Formulary
Bromocriptine: Indications, Dosing, Side Effects and Interactions
Bromocriptine is a stimulant of dopamine receptors in the brain; it also inhibits release of prolactin by the pituitary.
MedNext Academy | 4 min read
Bromocriptine: Indications, Dosing, Side Effects and Interactions
Bromocriptine is a stimulant of dopamine receptors in the brain; it also inhibits release of prolactin by the pituitary.
Drug action
Bromocriptine is a stimulant of dopamine receptors in the brain; it also inhibits release of prolactin by the pituitary.
Indications and dose
**Prevention of lactation**
- **Adult** (By Mouth): Initially 2.5 mg daily for 1 day, then 2.5 mg twice daily for 14 days.
**Suppression of lactation**
- **Adult** (By Mouth): Initially 2.5 mg daily for 2-3 days, then 2.5 mg twice daily for 14 days.
**Hypogonadism,Galactorrhoea,Infertility**
- **Adult** (By Mouth): Initially 1-1.25 mg daily, dose to be taken at bedtime, increase dose gradually; usual dose 7.5 mg daily in divided doses, increased if necessary up to 30 mg daily, usual dose in infertility without hyperprolactinaemia is 2.5 mg twice daily.
**Acromegaly**
- **Adult** (By Mouth): Initially 1-1.25 mg daily, dose to be taken at bedtime, then increased to 5 mg every 6 hours, increase dose gradually.
**Prolactinoma**
- **Adult** (By Mouth): Initially 1-1.25 mg daily, dose to be taken at bedtime, then increased to 5 mg every 6 hours, increase dose gradually. Occasionally patients may require up to 30 mg daily.
**Parkinson's disease**
- **Adult** (By Mouth): Initially 1-1.25 mg daily for 1 week, dose to be taken at night, then 2-2.5 mg daily for 1 week, dose to be taken at night, then 2.5 mg twice daily for 1 week, then 2.5 mg 3 times a day for 1 week, then increased in steps of 2.5 mg every 3-14 days, adjusted according to response; maintenance 10-30 mg daily.
Cautions
Cardiovascular disease; history of peptic ulcer (particularly in acromegalic patients); history of serious mental disorders (especially psychotic disorders); Raynaud's syndrome Cautions, further information Hyperprolactinemic patients In hyperprolactinaemic patients, the source of the hyperprolactinaemia should be established (i.e. exclude pituitary tumour before treatment).
Contraindications
Cardiac valvulopathy (exclude before long-term treatment); hypertension in postpartum women or in puerperium; hypertensive disorders of pregnancy (e.g. pre-eclampsia, eclampsia, or pregnancy-induced hypertension); uncontrolled hypertension Contra-indications, further information Use in prevention or suppression of lactation or other non-life threatening indications Avoid in these indications for patients with a history of severe cardiovascular conditions, including coronary artery disease, or symptoms (or history) of severe psychiatric disorders. Very rarely hypertension, myocardial infarction, seizures or stroke (both sometimes preceded by severe headache or visual disturbances), and psychiatric disorders have been reported in postpartum women given bromocriptine for lactation suppression-caution with drugs that affect blood pressure and avoid other ergot alkaloids. Discontinue immediately if hypertension, suggestive chest pain, severe progressive or unremitting headache, or signs of CNS toxicity develop. M
Side effects
Common or very common Constipation; drowsiness; headache; nasal congestion; nausea Uncommon Allergic dermatitis; alopecia; confusion; dizziness; dry mouth; fatigue; hallucination; hypotension; leg cramps; movement disorders; vomiting Rare or very rare Abdominal pain; arrhythmias; cardiac valvulopathy; diarrhoea; dyspnoea; gastrointestinal disorders; gastrointestinal haemorrhage; insomnia; neuroleptic malignant-like syndrome; pallor; paraesthesia; pericardial effusion; pericarditis; peripheral oedema; psychotic disorder; pulmonary fibrosis; respiratory disorders; sudden onset of sleep (can occur without warning); tinnitus; vision disorders Frequency not known Eating disorders; hypertension; myocardial infarction; pathological gambling; psychiatric disorders; seizure; sexual dysfunction; stroke Side-effects, further information Treatment should be withdrawn if gastro-intestinal bleeding occurs.
Interactions
**Severe interactions:**
- In vitro the following substances have been shown to be potential inhibitors of tacrolimus metabolism: bromocriptine, cortisone, dapsone, ergotamine, gestodene, lidocaine, mephenytoin, midazolam,...
**Other interactions (6):**
- Amisulpride may oppose the effect of dopamine agonists e.g.
- Combinations not recommended Dopaminergic antiparkinsonism agents (amantadine, bromocriptine, cabergoline, levodopa, lisuride, pergolide, piribedil, ropinirole) are not recommended: reciprocal...
- Such inhibitors include certain antifungals (e.g.
- Since droperidol blocks dopamine receptors, it may inhibit the action of dopamine agonists, such as bromocriptine, lisuride, and of L-dopa.
- Contra-indicated drug combinations: Antiparkinsonism dopaminergic agonists agents (amantadine, apomorphine, bromocriptine, cabergoline, entacapone, lisuride, pergolide, piribedil, pramiprexole,...
- Alcohol is also known to interact with the following medicines or group of medicines: antihypertensive agents such as ACE inhibitors, adrenergic neurone blockers, beta-blockers, antidiabetic agents...
Breast feeding
Suppresses lactation; avoid breast feeding for about 5 days if lactation prevention fails.
Hepatic impairment
Dose adjustments Manufacturer advises dose adjustment may be necessary-risk of increased plasma concentration.
Medicinal forms
Suspension
Clinical governance
**Author:** MedNext Clinical Team. **Clinical reviewer:** Dr Shameer Deen, MBBS, MS, MRCS. **Sources:** BNF, Indian Pharmacopoeia, CIMS India. **Correction:** Report errors at support@mednext.academy.
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