Parlodel

Generic name:

Bromocriptine mesylate

Drug class:

Dopamine D2 receptor agonist; ergot derivative

Dosage form:

• Tablets: 0.5 mg, 2.5 mg

Root of administration:

Oral

Dose:

• Hyperprolactinemia: Initial 1.25 mg once daily; increase by 1.25 mg weekly up to 1.25–2.5 mg two to three times daily (max 15 mg/day).
• Parkinson’s disease: 1.25 mg once daily; may increase gradually to 30 mg/day in divided doses.
• Acromegaly: Start 1.25 mg daily; titrate up to 15–30 mg/day.
• Type 2 diabetes mellitus (adjunct): 0.8 mg once daily within 2 hours of waking.
• Postpartum lactation suppression: 2.5 mg twice daily for 14 days.
• Off-label uses: Varies by indication; consult label.

Mechanism of action:

Bromocriptine is a dopamine D2 receptor agonist that inhibits prolactin secretion from the anterior pituitary and exerts central dopaminergic effects.

Drug usage cases:

• Hyperprolactinemia (e.g., prolactin-secreting pituitary adenoma)
• Parkinson’s disease
• Acromegaly
• Type 2 diabetes mellitus (adjunct therapy)
• Postpartum lactation suppression
• Neuroleptic malignant syndrome (off-label)
• Restless legs syndrome (off-label)

Drug contra indications:

• Hypersensitivity to ergot alkaloids or bromocriptine
• Uncontrolled hypertension
• Preeclampsia or eclampsia
• History of stroke or myocardial infarction within 6 months
• Psychotic disorders
• Active peptic ulcer disease
• Breastfeeding or intended to breastfeed
• Severe hepatic impairment

Side effects:

• Nausea, vomiting
• Headache, dizziness
• Orthostatic hypotension
• Fatigue, somnolence
• Nasal congestion
• Constipation, abdominal cramps
• Depression, anxiety
• Hallucinations, psychosis
• Peripheral edema
• Valvular heart disease
• Pulmonary fibrosis, pleural effusion
• Raynaud’s phenomenon

Warnings:

• Monitor blood pressure for hypotension
• Risk of cardiac valvulopathy; periodic echocardiograms recommended
• Potential for fibrotic complications (pulmonary, retroperitoneal, cardiac)
• May cause excessive somnolence or sudden sleep episodes
• Psychiatric events: hallucinations, impulse control disorders
• Monitor liver function in hepatic impairment
• Abrupt withdrawal may cause rebound hyperprolactinemia

Use during pregnancy or breastfeeding:

Pregnancy: Category B. Animal studies show no teratogenicity; limited human data. Use only if clearly needed; monitor patient closely. Bromocriptine may inhibit lactation and has been used to suppress postpartum lactation; avoid if breastfeeding is desired.

Breastfeeding: Contraindicated as it suppresses milk production and is excreted in breast milk; not recommended.