Bromocriptine is a synthetic ergot derivative. It is a potent dopamine agonist with prolactin inhibitory action. Its plasma t½ is 3–6 hours.
Mechanism of action
- It decreases prolactin release from the pituitary by activating the dopaminergic receptors on lactotroph cells; hence it is a strong antigalactopoietic.
- It increases growth hormone release in normal individuals but decreases the same from pituitary tumors; hence can cause acromegaly.
- Stimulates dopaminergic receptors in the CTZ.
- It decreases gastrointestinal motility.
Clinical uses
- Hyperprolactinemia is due to macroprolactinomas causing galactorrhoea, amenorrhoea, and infertility in women.
- In acromegaly due to small pituitary tumors.
- In parkinsonism.
- In hepatic coma to cause arousal.
- Diabetes mellitus as an adjunctive drug.
- Bromocriptine suppresses lactation and breast engorgement in case of neonatal death.
Adverse effects
- Nausea, vomiting, and constipation.
- Nasal blockage.
- Postural hypotension.
- Behavioral alterations.
- Mental confusion.
- Hallucinations and psychosis.
Drug interaction
- Chloramphenicol increases the level and effect of bromocriptine by affecting hepatic/intestinal enzyme CYP3A4 metabolism.
- Sumatriptan increases the toxicity of the drug by pharmacodynamic synergism.
Contraindication
· Hypersensitivity to bromocriptine.
· Uncontrolled hypertension.
· Pregnancy in patients treated for hyperprolactinemia.
Dosage
- PROCTINAL, PARLODEL, SICRIPTIN, BROMOGEN 1.25mg, 2.5 mg tablets.
