Home Drug Guide Bromocriptine Mesylate

Drug Guide

Generic Name

Bromocriptine Mesylate

Brand Names Parlodel, Cycloset

Classification

Therapeutic: Antiparkinsonian agent, Hyperprolactinemia agent

Pharmacological: Dopamine Agonist

FDA Approved Indications

Parkinson's disease
Hyperprolactinemia (prolactin-secreting tumors)
Type 2 diabetes mellitus (Cycloset)

Mechanism of Action

Bromocriptine is a dopamine D2 receptor agonist that inhibits prolactin secretion and modulates dopaminergic activity in the central nervous system, which can influence glucose and lipid metabolism.

Dosage and Administration

Adult: For Parkinson's disease: typically starting at 1.25 to 2.5 mg once daily, titrated based on response. For hyperprolactinemia: 1.25 to 2.5 mg twice daily. For Cycloset (Type 2 diabetes): 0.8 to 1.6 mg once daily, morning.

Pediatric: Not commonly used in children; consult specific guidelines.

Geriatric: Use with caution; start at lower doses due to increased sensitivity.

Renal Impairment: Adjust dose as needed; monitor renal function.

Hepatic Impairment: Use with caution; no specific dose adjustment recommended.

Pharmacokinetics

Absorption: Rapidly absorbed after oral administration.

Distribution: Widely distributed in body fluids and tissues.

Metabolism: Extensively metabolized in the liver via the CYP3A4 pathway.

Excretion: Excreted mainly in feces; small amount in urine.

Half Life: Approximately 2.5 hours.

Contraindications

Uncontrolled hypertension
History of hypersensitivity to bromocriptine or other ergot alkaloids
Pregnancy Category B and C (use with caution; consult specific guidelines)

Precautions

Use with caution in patients with known cardiovascular disease, impaired hepatic or renal function, or psychosis.
Monitor blood pressure and mental status regularly.

Adverse Reactions - Common

Nausea (Often)
Orthostatic hypotension (Often)
Dizziness (Often)
Fatigue (Often)
Headache (Common)

Adverse Reactions - Serious

Deep vein thrombosis (Rare)
Psychiatric disturbances (hallucinations, confusion) (Rare)
Retroperitoneal fibrosis (long-term use) (Very rare)
Severe hypotension (Rare)

Drug-Drug Interactions

Other dopamine agonists or antagonists (e.g., antipsychotics)
Antihypertensives
Macrolide antibiotics (increased risk of hypotension)

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor BP, mental status, prolactin levels, and signs of hypotension or adverse psychiatric effects.

Diagnoses:

Risk for hypotension
Risk for hallucinations or psychiatric effects
Impaired physical mobility

Implementation: Administer with food to reduce nausea. Monitor for side effects.

Evaluation: Assess symptom improvement and adverse effects regularly.

Patient/Family Teaching

Take as directed, with food to minimize nausea.
Report signs of hypotension (dizziness, lightheadedness).
Avoid activities requiring alertness until response is known.
Inform about potential psychiatric side effects.
Pregnancy: consult healthcare provider about use.

Special Considerations

Black Box Warnings:

Valvular heart disease risk with ergot derivatives (less common with bromocriptine)

Genetic Factors: None specified.

Lab Test Interference: Can decrease serum prolactin levels; may interfere with certain hormone tests.

Overdose Management

Signs/Symptoms: Nausea, vomiting, hypotension, hallucinations, seizures.

Treatment: Supportive care, discontinuation of drug, vasopressors for hypotension, management of neurological symptoms.

Storage and Handling

Storage: Store at room temperature (20-25°C), away from moisture and light.

Stability: Stable for the duration of the labeled expiration date.