Bromocriptine


Generic Medicine Info
Indications and Dosage
Oral
Suppression of lactation
Adult: For the suppression of lactation for medical reasons: Initially, 2.5 mg daily for 2-3 days, then increase to 2.5 mg bid for 14 days. Treatment recommendations may vary among countries and individual products (refer to specific product guidelines).

Oral
Acromegaly
Adult: As an adjunct to surgery and/or radiotherapy to reduce circulating growth hormone: Initially, 1-1.25 mg given at night, then increased to 2-2.5 mg after 2-3 days. May be subsequently increased by 1 mg at 2-3 day intervals, until a dose of 2.5 mg bid is achieved. Doses may be further increased by 2.5 mg daily at 2-3 day intervals in the following scheme: 2.5 mg 8 hourly, 2.5 mg 6 hourly, then 5 mg 6 hourly. Dosage and treatment recommendations may vary among countries and individual products (refer to specific product guidelines).

Oral
Hyperprolactinaemia
Adult: For the treatment of disorders associated with hyperprolactinaemia (e.g. amenorrhoea with or without galactorrhoea, hypogonadism, or infertility): Initially, 1-1.25 mg given at night, then increased to 2-2.5 mg after 2-3 days. May be subsequently increased by 1 mg at 2-3 day intervals, until a dose of 2.5 mg bid is achieved. Usual dose: 7.5 mg daily in divided doses, increased up to 30 mg daily as necessary. In cases of infertility without hyperprolactinaemia, the usual dose is 2.5 mg bid. Dosage recommendations may vary among countries and individual products (refer to specific product guidelines).
Child: ≥7 years Doses are initiated and adjusted according to growth hormone levels. Max daily dose: 7-12 years 10 mg; 13-17 years 20 mg. Dosage recommendations may vary among countries and individual products (refer to specific product guidelines).

Oral
Parkinson's disease
Adult: As adjunct to levodopa: Week 1: 1-1.25 mg at bedtime; Week 2: 2-2.5 mg at bedtime; Week 3: 2.5 mg bid; Week 4: 2.5 mg tid. Doses may be increased by 2.5 mg every 3-14 days according to patient's response, adjusted until the optimum dose is achieved. Maintenance dose: 10-30 mg daily. Max: 30 mg daily. Dosage recommendations may vary among countries and individual products (refer to specific product guidelines).

Oral
Prolactinoma (prolactin secreting adenoma)
Adult: To reduce tumour size, particularly in patients at risk of optic nerve compression: Initially, 1-1.25 mg given at night, then increased to 2-2.5 mg after 2-3 days. May be subsequently increased by 1 mg at 2-3 day intervals, until a dose of 2.5 mg bid is achieved. Doses may be further increased by 2.5 mg daily at 2-3 day intervals in the following scheme: 2.5 mg 8 hourly, 2.5 mg 6 hourly, then 5 mg 6 hourly. Max: 30 mg daily. Dosage and treatment recommendations may vary among countries and individual products (refer to specific product guidelines).
Child: ≥7 years 1 mg bid or tid, gradually increase dose to several tabs daily as needed to suppress the plasma prolactin levels adequately. Max daily dose: 7-12 years 5 mg; 13-17 years 20 mg. Dosage recommendations may vary among countries and individual products (refer to specific product guidelines).

Oral
Prophylaxis of puerperal lactation
Adult: 2.5 mg on the day of delivery, then 2.5 mg bid for 14 days. Initiate treatment within a few hours of parturition once vital signs have been stabilised. Treatment recommendations may vary among countries and individual products (refer to specific product guidelines).

Oral
Diabetes mellitus
Adult: Cycloset As an adjunct to diet and exercise to improve glycaemic control: Initially, 0.8 mg once daily in the morning. If additional glycaemic control is needed, doses may be increased by 0.8 mg at weekly intervals as tolerated. Maintenance dose: 1.6-4.8 mg once daily. Max: 4.8 mg daily. Treatment recommendations may vary among countries and individual products (refer to specific product guidelines).
What are the brands available for Bromocriptine in Thailand?
Administration
Bromocriptine Should be taken with food.
Contraindications
Uncontrolled hypertension, hypertensive disorders of pregnancy (e.g. eclampsia, pre-eclampsia), hypertension postpartum and in the puerperium; use in the suppression of lactation or other non-life-threatening indications in patients with a history of CAD or other severe CV conditions, or symptoms or history of severe psychiatric disorders. Diabetes mellitus specific contraindications: Syncopal migraine. Lactation (when used for diabetes mellitus).
Special Precautions
Patient with CV disease (e.g. MI, residual atrial, nodal, or ventricular arrhythmia), dementia, peptic ulcer disease, macroadenomas, prolactin-secreting adenomas, psychosis, unexplained pleuropulmonary disorders. Bromocriptine is available in multiple brands and formulations that are approved for specific indications; these brands and formulations are not interchangeable and must be used according to their approved indication (refer to specific product and international guidelines prior to administration). If used for diabetes mellitus, bromocriptine is not indicated for the treatment of type 1 diabetes or diabetic ketoacidosis. Avoid abrupt withdrawal and dose reduction. Hepatic impairment. Children and elderly. Pregnancy.
Adverse Reactions
Significant: Digital vasospasm; fibrotic thickening of the aortic, mitral, or tricuspid valve (long-term or chronic use); hypotension, orthostatic hypotension, syncope; hypertension, seizures, MI, stroke preceded by severe headache or visual changes; myocardial toxicity; CNS depression, visual or auditory hallucinations; impulse control disorders (e.g. pathological gambling, increased libido, hypersexuality, compulsive spending or buying, binge eating and compulsive eating); pleural and pericardial effusion, pleural, pulmonary and/or retroperitoneal fibrosis, constrictive pericarditis (prolonged use and high daily doses); confusion and mental disturbances (high doses in patients with dementia); rapid regrowth of tumour and increased prolactin serum levels (discontinuation of therapy in patients with macroadenomas); cerebrospinal fluid rhinorrhoea; NMS, drug withdrawal syndrome (abrupt withdrawal).
Gastrointestinal disorders: Nausea, constipation, dry mouth, vomiting.
General disorders and administration site conditions: Fatigue.
Musculoskeletal and connective tissue disorders: Leg cramps.
Nervous system disorders: Drowsiness, dizziness, dyskinesia.
Respiratory, thoracic and mediastinal disorders: Nasal congestion.
Skin and subcutaneous tissue disorders: Allergic skin reactions, alopecia.
Potentially Fatal: Gastrointestinal bleeding.
Patient Counseling Information
This drug may cause impaired physical or mental abilities, somnolence, and episodes of sudden sleep onset (particularly in patients with Parkinson's disease), if affected, do not drive or operate machinery. Women of childbearing potential must use appropriate birth control methods during treatment.
Monitoring Parameters
Monitor blood pressure and heart rate (e.g. orthostatic vital signs) at baseline and periodically thereafter; LFTs, haematopoietic, renal, and CV function periodically; visual fields, prolactin levels. Perform pregnancy test during amenorrhoeic period. Assess for signs and symptoms of gastrointestinal bleeding (patients with history of peptic ulcer). Patients treated for acromegaly: Monitor insulin-like growth factor 1 and growth hormone. Patients treated for diabetes mellitus: Monitor serum glucose and HbA1c. Patients treated for NMS: Monitor electrolytes, prothrombin time, INR, aPTT, creatine kinase level, urine output, and vital signs.
Overdosage
Symptoms: Vomiting, nausea, constipation, dizziness, diaphoresis, pallor, malaise, hypotension, postural hypotension, tachycardia, hallucinations, confusion, delusion, repetitive yawning, drowsiness, lethargy. Management: Symptomatic and supportive treatment. Administer activated charcoal. Consider gastric lavage if ingestion is recent. Metoclopramide may be given for emesis or hallucinations.
Drug Interactions
May cause visual or auditory hallucinations with levodopa. May increase the plasma concentrations with macrolide antibiotics (e.g. erythromycin) and octreotide. May reduce the prolactin-lowering and antiparkinsonian effects with dopamine antagonists including antipsychotics (e.g. phenothiazines, butyrophenones and thioxanthenes). May decrease the prolactin-lowering effect with metoclopramide and domperidone.
Food Interaction
Alcohol may reduce the tolerance to bromocriptine.
Action
Description:
Mechanism of Action: Bromocriptine is a semisynthetic ergot derivative and a sympatholytic dopamine D2 receptor agonist. It activates postsynaptic dopamine receptors in the tuberoinfundibular pathway, leading to the inhibition of prolactin secretion from the anterior pituitary gland. It also activates nigrostriatal pathways, thereby enhancing coordinated motor control. For the treatment of diabetes mellitus, its mechanism of action is unknown; however, its effect has been identified that with timed morning administration, enhanced insulin sensitivity and glucose disposal and decreased fasting and postprandial hyperglycaemia throughout the meals of the day without increasing plasma insulin levels have occurred.
Onset: Prolactin-lowering effect: 1-2 hours.
Duration: Prolactin-lowering effect: 8-12 hours.
Pharmacokinetics:
Absorption: Rapidly and well absorbed. Time to peak plasma concentration: 2.5 ± 2 hours.
Distribution: Crosses the placenta. Volume of distribution: Approx 61 L. Plasma protein binding: 90-96%, mainly to albumin.
Metabolism: Metabolised in the liver mainly by CYP3A isoenzymes. Undergoes extensive first-pass metabolism.
Excretion: Mainly via faeces (approx 82%); urine (2-6%). Elimination half-life: 4.85 hours.
Chemical Structure

Chemical Structure Image
Bromocriptine

Source: National Center for Biotechnology Information. PubChem Compound Summary for CID 31101, Bromocriptine. https://pubchem.ncbi.nlm.nih.gov/compound/Bromocriptine. Accessed May 28, 2025.

Storage
Store below 25°C. Protect from light.
MIMS Class
Antiparkinsonian Drugs / Other Drugs Affecting Hormonal Regulation
ATC Classification
G02CB01 - bromocriptine ; Belongs to the class of prolactine inhibitors. Used to suppress lactation.
N04BC01 - bromocriptine ; Belongs to the class of dopamine agonist. Used in the management of Parkinson's disease.
References
Brayfield A, Cadart C (eds). Bromocriptine Mesilate. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 03/02/2025.

Bromocriptine 1 mg Tablets (Brown & Burk UK Limited). MHRA. https://products.mhra.gov.uk. Accessed 03/02/2025.

Bromocriptine Mesylate Capsule (Mylan Pharmaceuticals Inc.). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed. Accessed 03/02/2025.

Bromocriptine Mesylate Tablet (Padagis US LLC). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed. Accessed 03/02/2025.

Bromocriptine Mesylate. UpToDate Lexidrug, AHFS DI (Adult and Pediatric) Online. American Society of Health-System Pharmacists, Inc. Waltham, MA. UpToDate, Inc. https://online.lexi.com. Accessed 03/02/2025.

Bromocriptine. UpToDate Lexidrug, Lexi-Drugs Multinational Online. Waltham, MA. UpToDate, Inc. https://online.lexi.com. Accessed 03/02/2025.

Cycloset Tablet (Avvisto Therapeutics LLC). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed. Accessed 03/02/2025.

Joint Formulary Committee. Bromocriptine. British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 03/02/2025.

Medocriptine 2.5 mg Tablets (Komedic Sdn Bhd). National Pharmaceutical Regulatory Agency - Ministry of Health Malaysia. https://www.npra.gov.my. Accessed 03/02/2025.

Parlodel 10 mg Capsules (Mylan Products Ltd.). MHRA. https://products.mhra.gov.uk. Accessed 03/02/2025.

Disclaimer: This information is independently developed by MIMS based on Bromocriptine from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to MIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, MIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2025 MIMS. All rights reserved. Powered by MIMS.com
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