Bromocriptine: Difference between revisions
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*[[Seizure]] | *[[Seizure]] | ||
*[[Stroke]] | *[[Stroke]] | ||
* | *[[Hallucinations]] | ||
*[[Syncope]] | *[[Syncope]] | ||
*[[Hypotension]], | *[[Hypotension]] | ||
*[[ | *[[Arrhythmia]], [[MI]] | ||
*[[ | *[[Pericardial effusion]], constrictive [[pericarditis]] | ||
*[[Pleural effusion]], [[pulmonary fibrosis]] | |||
*[[Hypertension]] | *[[Hypertension]] | ||
*Raynaud phenomenon | *Raynaud phenomenon | ||
*Retroperitoneal fibrosis | *Retroperitoneal fibrosis | ||
*[[GI bleeding]] | *[[GI bleeding]] | ||
* | *[[Neuroleptic malignant syndrome]]-like symptoms if abrupt discontinuation | ||
===Common=== | ===Common=== | ||
*[[Nausea]] | *[[Nausea/vomiting]], [[diarrhea]], [[constipation]], [[dyspepsia]], anorexia, [[abdominal pain]] | ||
*[[Headache]] | *[[Headache]], [[dizziness]], [[fatigue]] | ||
*Nasal congestion | *Nasal congestion | ||
*[[ | *Orthostatic [[hypotension]], orthostatic | ||
*Involuntary movements, [[ataxia]], visual disturbances | |||
*Compulsive behaviors | |||
* | |||
* | |||
*Digital vasospasm | *Digital vasospasm | ||
*ALT, AST, alk phos elevation | |||
*ALT, AST elevation | |||
==Pharmacology== | ==Pharmacology== | ||
Revision as of 02:06, 11 December 2016
Administration
- Type: Dopamine agonist
- Dosage Forms: 2.5, 5 mg
- Routes of Administration: Oral
- Common Trade Names: Parlodel, Cycloset
Adult Dosing
- Acromegaly
- 20-30 mg PO qd
- Start: 1.25-2.5 mg PO qhs x3 days
- Increase by 1.25-2.5 mg per day q 3-7 days
- Max: 100 mg per day
- Give with food and taper dose to D/C
- Start: 1.25-2.5 mg PO qhs x3 days
- 20-30 mg PO qd
- Hyperprolactinemia
- 2.5-15 mg PO qd
- Start: 1.5-2.5 mg PO qd
- Increase by 1.25-2.5 mg per day q 2-7 days
- Give with food and taper dose to D/C
- Start: 1.5-2.5 mg PO qd
- 2.5-15 mg PO qd
- Parkinson's disease
- 10-30 mg PO tid
- Max: 100 mg/day
- Give with food and taper dose to D/C
- 10-30 mg PO tid
- Neuroleptic malignant syndrome
- 5-10 mg PO tid-qid
- Start: 2.5 mg PO tid-qid
- Increase dose as tolerated
- Max: 20 mg PO qid
- Continue x7-10 days, then taper dose over 3 days to D/C
- Start: 2.5 mg PO tid-qid
- 5-10 mg PO tid-qid
Pediatric Dosing
- Adenoma, prolactin-secreting
- 11-15 yo
- 2.5-10 mg PO qd
- Start: 1.25-2.5 mg PO qd
- Give with food and taper dose to D/C
- 2.5-10 mg PO qd
- 16+ yo
- 2.5-15 mg PO qd
- Start: 1.25-2.5 mg PO qd
- Give with food and taper dose to D/C
- 2.5-15 mg PO qd
- 11-15 yo
Special Populations
- Pregnancy Rating: B; No known risk of fetal harm based on human data. Monitor hyperprolactinemic pts closely for potential prolactin-secreting tumor enlargement.
- Lactation risk: L5; Contraindicated in postpartum lactation
Renal Dosing
- Adult: Not defined. Caution advised.
- Pediatric: Not defined. Caution advised.
Hepatic Dosing
- Adult: Not defined. Caution advised.
- Pediatric: Not defined. Caution advised.
Contraindications
- Allergy to class/drug
- Hypersensitivity to ergot derivatives
- Hypertension, uncontrolled
- Breastfeeding
- Avoid abrupt withdrawal
Adverse Reactions
Serious
- Seizure
- Stroke
- Hallucinations
- Syncope
- Hypotension
- Arrhythmia, MI
- Pericardial effusion, constrictive pericarditis
- Pleural effusion, pulmonary fibrosis
- Hypertension
- Raynaud phenomenon
- Retroperitoneal fibrosis
- GI bleeding
- Neuroleptic malignant syndrome-like symptoms if abrupt discontinuation
Common
- Nausea/vomiting, diarrhea, constipation, dyspepsia, anorexia, abdominal pain
- Headache, dizziness, fatigue
- Nasal congestion
- Orthostatic hypotension, orthostatic
- Involuntary movements, ataxia, visual disturbances
- Compulsive behaviors
- Digital vasospasm
- ALT, AST, alk phos elevation
Pharmacology
- Half-life: Biphasic 4-4.5 hr and 15 hr
- Metabolism: Liver; CYP450: 3A4 substrate
- Excretion: Bile 95%, urine 2.5-5.5%
Mechanism of Action
- Stimulates dopamine receptors
- Inhibits anterior pituitary prolactin secretion