Bromocriptine: Difference between revisions

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==Administration==
==Administration==
*Type: Dopamine agonist
*Type: Dopamine agonist
*Dosage Forms: 2.5, 5 mg
*Dosage Forms: capsule, tablet
*Routes of Administration: Oral
*Dosage Strengths: capsule: 5mg; tablet: 0.8, 2.5mg
*Routes of Administration: PO
*Common Trade Names: Parlodel, Cycloset
*Common Trade Names: Parlodel, Cycloset


==Adult Dosing==
==Adult Dosing==
*Acromegaly
*Acromegaly
**20-30 mg PO qd
**20-30 mg PO QD
***Start: 1.25-2.5 mg PO qhs x3 days
***Start: 1.25-2.5 mg PO qhs x3 days
****Increase by 1.25-2.5 mg per day q 3-7 days
****Increase by 1.25-2.5 mg per day q 3-7 days
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***Give with food and taper dose to D/C
***Give with food and taper dose to D/C
*Hyperprolactinemia
*Hyperprolactinemia
**2.5-15 mg PO qd
**2.5-15 mg PO QD
***Start: 1.5-2.5 mg PO qd
***Start: 1.5-2.5 mg PO QD
****Increase by 1.25-2.5 mg per day q 2-7 days
****Increase by 1.25-2.5 mg per day q 2-7 days
***Give with food and taper dose to D/C
***Give with food and taper dose to D/C
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***Give with food and taper dose to D/C
***Give with food and taper dose to D/C
*[[Neuroleptic malignant syndrome]]
*[[Neuroleptic malignant syndrome]]
**5-10 mg PO tid-qid
**5-10 mg PO tid-QID
***Start: 2.5 mg PO tid-qid
***Start: 2.5 mg PO tid-QID
****Increase dose as tolerated
****Increase dose as tolerated
***Max: 20 mg PO qid
***Max: 20 mg PO QID
***Continue x7-10 days, then taper dose over 3 days to D/C
***Continue x7-10 days, then taper dose over 3 days to D/C


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*Adenoma, prolactin-secreting
*Adenoma, prolactin-secreting
**11-15 yo
**11-15 yo
***2.5-10 mg PO qd
***2.5-10 mg PO QD
****Start: 1.25-2.5 mg PO qd
****Start: 1.25-2.5 mg PO QD
****Give with food and taper dose to D/C
****Give with food and taper dose to D/C
**16+ yo
**16+ yo
***2.5-15 mg PO qd
***2.5-15 mg PO QD
****Start: 1.25-2.5 mg PO qd
****Start: 1.25-2.5 mg PO QD
****Give with food and taper dose to D/C
****Give with food and taper dose to D/C


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*[[Seizure]]
*[[Seizure]]
*[[Stroke]]
*[[Stroke]]
*Hallucination
*[[Hallucinations]]
*[[Syncope]]
*[[Syncope]]
*[[Hypotension]], severe
*[[Hypotension]]
*[[MI]]
*[[Arrhythmia]], [[MI]]
*[[Arrhythmia]]
*[[Pericardial effusion]], constrictive [[pericarditis]]
*[[Pleural effusion]], [[pulmonary fibrosis]]
*[[Hypertension]]
*[[Hypertension]]
*Raynaud phenomenon
*Raynaud phenomenon
*[[Pleural effusion]]
*[[Pericardial effusion]]
*[[Pulmonary fibrosis]]
*Retroperitoneal fibrosis
*Retroperitoneal fibrosis
*Constrictive pericarditis
*[[GI bleeding]]
*[[GI bleeding]]
*NMS-like symptoms if abrupt D/C
*[[Neuroleptic malignant syndrome]]-like symptoms if abrupt discontinuation


===Common===
===Common===
*[[Nausea]]
*[[Nausea/vomiting]], [[diarrhea]], [[constipation]], [[dyspepsia]], anorexia, [[abdominal pain]]
*[[Headache]]
*[[Headache]], [[dizziness]], [[fatigue]]
*[[Dizziness]]
*Drowsiness
*[[Fatigue]]
*Lightheadedness
*Nasal congestion
*Nasal congestion
*[[Abdominal pain]]
*Orthostatic [[hypotension]], orthostatic
*[[Diarrhea]]
*Involuntary movements, [[ataxia]], visual disturbances
*[[Constipation]]
*Compulsive behaviors
*[[Hypotension]], orthostatic
*Anorexia
*[[Dyspepsia]]
*Involuntary movments
*Visual disturbance
*Digital vasospasm
*Digital vasospasm
*[[Vomiting]]
*ALT, AST, alk phos elevation
*[[Ataxia]]
*ALT, AST elevation
*Alk Phos elevation
*Compulsive behaviors


==Pharmacology==
==Pharmacology==
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<references/>
<references/>
[[Category:Pharmacology]]
[[Category:Pharmacology]]
[[Category:Toxicology]]

Latest revision as of 21:36, 19 September 2019

Administration

  • Type: Dopamine agonist
  • Dosage Forms: capsule, tablet
  • Dosage Strengths: capsule: 5mg; tablet: 0.8, 2.5mg
  • Routes of Administration: PO
  • 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
  • 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
  • Parkinson's disease
    • 10-30 mg PO tid
      • Max: 100 mg/day
      • Give with food and taper dose to D/C
  • 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

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
    • 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

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

Common

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

Comments

See Also

References

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