Apo-Bromocriptine

bromocriptine

How Does This Medication Work?

Bromocriptine belongs to a group of medications called ergot alkaloids. It is used** to treat Parkinson's disease and conditions caused by too much of the hormone prolactin.** These conditions include some types of menstrual problems, increased milk production, female infertility, male development problems, and small tumours called adenomas.

For Parkinson's disease, bromocriptine works by behaving like dopamine, a chemical in the brain, which is involved in producing the symptoms of this disease. Bromocriptine may be used alone or with levodopa to reduce symptoms of Parkinson's disease.

For conditions associated with too much prolactin, bromocriptine works by blocking the release of prolactin from the pituitary gland in the brain.

Bromocriptine is used to treat acromegaly (overproduction of growth hormone causing unusual enlargement of the hands, jaw, and feet) by decreasing the production of growth hormone.

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

How Should I Use This Medication?

The specific dose of bromocriptine will depend on the condition being treated and the needs of the person.

The initial adult dose for all conditions is 1.25 mg to 2.5 mg taken at bedtime with food to determine the likelihood and severity of side effects. Your doctor will recommend increasing the dose slowly until an effect is seen. Depending on the medical condition being treated, a total daily dose of 20 mg to 40 mg may be required.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

To reduce side effects such as upset stomach and nausea, bromocriptine should always be taken with or immediately after food.

It is important to take this medication exactly as prescribed by your doctor. If you miss a dose, take it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule.** Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.**

Store this medication at room temperature, protect it from light and moisture, and keep it out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

What Form(S) Does This Medication Come In?

**Tablet
** Each white, oval-shaped, scored tablet, engraved "2.5", contains bromocriptine 2.5 mg (as mesylate). Nonmedicinal ingredients: croscarmellose sodium, lactose, magnesium stearate, and microcrystalline cellulose.

**Capsule
** Each white and caramel No. 4, opaque capsule, imprinted "5", contains bromocriptine 5 mg (as mesylate). Nonmedicinal ingredients: cornstarch, lactose, and stearic acid.; capsule shell: gelatin, red iron oxide, silicon dioxide, sodium lauryl sulfate, titanium dioxide, and yellow iron oxide.

Who Should Not Take This Medication?

Do not take bromocriptine if you:

  • are allergic to bromocriptine or any ingredients of this medication

  • are allergic to other ergot alkaloid medications

  • have coronary artery disease or other severe heart conditions

  • have uncontrolled high blood pressure

  • have a pregnancy-related high blood pressure disorder or a history of high blood pressure during pregnancy

What Side Effects Are Possible With This Medication?

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

  • abdominal pain

  • constipation

  • depression

  • diarrhea

  • dizziness or lightheadedness, especially when rising from a lying or sitting position (more common during the first few days of treatment)

  • drowsiness or tiredness

  • loss of appetite

  • nausea

  • nightmares

  • problems sleeping

  • sensation of spinning

  • stuffy nose

  • vomiting

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

  • abdominal or stomach pain (prolonged or severe)

  • confusion

  • difficulty starting urine flow

  • hallucinations (seeing or hearing things that aren't there)

  • increased frequency of urination

  • loss of appetite (prolonged)

  • signs of depression (e.g., poor concentration, changes in weight, changes in sleep, decreased interest in activities, thoughts of suicide)

  • signs of too much medication (tingling or pain in fingers and toes, cold feet, muscle cramps in feet and legs)

  • uncontrolled movements of the body, such as the face, tongue, arms, hands, head, and upper body

  • weakness

Stop taking the medication and seek immediate medical attention if any of the following side effects occur:

  • convulsions (seizures)

  • fast heartbeat

  • nervousness

  • shortness of breath (unexplained)

  • signs of bleeding in the stomach (e.g., bloody, black, or tarry stools; spitting up of blood; vomiting blood or material that looks like coffee grounds)

  • signs of heart attack (e.g., fainting, nausea and vomiting [prolonged or severe], chest pain, [severe], increased sweating)

  • signs of stroke (e.g., headache [unusual], vision changes, difficulty speaking, difficulty walking, sudden weakness)

  • weakness (sudden)

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Are There Any Other Precautions Or Warnings For This Medication?

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Drowsiness/reduced alertness: This medication may cause dizziness and drowsiness or suddenly falling asleep. Do not drive, operate machinery, or perform other potentially hazardous tasks until you have determined how this medication affects you.

Fertility: Bromocriptine may reverse infertility for women by restoring normal menstrual cycles and ovulation. Women who do not wish to get pregnant should use a reliable method of birth control.

Heart disease: Bromocriptine can cause changes in blood pressure, affecting heart conditions. Also, because it is known to cause a significant drop in blood pressure when you start treatment, it is important to rise from lying or sitting positions slowly, until your blood pressure increases to the point where severe dizziness is not a problem.

If you have a history of heart attack, heart disease or are taking medication for blood pressure or heart conditions, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Kidney function: If you have reduced kidney function or severe kidney disease, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Liver function: The liver helps to remove bromocriptine from the body. If you have reduced liver function or severe liver disease, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Low blood pressure: Bromocriptine may cause low blood pressure, particularly during the first days of treatment. If you have low blood pressure or are taking medication to control high blood pressure, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Lung problems: Long-term treatment (6 to 36 months) with bromocriptine at high doses been associated with lung problems including pulmonary fibrosis (a condition where the air sacs of the lungs are replaced by scar tissue, making the lungs stiff). If you experience unusual back pain, swelling of the lower legs or feet, or difficulty breathing, contact your doctor immediately.

Mental health: The use of high doses of bromocriptine, such as those used for Parkinson's disease, may be associated with mental confusion and mental disturbances. When bromocriptine is combined with levodopa, side effects may increase including auditory or visual hallucinations (seeing or hearing things that are not there). These effects usually disappear with lower bromocriptine doses.

Pregnancy: Bromocriptine may be taken by women who are pregnant if the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.

**Breast-feeding: **Bromocriptine reduces the production of breast milk. The use of bromocriptine after childbirth is more likely to cause serious blood pressure changes and heart problems, as well as seizure. For these reasons, it should not be taken by women who are breast-feeding.

What Other Drugs Could Interact With This Medication?

There may be an interaction between bromocriptine and any of the following:

  • alcohol

  • aliskiren

  • alpha-agonists (e.g., clonidine, methyldopa)

  • alpha-blockers (e.g., alfuzosin, doxazosin, tamsulosin)

  • amiodarone

  • angiotensin converting enzyme inhibitors (ACEIs; captopril, enalapril, ramipril)

  • angiotensin receptor blockers (ARBs; e.g., candesartan, irbesartan, losartan)

  • antipsychotics (e.g., clozapine, methotrimeprazine, olanzapine, pimozide, quetiapine, risperidone)

  • apalutamide

  • apomorphine

  • "azole" antifungals (e.g., itraconazole, ketoconazole, posaconazole, voriconazole)

  • beta-adrenergic blockers (e.g., atenolol, propranolol, sotalol)

  • bupropion

  • calcium channel blockers (e.g., amlodipine, diltiazem, nifedipine, verapamil)

  • carbamazepine

  • cobicistat

  • conivaptan

  • decongestants (e.g., oxymetazoline, phenylephrine, pseudoephedrine, xylometazoline)

  • diuretics (water pills; e.g., furosemide, hydrochlorothiazide, triamterene)

  • duloxetine

  • other ergot derivatives (e.g., dihydroergotamine, ergotamine, methylergonovine)

  • grapefruit juice

  • guanfacine

  • hepatitis C antivirals (e.g. glecaprevir and pibrentasvir, sofosbuvir, velpatasvir, voxilaprevir)

  • HIV protease inhibitors (e.g., atazanavir, indinavir, lopinavir, ritonavir, saquinavir)

  • hydralazine

  • lanreotide

  • levodopa

  • linezolid

  • lithium

  • macrolide antibiotics (e.g., clarithromycin erythromycin,)

  • MAO inhibitors (e.g., maprotiline, moclobemide, phenelzine, rasagiline, selegiline, tranylcypromine)

  • methylene blue

  • metoclopramide

  • mifepristone

  • minoxidil

  • mirtazapine

  • narcotic pain relievers (e.g., codeine, fentanyl, morphine, oxycodone)

  • nitrates (e.g., isosorbide dinitrate, nitroglycerin)

  • obinutuzumab

  • octreotide

  • pasireotide

  • pegvisomant

  • pentoxifylline

  • phenobarbital

  • phenytoin

  • phosphodiesterase 5 inhibitors (e.g., sildenafil, tadalafil, vardenafil)

  • pramipexole

  • primidone

  • protein kinase inhibitors (e.g., crizotinib, imatinib, nilotinib)

  • quinolone antibiotics (e.g., ciprofloxacin, norfloxacin)

  • rifampin

  • riociguat

  • ropinirole

  • rotigotine

  • sacubitril

  • selective serotonin reuptake inhibitors (SSRIs; e.g., citalopram, fluoxetine, sertraline)

  • serotonin-norepinephrine reuptake inhibitor (SNRIs; e.g. desvenlafaxine, duloxetine, venlafaxine)

  • solriamfetol

  • somatostatin

  • testosterone

  • tizanidine

  • tramadol

  • trazodone

  • tretinoin

  • tricyclic antidepressants (e.g., amitriptyline, desipramine, nortriptyline)

  • "triptan" migraine medications (e.g., eletriptan, rizatriptan, sumatriptan, zolmitriptan)

  • tryptophan

  • vilazodone

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

  • stop taking one of the medications,

  • change one of the medications to another,

  • change how you are taking one or both of the medications, or

  • leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

All material copyright MediResource Inc. 1996 – 2024. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source: www.medbroadcast.com/drug/getdrug/Apo-Bromocriptine