespective of gender only Adults (18 years old or older)

In the treatment of idiopathic Parkinson’s Disease, bromocriptine has been used both alone and in combination with Levodopa in the management of previously untreated patients and those disabled by ‘on-off’ phenomena. Bromocriptine has been used with occasional benefit in patients who do not respond to or are unable to tolerate Levodopa and those whose response to Levodopa is declining.

For this indication, the medical literature mentions below treatments (click for details):

Treatment 1: Oral - 1-30 mg in 1-4 divided doses daily

Amenorrhoea and oligomenorrhoea, with or without galactorrhoea

Women only, only Adults (18 - 65 years old)

For this indication, the medical literature mentions below treatments (click for details):

Treatment 1: Oral - 1.25-10 mg in 1-2 divided doses daily

Polycystic ovary syndrome

Women only, only Adults (18 - 65 years old)

For this indication, the medical literature mentions below treatments (click for details):

Treatment 1: Oral - 1.25-10 mg in 1-2 divided doses daily

Contraindications

Active ingredient Bromocriptine is contraindicated in the following cases:

Lactation

No gender/age discrimination

Since bromocriptine inhibits lactation, it should not be administered to mothers who elect to breast-feed.

Pregnancy

No gender/age discrimination

If pregnancy occurs it is generally advisable to withdraw bromocriptine after the first missed menstrual period.

Rapid expansion of pituitary tumours sometimes occurs during pregnancy and this may also occur in patients who have been able to conceive as a result of bromocriptine therapy. As a precautionary measure, patients should be monitored to detect signs of pituitary enlargement so that bromocriptine may be reintroduced if necessary. Based on the outcome of more than 2,000 pregnancies, the use of bromocriptine to restore fertility has not been associated with an increased risk of abortion, premature delivery, multiple pregnancy or malformation in infants. Because this accumulated evidence suggests a lack of teratogenic or embryopathic effects in humans, maintenance of bromocriptine treatment during pregnancy may be considered where there is a large tumour or evidence of expansion.

Cardiac valvulopathy

No gender/age discrimination

For long-term treatment: Evidence of cardiac valvulopathy as determined by pre-treatment echocardiography.

Uncontrolled hypertension

No gender/age discrimination

Bromocriptine is contraindicated in patients with uncontrolled hypertension, hypertensive disorders of pregnancy (including eclampsia, pre-eclampsia or pregnancy-induced hypertension), hypertension post partum and in the puerperium.

Cardiovascular disorders, psychiatric disorders

No gender/age discrimination

Patients with severe cardiovascular disorders or psychiatric disorders taking PARLODEL for the indication of macro-adenomas should only take it if the perceived benefits outweigh the potential risks.