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Parlodel 2.5mg Tablet
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Indications & Clinical Uses
- Parlodel 2.5mg tablets contain bromocriptine mesylate, a dopamine agonist (ergot derivative).
- It is used in adults to treat disorders linked to high prolactin levels (hyperprolactinaemia), including absent or irregular periods, milk production unrelated to breastfeeding (galactorrhoea), infertility and low sex-hormone states, and to shrink prolactin-secreting pituitary tumours; it is also used, at higher doses, to control excess growth hormone in acromegaly, and as an add-on treatment for Parkinson's disease alongside levodopa.
- Bromocriptine was previously used to suppress breast milk production after childbirth, but this use was withdrawn in the US and most other markets because of reports of stroke, heart attack and seizures in postpartum women, and Parlodel must not be used for this purpose.
- Dosing is individualised and started low, then increased gradually under specialist supervision.
Side Effects
- Very common side effects, affecting around half of people starting treatment for hyperprolactinaemia, include nausea; headache and dizziness are also common, along with fatigue and vomiting.
- In Parkinson's disease, bromocriptine can additionally cause hallucinations, confusion, low blood pressure on standing, and abnormal involuntary movements.
- There is no current boxed warning on the Parlodel/bromocriptine label, but the label carries a strong warning that serious events - dangerously high blood pressure, heart attack, seizures and stroke - have been reported, historically in postpartum women given bromocriptine to stop lactation; a severe, worsening headache, sudden vision changes, seizures or chest pain require immediate emergency care.
- Taking the first doses with food at bedtime, lying down, reduces nausea and dizziness.
Precautions & Warnings
- Do not use Parlodel if you have uncontrolled high blood pressure, pregnancy-related hypertension (pre-eclampsia/eclampsia), or a known allergy to bromocriptine or other ergot medicines.
- If pregnancy occurs while being treated for a prolactin-secreting tumour, discuss with your specialist promptly, since stopping treatment can allow the tumour to enlarge; for other indications, treatment is usually stopped once pregnancy is confirmed.
- Blood pressure should be monitored closely, especially in the first days of treatment and after any dose increase.
- Use with caution in people with a history of psychiatric illness, peptic ulcer, or cardiovascular disease.
- Bromocriptine can cause drowsiness or sudden sleep onset; take care or avoid driving and operating machinery until you know how it affects you.
- Long-term high-dose use has been linked to fibrotic reactions affecting heart valves or the lungs; report new breathlessness or swelling.
Avoid Interactions
- Tell your healthcare provider about all medicines and supplements you take.
- Parlodel is broken down by the liver enzyme CYP3A4, so strong CYP3A4 inhibitors - macrolide antibiotics such as erythromycin, azole antifungals like ketoconazole, and HIV protease inhibitors - can raise bromocriptine levels several-fold and increase side effects; combining with other ergot medicines adds to this risk and should be avoided.
- Alcohol may worsen nausea and dizziness.
- Dopamine-blocking drugs, including many antipsychotics and metoclopramide, reduce Parlodel's effectiveness and are best avoided.
- Other blood-pressure-lowering medicines can add to Parlodel's tendency to lower blood pressure, particularly when standing up.
References
Frequently Asked Questions
Parlodel (bromocriptine) treats conditions caused by high prolactin, such as irregular periods, unwanted milk production and infertility, and shrinks prolactin-secreting pituitary tumours. Higher doses treat acromegaly, and it is also used as an add-on for Parkinson's disease.
Parlodel tablets are taken by mouth, usually starting at a low dose with food to reduce nausea, then increased gradually as directed. Dosing varies widely by condition, from about 2.5 mg once daily up to much higher doses for acromegaly or Parkinson's disease.
Nausea affects about half of people starting Parlodel; headache, dizziness and tiredness are also common. Rarely, it has been linked to dangerously high blood pressure, seizures or stroke - get emergency help for a severe headache, vision changes or chest pain.
Avoid alcohol and other ergot medicines while on Parlodel, and tell your prescriber about macrolide antibiotics or azole antifungals, which can raise bromocriptine levels. Do not combine it with antipsychotics or metoclopramide, which block its effect.
Parlodel is not used to suppress breast milk after childbirth because of stroke and heart attack risk. If you become pregnant while being treated for a prolactin tumour, contact your specialist promptly rather than stopping it yourself, as this needs individual assessment.
Yes, Parlodel can cause dizziness, low blood pressure on standing and, rarely, sudden sleep episodes. Avoid driving or operating machinery until you know how the medicine affects you, especially after starting treatment or increasing the dose.
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