Drug reference

Bromocriptine

Dopamine Agonist · Antiparkinsonian

Dopamine AgonistAntiparkinsonian

CDSCO approvedSchedule H

EXCRETION

—

not curated

INTERACTIONS

12 major

SEVERE in our sources

PREGNANCY

Prescribing in pregnancy 27

FDA category + note

Top interactionssee all 12 →

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Mechanism

Bromocriptine is an ergot-derived dopamine-receptor agonist. In Parkinson's disease, it works by stimulating dopamine receptors, which helps to alleviate motor symptoms. It has also been used to treat Neuroleptic Malignant Syndrome, likely by reversing central dopamine blockade.

Indications

Adjunct to levodopa for Parkinson's disease when symptoms (dyskinesia or motor fluctuations) are not adequately controlled with a non-ergot-derived dopamine-receptor agonistNeuroleptic malignant syndromeHyperprolactinemiaParkinson's disease (historical use)Reduction in size of prolactinomasParkinson diseaseType 2 diabetes mellitus (as an adjunct to diet and exercise to improve glycemic control)Treatment of type 2 diabetes (low-dose tablet formulation)Parkinson’s diseaseHyperprolactinemia (due to microprolactinomas, causing galactorrhoea, amenorrhoea and infertility in women; gynaecomastia, impotence and sterility in men)Acromegaly (due to small pituitary tumours and inoperable cases)Parkinsonism (as an adjunct to levodopa)Type 2 Diabetes Mellitus (adjunctive drug)Hepatic coma (may cause arousal)Suppression of lactation and breast engorgement (not recommended due to unfavourable risk:benefit ratio)adjunctive treatment of type 2 diabetes mellitus (alone, or added to metformin or SU or both)Parkinson's disease (supplement to levodopa in late cases to improve control and smoothen 'on-off' fluctuations)

Dosing

Adult: dose at the right time. Analgesics can be divided into three broad classes: non-opioid (paracetamol p. 465, NSAID), opioid (e.g. codeine phosphate p. 475 ‘weak’, morphine p. 484 ‘strong’) and adjuvant (e.g. antidepressants, antiepileptics). Drugs from the different classes are used alone or in combination according to the type of pain and response to treatment.…

Pharmacokinetics

Half-life

between 2 and 8 h

Bioavailability

7% (oral, due to extensive first-pass metabolism)

Metabolism

High first pass metabolism in liver

Excretion

Metabolites are excreted mainly in bile

Side effects

Common

Excessive sleepinessHallucinationsImpulse control disordersAffects lactationNauseaVomitingHeadachePostural hypotension (particularly on initial use)Nasal congestionDigital vasospasmPsychosisNightmaresInsomniaFatigueDizzinessOrthostatic hypotensionConstipationNasal blockagePostural hypotensionhypotensionnasal stuffinessconjunctival injectionmarked fall in BP (especially in patients on antihypertensive medication)

Serious

Cardiac valvulopathies (via 5HT2B stimulation, particularly at higher doses used for PD)
Behavioral alterations
Mental confusion
Hallucinations
Psychosis
Abnormal movements
Livedo reticularis
Syncope (if starting dose is high)