Bromocriptine is derived from ergot and has several uses. Discussed here is its use for Parkinson’s disease, for which it is the second-choice drug, after a combination of levodopa and carbidopa (SINEMET, SINEMET CR). If you have Parkinson’s disease, your doctor should first try levodopa with carbidopa and should prescribe bromocriptine only if the combination drug does not decrease your symptoms or if it causes too many adverse effects. Bromocriptine often works best when given with...
Bromocriptine is derived from ergot and has several uses. Discussed here is its use for Parkinson’s disease, for which it is the second-choice drug, after a combination of levodopa and carbidopa (SINEMET, SINEMET CR). If you have Parkinson’s disease, your doctor should first try levodopa with carbidopa and should prescribe bromocriptine only if the combination drug does not decrease your symptoms or if it causes too many adverse effects. Bromocriptine often works best when given with levodopa. If you are over 60, you should generally be taking less than the usual adult dose.
If you have symptoms of parkinsonism (tremor; rigid muscles and disturbances in posture; or difficulties in walking, balance, speech, swallowing or muscle strength), there is a good chance that they are caused by a drug you are taking. As many as half of older adults with symptoms of parkinsonism may have developed them as adverse effects of a drug. (See "List of drugs that cause parkinsonism, drug induced" on WorstPills.org.) If you take any of the drugs on that list, discuss the possibility of drug-induced parkinsonism with your doctor and ask to have your prescription changed or stopped.
Prescrire International published an article in March 2011 on the risk of inhibited lactation in women associated with using bromocriptine. Adverse cardiovascular and neurological effects (including hypertension, stroke, hallucinations and seizures) were reported during the period studied.
In 2014, a committee within the European Medicines Agency (EMA), an agency similar to the FDA, recommended that bromocriptine not be used to suppress lactation in women after giving birth unless there is a compelling medical reason for stopping lactation. Women who have an increased risk for side effects should not use bromocriptine.,
In 2015, a study published in the obstetrics and gynecology journal BJOG showed that cardiovascular, neurological and psychiatric adverse effects were reported when bromocriptine was used to suppress lactation in women after giving birth.
(See the above warning section: “Do Not Use Bromocriptine for Postpartum Breast Engorgement.”)
In older adults, bromocriptine often causes dizziness, nausea, constipation, and tingling in fingers or toes when they are exposed to the cold. It can also cause more serious adverse effects called choreiform movements — unusual and uncontrolled movements in the body, face, tongue, arms, hands, and upper body. About 25 percent of bromocriptine users in all age groups experience this adverse effect. If you have any of these symptoms, especially if they are severe or persistent, call your doctor and ask if your dose of bromocriptine should be reduced. Do not take less bromocriptine than your doctor prescribes unless he or she instructs you to do so.
Physicians from the Mayo Clinic in Rochester, Minn., publishing in the September 2005 Archives of Neurology, examined the relationship between the drugs used to treat Parkinson’s disease, known as dopamine agonists, and pathological gambling. The dopamine agonist group of drugs includes bromocriptine, pergolide (PERMAX), pramipexole (MIRAPEX) and ropinirole (REQUIP).
The Mayo Clinic physicians identified 11 patients between 2002 and 2004 who met the definition of pathologic gamblers. All had Parkinson’s disease, and all were being treated with levodopa and a dopamine agonist. The Mayo Clinic physicians also searched the world’s medical literature for other reports of pathological gambling associated with the use of dopamine agonists. They found six published reports involving an additional 17 patients. The authors commented, “The relationship of pathological gambling to dopamine agonist therapy in these cases is striking.”
A study published in JAMA Internal Medicine in December 2014 showed that patients using dopamine agonist drugs have a higher risk of having impulse control disorder. Symptoms of this disorder include compulsive gambling and shopping, hypersexuality, and more rarely binge eating and “punding,” which is a compulsive fascination with and performance of repetitive mechanical tasks.
Regulatory actions surrounding bromocriptine
2005: The FDA revised the product package insert of bromocriptine regarding postmarketing safety data relating to sudden onset of sleep and possible problems involving the membranes that line and surround the heart and lungs.