Bromocriptine

Key facts

• Bromocriptine is an ergot-derived dopamine agonist. It lowers prolactin, a hormone released by the pituitary gland, and stimulates dopamine receptors elsewhere in the body.
• Doses are built up slowly over days to weeks and taken with food to limit nausea; effects on prolactin and periods can take several weeks to show.
• It must never be used to stop normal breast milk production after childbirth. This once-common use is now considered dangerous, having caused strokes, seizures, and heart attacks in postpartum women.
• Seek urgent care for a severe headache, sudden vision changes, chest pain, or a seizure while taking it.

What bromocriptine treats

Bromocriptine treats conditions caused by too much prolactin, including prolactin-secreting pituitary tumors (prolactinomas), irregular or absent periods, unwanted milk production, and infertility linked to high prolactin. It is also used as an add-on treatment for Parkinson's disease and, at higher doses, for acromegaly, a disorder of excess growth hormone. It is not a treatment for suppressing normal postpartum breastfeeding; that use has been withdrawn in most countries because of serious cardiovascular risks.

How bromocriptine works

The pituitary gland normally releases prolactin and growth hormone under the brake of dopamine. Bromocriptine mimics dopamine at these pituitary receptors, directly reducing prolactin release, and at higher doses it also lowers growth hormone. In the brain's movement circuits, the same dopamine-like action eases the muscle stiffness and slowness of Parkinson's disease.

Before you take it

• Do not take bromocriptine to suppress breastfeeding after delivery, or if you have uncontrolled high blood pressure, pre-eclampsia, or a history of heart attack or stroke.
• Tell your prescriber about any history of psychiatric illness, peptic ulcer, or heart valve disease.
• Alcohol can worsen nausea and dizziness; other blood-pressure-lowering drugs and certain antidepressants can interact with it.
• The first dose commonly causes light-headedness or fainting on standing; take the first few doses somewhere you can sit or lie down.

Side effects

Common effects include nausea, headache, dizziness on standing, and fatigue, especially early in treatment.

Stop and seek urgent medical care for any of these:

• Severe headache with vision changes, confusion, or a seizure.
• Chest pain, a fast or irregular heartbeat, or fainting.
• Signs of a stroke, such as sudden weakness, slurred speech, or facial drooping.

Safety essentials

• The postpartum lactation-suppression warning is absolute: bromocriptine given to stop normal milk production after childbirth has caused strokes, seizures, and heart attacks, and this use is no longer recommended.
• Report any new shortness of breath, leg swelling, or persistent chest pain promptly. Long-term, high-dose ergot use has rarely been linked to scarring of heart valves or the tissue around the kidneys.
• Have your blood pressure checked regularly during treatment, particularly in the first weeks and after any dose increase.

This page is educational and does not replace advice from a doctor or pharmacist who knows your health history.