What is Bromocriptine?
Bromocriptine or Parlodel is a medication which is used to lower abnormal levels of the pituitary hormone called prolactin. It was originally developed several years ago to help women who did not want to breast feed their infants by blocking (or drying up) milk production from their breasts. It is a specific medication which acts only to decrease production of prolactin by the pituitary gland in the brain.
Why is it necessary to lower prolactin levels?
Elevated prolactin hormone levels are a protective mechanism in women who are breast feeding which block ovulation and temporarily prevent another pregnancy at the same time. Most women who are actively breast feeding will not ovulate or have regular menstrual periods. However, if a woman is producing too much prolactin and is not breast feeding, she may have irregular menstrual periods or ovulation problems that prevent pregnancy. By using Bromocriptine to return prolactin levels to normal, she may return to normal ovulation or respond better to fertility drug treatment.
What causes abnormal prolactin levels?
We do not know the cause of abnormal prolactin levels in most women. Rare women with very high levels may have a benign (non-cancerous) tumor or growth of the pituitary gland called a microadenoma. This is very uncommon in women who present for fertility treatment. Bromocriptine treatment will lower prolactin levels in almost all cases and will stop the growth of a microadenoma if present.
Are they any side effects of Bromocriptine?
Bromocriptine has been widely used for several years now and appears to be a safe medication. Minor side effects can occur when first starting the medication but usually rapidly improve as your body gets accustomed to it. These may include lowered blood pressure with dizziness or light-headedness when getting up quickly, headaches, nausea, fatigue, nasal congestion, constipation, and drowsiness. These symptoms are usually mild and many women will have no symptoms from the medication. It is very unusual for the symptoms to persist after your body gets used to the medication in 1-2 weeks.
In women using Bromocriptine for postpartum suppression of lactation (breast feeding), there have been a small number of reported cases of serious complications including strokes and seizures. Many of these women had other complicating medical conditions, and the role of Bromocriptine therapy in causing these problems is still unclear. No similar problems have been reported in women using this medication for the treatment of fertility conditions.
Is Bromocriptine dangerous to the baby if I get pregnant?
There is no data to suggest any harmful effect of Bromocriptine to a fetus in pregnancy. The medication is sometimes used during pregnancy in women with pituitary tumors. We recommend that you stop the medication as soon as we confirm a pregnancy because it is not necessary after that time.
How long do I need to take Bromocriptine?
Bromocriptine will only work to lower prolactin levels for as long as you continue to take it. We usually recommend that you continue it until we confirm a pregnancy or until you decide to stop fertility treatment. It does not appear to be harmful to take the medication for many months or longer if needed.
How do I start Bromocriptine?
We recommend that you start the medication with the onset of a period so that you do not take it unnecessarily if you are pregnant. You should start with ½ tablet at night right before you go to bed for the first week. This allows your body to get accustomed to the medication while you are asleep. If you are having no problems after the first week, you should then begin ½ tablet twice a day. It is important not to increase the dose if you are experiencing side effects as this means you are not yet used to the medication. Please call the nurse for further instructions if you have any questions or problems. After you have been on the medication twice a day for three weeks, please call the office to arrange a blood test for prolactin to see if your level is back to normal. It is sometimes necessary to increase the dose of Bromocriptine in order to return prolactin levels to normal in some women.