Bromocriptine Oral Route

Bromocriptine treats several diseases associated with excessive hormone production affecting normal body functions.

Overview

Bromocriptine treats menstrual conditions (amenorrhea), abnormal milk leakage and infertility in men and women due to excessive production of prolactin. It blocks the release of hormones causing abnormal functions by lowering the hormone prolactin levels - it is not a cure.

In relation to human reproduction functions, by reducing the level of prolactin hormone released, it helps to prevent unwanted lactation or milk production in both male and female - a condition known as galactorrhea. This medicine is a drug of choice for lactation problems. It also treats a condition called hypogonadism predominate in men when the body's production of testosterone is insufficient.

It shares a trait with our brain stimulating dopamine receptors to prevent the release of certain hormones from the pituitary gland. Bromocriptine is also used to lower disproportionate levels of the growth hormone - treating a condition known as acromegaly, responsible for the excessive growth of hands, feet, and face. This medicine has helped to reduce the symptoms of Parkinson's disease by stimulating the nerves that control movement.

Condition(s) Treated

• Acromegaly
• Anovulatory infertility
• Cyclical benign breast disease
• Galactorrhoea
• Hyperprolactinaemia
• Hypogonadism
• Infertility
• Infertility without hyperprolactinemia
• Parkinsonism
• Parkinson's disease
• Pituitary adenoma
• Premenstrual syndrome
• Suppression of lactation

Type of medicine

• Dopamine receptor agonists

Side Effects

When undergoing treatment, you need to weigh the risks and the benefits. Your doctor has prescribed this medication based on the test evaluations, your medical history, and your current health status. Although the risks of side effects exist, the benefits to ongoing health disorders may outweigh them. Not everyone taking this medication experiences the serious side effects.

Take this medication as directed and if you experience any side effects, contact your doctor. Other medicines work well with bromocriptine to reduce or prevent the effects. If you are taking medicine for existing disorders and they aggravate the effects, your doctor may decide to adjust the medications until you complete treatment. Most effects occur after the first treatment.

Be sure to share all of your medical experiences with the doctor, including dietary routines. In some cases, over-the-counter medicines, health supplements, and herbal remedies can trigger side effects with this medicine.

Depending on the severity of hormone levels, the medication dose will vary for each type of condition. This variable may cause a change in the level of effects since each person responds differently. It's important to keep your doctor updated on how you are feeling.

Here’s a list of the more common, less common and rare side effects.

More common

• Dizziness
• Nausea

Less common

• Constipation
• Diarrhea
• Fatigue
• Dry mouth
• Leg cramps
• Loss of appetite
• Mental depression
• Stomach pain
• Stuffy nose
• Tingling or pain in the fingers and toes when exposed to cold
• Vomiting

Rare – occurs with large doses of this medicine

• Abdominal or stomach pain
• Increased frequency of urination
• Loss of appetite
• Lower back pain
• Runny nose
• Weakness

Rare

• Black, tarry stools
• Bloody vomit
• Chest pain
• Convulsions
• Fainting
• Fast heartbeat
• Headache
• Increased sweating
• Nervousness
• Shortness of breath
• Vision changes
• Weakness

If you experience side effects not listed - be sure to tell your doctor. There are solutions to ease the discomfort through treatment. Some effects need medical attention, not emergency help - if you are unsure about anything, ask questions.

Other Side Effects

Bromocriptine can cause drowsiness as you go about your daily activities, like talking on the phone, driving a vehicle or operating machinery. If you fall asleep or get drowsy after taking treatment, you need to avoid these activities. If you are taking this medicine for the long term and you experience this side effect - it may be necessary for you to avoid or schedule these activities to prevent accidents.

• Consumption of alcohol or other medications may increase your sleepiness.

Larger doses of this medicine are known to cause severe reactions when treating Parkinson’s disease, acromegaly and pituitary tumors. If you experience common or more common side effects and they worsen over time – talk to your doctor. Bromocriptine may help to control your condition; your doctor can help to manage the side effects until your body adjusts to this medicine.

Parkinson disease side effects:

• Confusion
• Hallucinations
• Uncontrolled movements of the body

If you have blood pressure problems, this treatment will affect the condition. You need to talk to your doctor about your condition and the medications you are taking now. A decrease in blood pressure will change your response to this medicine. Different effects occur in each person. It’s important that you know the symptoms that occur in your own body - this information is going to help your doctor treat the side effects.

• A decrease in blood pressure causes lightheadedness or fainting spells when you stand up quickly.

Serious Side Effects

Treatment of bromocriptine to stop the milk flow after pregnancy has life-threatening effects. You need to have a discussion with your doctor before starting treatment. This may not be the medicine for you if you have a history of these health conditions.

• Heart attack
• Seizures
• Stroke

If you experience any of these side effects, head to the nearest health facility, hospital or emergency center.

• Left side pain
• Trouble breathing
• Trouble speaking
• Vision changes
• Weakness on one side of the body

Other Medical Problems

The existence of other medical ailments may affect your response to this medicine. Make sure you tell your doctor if you have any other medical problems – DO NOT stop taking any medications until you talk to your doctor.

• Coronary artery disease or other serious cardiovascular disorder
• Fever
• Hypertension
• Infection
• Liver disease
• Lung disease
• Mental illness
• Migraine headaches
• Pregnancy-induced high blood pressure
• Stomach ulcers
• Surgery
• Trauma
• Type 2 Diabetes

DO NOT take any new medications without your doctor’s approval. It may have drastic effects on your response to treatment. It may also trigger other health illnesses. In some cases, conditions worsen when you stop taking bromocriptine. To prevent these symptoms while you are taking treatment, your doctor may reduce your dose gradually.

Dosage

Your doctor may start you on a low dose of bromocriptine and increase the dose gradually, monitoring your reaction. An increased dose depends on the condition and your body’s acceptance to this medicine. Report any side effects that increase pain or impair your normal body functions.

• The most important part of controlling your condition, is verifying the medication is working.

The best results come from taking this medicine at the same time every day – follow the prescribed instructions meticulously. Talk with your doctor if there’s something that you don’t understand or if you have a question.

• DO NOT take less or more than prescribed by your doctor.

Bromocriptine comes in a capsule and a tablet – taken orally at least once a day, depending on the diagnoses. Your doctor may adjust the dose to maintain balance with the other medications you're taking.

The doses vary for each individual, depending on the disorder, the condition’s severity and other health issues. Follow your doctor's orders or the directions on the product label. The following information is an average dose for most treatments – it may change due to your own circumstances. If your dose is different, do not change it unless your doctor tells you to do so.

Taking this medicine with food and at bedtime may help relieve nausea. If you experience an upset stomach, talk to your doctor. For infertility, pituitary tumors, testosterone hormone problem, menstrual cycle or abnormal milk secretion – your doctor may prescribe:

• Adults and teenagers 16 years of age or older

o Starting doses range from 1.25 to 2.5 milligrams (mg), once or twice a day.

o Your doctor may increase your dose by 2.5 mg every 2 to 7 days to manage the condition and your tolerance.

o The maximum daily dose is not more than 15 mg per day – talk with your doctor.

• Children 11 to 15 years of age

o Range from 1.25 to 2.5 mg once a day.

o Your doctor may increase your dose.

o Maximum daily dose is not more than 10 mg per day.

• Children younger than 11 years of age - Your doctor will decide the dose.

For Acromegaly:

• Adults

o Beginning daily doses range from 1.25 to 2.5 milligrams (mg) daily with food at bedtime for 3 days.

o After the 3rd day, your doctor may increase the daily dose over the next seven days.

o Maximum daily dose is not more than 100 mg per day.

• Children - Your doctor will decide the dose.

For Parkinson's disease:

• Adults

o Beginning daily doses range from 1.25 milligrams (mg) twice a day with meals.

o Your doctor may increase your dose as needed.

o Maximum daily dose is not more than 100 mg per day.

• Children - Your doctor will decide the dose.

For Type 2 diabetes:

• Adults

o Beginning daily doses start at 0.8 milligram (mg) once a day, within two hours after waking up in the morning.

o Your doctor may increase your dose as needed.

o Maximum daily dose is not more than 1.6. to 4.8 mg, per day per your doctor’s instructions.

• Children - Your doctor will decide the dose.

For Hyperprolactinemia:

• Adult Dose

o Starting doses range from 1.25 mg to 2.5 mg and taken each day orally.

o Your doctor will monitor the response to this medicine and may increase the dose over the next seven days.

o Managing this disorder may require taking 2.5 mg up to 15 mg per day.

• Pediatric Dose - Children from the age of 11 to 15 years old

o Starting doses range from 1.25 mg to 2.5 mg daily

o Managing this disorder may require 2.5 mg, up to 10 mg per day

The chemical compounds of drugs can be sensitive to the conditions in our stomach. These tips are helpful when scheduling your medication. This medicine is absorbed best when taken with food – talk with your doctor and ask what works best. Sometimes medications get into our bloodstream within two hours after having a meal or a light snack. Healthy drinks like fruit shakes, juices or teas may help to increase the absorption rate of this medication.

Missed Dose

Medications need to be taken as scheduled to make sure your body's system has enough to function properly. Missing a dose happens, but when medications are missed, the level of the drug in your blood may not be sufficient to prevent abnormal functions from happening. In most cases, given enough time our body will react to the shortage.

Bromocriptine is treating serious disorders that interfere with body’s normal functions – to minimize the effects your doctor has prescribed exact doses with the proper intervals for taking the medicine.

Missing a dose by an hour is not critical in most cases, frequently missing doses or taking an incorrect dose may have serious effects. If you forget a dose, take it as soon as possible – if it is close to the time of your next dose, skip the forgotten dose and continue with your scheduled dose.

• DO NOT double your dose in an attempt to catch up – there may be serious consequences.

Symptoms of overdose may be similar to the side effects experienced during the start of treatment – it’s your body sending signals that something is wrong and needs attention. It’s time to contact your doctor.

• Confusion
• Constipation
• Dizziness
• Drowsiness
• Fainting
• Lack of energy
• Nausea
• Pale skin
• Sweating
• Uneasiness
• Vomiting

Interactions

Drug interactions are common when multiple health conditions exist and adding another medication may intensify the reaction between two different medicines. Some interactions happen between medicinal treatments and herbal remedies. Your doctor may change the dose to help prevent serious interactions and continue with treatment. It’s important that you share as much information with your doctor about your family’s medical history, your own health experiences related to allergies, and sensitivity to certain drugs.

Interactions have been noted in patients taking bromocriptine and these medicines – there may be others not listed. Depending on your own health issues, you may experience some reaction and if so, the level of seriousness will vary according to your medical health. Your doctor may prescribe an alternative for the existing condition before starting your bromocriptine treatment.

It’s imperative that you speak with your doctor if you are taking any of these medicines – make sure you understand the consequences and risks.

• Almotriptan
• Amoxapine
• Boceprevir
• Ceritinib
• Clarithromycin
• Clomipramine
• Cobicistat
• Conivaptan
• Dihydroergotamine
• Eletriptan
• Frovatriptan
• Idelalisib
• Indinavir
• Isometheptene
• Itraconazole
• Ketoconazole
• Lopinavir
• Metoclopramide
• Naratriptan
• Nefazodone
• Nelfinavir
• Phenylpropanolamine
• Posaconazole
• Propatyl Nitrate
• Ritonavir
• Rizatriptan
• Saquinavir
• Sulpiride
• Sumatriptan
• Telaprevir
• Telithromycin
• Thioctic Acid
• Thioridazine
• Voriconazole

Health Impacts

Drug Interactions can make your treatment medicine less effective and changes in how the other medications perform. Some interactions are harmful, while others initiate discomforting or serious side effects. You can reduce the risk and possibility of harmful effects by learning about your medication, following the treatment instructions and talking to the doctor when you experience uncomfortable reactions.

There are over seven hundred drugs known to interact with bromocriptine at some level.

• 68 major drug interactions
• 638 moderate drug interactions
• 5 minor drug interactions

Dietary Interactions

Health supplements and herbal remedies have become a major part of our lives and diet. They also have powers to interact with the medication we take daily, delivering adverse effects. Over-the-counter medicines, consumption of alcohol or tobacco can change how bromocriptine interacts with your body. Sometimes dietary and lifestyle choices can remove bromocriptine from the body – the result is failure to manage or treat the condition.

• Pain relievers
• Muscle relaxants
• Antihistamines
• Marijuana
• Cold medicines

Each medicine has it's own character and is prescribed to help manage a particular disorder – but when they intermingle with other medications the effects can be fatal. Check the labels on your medicines and talk to your doctor before changing your routines.

Nicotine has known health effects - it may have some moderate drug interactions with this medicine. Bromocriptine narrows the blood vessel to decrease and slow down the blood flow – nicotine may increase this action affecting treatment and triggering other health conditions.

A severe decrease in blood flow to the brain or other parts of the body can lead to dangerous effects. If you experience coldness, numbness or tingling - the nicotine in your body may be a trigger interacting with the medicine. Other signs that nicotine interferes with this medicine include headaches that get worse with or without an approved pain relief medicine. Some individuals experience muscle pain or weakness, abdominal or chest pain and a shortness of breath. These are serious reactions needing medical attention.

Alcohol is another lifestyle choice that increases the side effects to the nervous system when being treated with bromocriptine. The symptoms include dizziness, drowsiness and trouble concentrating – it’s the interaction of the two drugs that causes an extreme impairment in understanding and judgment.

It may be possible to limit the volume of alcohol consumption when undergoing this treatment, in some cases your doctor may suggest that you avoid alcohol completely. If you are allowed alcohol, be sure to follow your doctor’s instructions on bromocriptine’s dose and schedules. As a precaution, it’s a good idea not to operate or participate in dangerous activities until you understand how you react to this treatment. If you have questions – your doctor can help with the answers and suggestions for better health.

Here's three categories of interactions that may help you navigate through treatment:

• Condition interactions – occurs when an existing medical condition changes the effect of other drugs.
• Food interactions – mixing alcohol with certain medication intensifies the effects and impair your concentration.
• Drug interactions – taking two or more drugs can slow down the response to treatment.

Disease Interactions

Bromocriptine treats several disorders, and the level of interaction with this medicine depends on existing ailments and medications. The biggest challenge of these reactions is your body’s willingness to accept the medicine. Medical observations may be necessary during the start of your treatment – the doctor is looking for harmful reactions or a threat to your life.

Condition Precautions:

Using a dopamine agonist like bromocriptine is associated with psychiatric effects – requiring prudent administration of this drug. The medical staff is watching for any development in depression or suicidal inclinations. Symptoms may include anxiety, confusion, rapid mood change, nightmares or hallucinations.

Cardiac irregularities don’t happen often with this drug, but don't be surprised if the beginning treatment is administered within or close to a facility with an intensive cardiac care unit. Adverse effects known to happen vary include sinus tachycardia causing an increase in the body's demand for oxygen, a heart rhythm disorder called ventricular tachycardia or an abnormal heart rhythm that starts in the atrial chambers of the heart, known as an atrial flutter.

Bromocriptine may impair the systemic regulation of blood pressure, when high doses are prescribed. Our autonomic nervous system responds to change in our positions by increasing the heart rate. This medicine may impair the mechanisms with a patient suffering from Parkinson’s disease causing orthostatic hypotension to occur. The same effects may affect individuals taking antihypertensive drugs.

Patients with psychotic disorders are rarely treated with this medicine due to the high risks related to the condition. Treating this disorder with this medication may decrease the effectiveness and intensify symptoms.

Warnings

Every patient experiences the prescribing of medication for a set of symptoms, but some situations deliver completely different responses. For this reason, U.S. Food and Drug Administration (FDA) post warnings and provide information based on actual experience and clinical trials for individuals and health care professionals deciding about treatments.

The FDA has assigned Bromocriptine to pregnancy category B. Careful observation is needed. If you become pregnant during treatment, it’s critical that you talk with your doctor to monitor any harmful side effects of this drug.

• Studies of pregnant women have not shown that bromocriptine increases the risk of abnormalities when administered during pregnancy.
• This medication may affect a pituitary tumor in the mother during pregnancy.

If you are pregnant or become pregnant during treatment, make sure your doctor knows - hypertension has been reported during the beginning stages of treatment. This drug is not recommended for use when an uncontrollable hypertension condition exists.

Seizures occurred with early symptoms developing in the form of severe headaches hours or days before the actual event. This drug should not be used during the postnatal period in women with a history of coronary artery disease and other severe cardiovascular conditions unless withdrawal is considered a greater risk to one’s health. If the drug is used, careful observation is recommended.

Parkinson ’s disease

Bromocriptine is linked to episodes of sudden sleep in patients with Parkinson's disease. Before starting treatment, understand it can affect functions in activities requiring rapid and precise responses - causing unintended injuries. Your doctor may recommend a reduction in dosage or suspension of treatment.

Other Precautions

Long-term and high dose treatments with bromocriptine report unexplained disorders related to pleuropulmonary blastoma – a rare cancer originating in the lung. It occurs most often in infants or young children, rarely in adults. In this instance, further medical observation is necessary and along with termination of treatment.

Bromocriptine may cause dryness of the mouth. If the condition persists check with your doctor – this may be a sign of dental disease or fungus infection.

Storage

This medicine should be kept in the container it came in - make sure the cap is secured and out of reach of children or pets. If you do keep your medication in pill containers, remember these may not be child resistant. DO NOT share this medicine with someone else having similar symptoms. This medicine could cause serious reactions when ingested by accident or incorrectly used.

• Store it at room temperature, away from light, heat and moisture.
• DO NOT flush this medicine down the toilet or dispose of it in the household trash – accident happens.

Take any unused or outdated medication to your local healthcare facility or pharmacist – there are take-back programs to dispose of these medications properly.

Summary

Bromocriptine has been effective in treating disorders, frequently evaluating dosage to determine the lowest dose for yielding medicinal responses. Studies conducted report no specific problems that limit the usefulness of this medicine related to age groups, although there are precautions suggested when treating children less than 16 years of age. Recommendations when treating elderly patients were also cited as this age group tends to be more sensitive to adverse side effects of this medicine triggered by aging ailments and the interaction of other medications.