Adult Dosing
Hyperprolactinemia
- Start 1.25-2.5 mg PO Daily
- Increase 2.5 mg/day q2-7 days until optimal therapeutic response is obtained
- Usual range: 2.5-15 mg/day
Acromegaly
- Start 1.25-2.5 mg PO Daily for 3 days with food
- Increase 1.25-2.5 mg/day q3-7 days until optimal therapeutic response is obtained
- Usual range: 20-30 mg/day; Max: 100 mg/day
Parkinson's disease
- Start 1.25 mg PO bid
- Increase 2.5 mg/day q14-28 days with meals
- Usual range: 10-40 mg/day; Max: 100 mg/day
Diabetes mellitus type 2
- Initial dose is one tablet (0.8 mg) daily increased weekly by one tablet until maximal tolerated daily dose of 1.6 to 4.8 mg is achieved
Neuroleptic malignant syndrome [Non-FDA approved]
- 2.5-10 mg PO bid; Max 40 mg/day
Pediatric Dosing
Prolactinoma
- 11-15 yrs
- Start 1.25-2.5 mg PO Daily
- Increase q2-7 days until optimal therapeutic response is obtained
- Usual range: 2.5-10 mg/day in children with prolactin-secreting pituitary adenomas.
- >16 yrs
- Start 1.25-2.5 mg PO Daily
- Increase 2.5 mg/day q2-7 days until optimal therapeutic response is obtained
- Usual range: 2.5-15 mg/day
[Outline]
See Supplemental Patient Information
- Use in postpartum women for prevention of physiological lactation, or in patients with uncontrolled hypertension is not recommended. Increased risk of hypertension, seizures, strokes, and myocardial infarction.
- Concomitant use with dopamine receptor agonists, neuroleptic and ergot alkaloid drugs not recommended
- Hyperprolactinemia with amenorrhea/galactorrhea and infertility has reported in patients with pituitary tumors, a complete evaluation of the pituitary is recommended before treatment with bromocriptine
- Monitor patients if pregnancy occurs during bromocriptine administration
- Symptomatic hypotension may occur in patients treated with bromocriptine for any indication. Decreases in supine systolic and diastolic pressures is observed in almost 30% of patients receiving therapy
- Patient treated with this therapy have reported hypotension, seizures, stroke, severe headache , visual disturbances, acute myocardial infarction
- In patients treated for hyperprolactinemia, therapy should be withdrawn if pregnancy is detected. If reinitiated to control a rapidly expanding macroadenoma and patient develops hypertensive disorders of pregnancy; benefit of continuing bromocriptine must be weighed against the possible risk of its use during a hypertensive disorder of pregnancy
- Consider necessity of therapy when used to treat acromegaly or Parkinson’s disease in patients who subsequently become pregnant, if therapy is continued drug should be withheld who experience hypertensive disorders of pregnancy
- Monitor blood pressure during the first weeks of therapy, Discontinue the treatment if hypertension, severe, progressive, unremitting headache or evidence of CNS toxicity occurs
- Long-term treatment with bromocriptine may cause pulmonary infiltrates, pleural effusion and thickening of the pleura in a few patients. Terminate the therapy if such events occur
Cautions: Use cautiously in
- Renal impairment
- Hepatic impairment
- Cardiovascular disease
- Concurrent antihypertensives
- Hx of MI with arrhythmias
- Hx of PUD/GI bleed
- Hx of psychotic disorder
- Dementia
- Geriatric patients
- Long term use
- Lactose intolerance patients
Supplemental Patient Information
- Advise patient not to engage in activities requiring rapid and precise responses, such as driving an automobile or operating machinery while on therapy
Cycloset, Parlodel interacts with :
Pregnancy Category:B
Breastfeeding: Unsafe. Bromocriptine should not be used during breastfeeding because it suppresses lactation and may increase the risk of maternal stroke and seizures. This information is based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 18 February 2011). Manufacturer advises bromocriptine should not be used during lactation in postpartum women.
Pricing data from www.DrugStore.com in U.S.A.
- Parlodel 5 MG CAPS [Bottle] (NOVARTIS)
30 mg = $259.99
90 mg = $709.96 - Cycloset 0.8 MG TABS [Bottle] (SANTARUS)
30 mg = $67.99
90 mg = $185.4 - Parlodel 2.5 MG TABS [Bottle] (NOVARTIS)
30 mg = $165.99
90 mg = $497.98
Warning: This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.
