Bromocriptine interaction

Montastruc JL, Rascol A. Traitement de la maladie de Parkinson par doses elevees de bromocriptine. Interaction possible avec la josamycine. Presse Med (1984) 13,2267-8. 

Bromocriptine (Parl el) [Antiparkinsonian Agent/Dopamine Receptor Agonist] Uses Parkin on Dz, hyperprolactinemia, acromegaly, pituitary tumors Action Direct-acting on the striatal dopamine receptors X prolactin secretion Dose Initial, 1.25 mg PO bid titrate to effect, w/ food Caution [B, ] Contra Severe ischemic heart Dz or PVD Disp Tabs, caps SE X BP, Raynaud phenomenon (vasospastic disorder resulting in discoloration of the fmgers/toes), dizziness, N, hallucinations Interactions T Effects W/ erythromycin, fluvoxamine, nefazodone, sympathomimetics, antihypertensives X effects W/ phenothiazines, antipsychotics EMS Monitor BP may cause intolerance to EtOH OD May cause NA, severe hypotension give IV fluids symptomatic and supportive... 

Bromocriptine Inhibits adenylyl cyclase and interacts with other intracellular pathways Restores dopamine actions in the central nervous system Parkinson s disease, prolactinemia Oral Toxicity Nausea, headache, orthostatic hypotension... 

Incompatibilities of metoclopramide depend on drug concentration, pH, and temperature. It is incompatible with cephalosporins, chloramphenicol, sodium bicarbonate, doxorubicin, cisplatin, and cyclophosphamide. Caution should be exercised with simultaneous administration of metoclopramide with lithium, sym-pathomimetics, antidepressants, bromocriptine, and carbamazepine. Omperazole interacts with tolbutamide, clarithromycin, and phenytoin. Coadministration of rantidine and cisapride increases the plasma concentration of rantidine. Abuse of senna laxative has been reported and may cause hepatitis.176-178... 

Trade names Apo-Bromocriptine Bromed Cryocriptina Kripton Parilac Parlodel (Novartis) Pravidel Serocryptin Indications Amenorrhea, parkinsonism, infertility Category Dopamine receptor agonist Half-life initial 6-8 hours terminal 50 hours Clinically important, potentially hazardous interactions with erythromycin, lanreotide, pseudoephedrine, sympathomimetics... 

Clinically important, potentially hazardous interactions with alfentanil, aminophylline, amisulpride, amoxicillin, ampicillin, anticonvulsants, astemizole, atorvastatin, benzodiazepines, bromocriptine, buprenorphine, bupropion, carbamazepine, cilostazol, ciprofloxacin, cisapride, clindamycin, colchicine, cyclosporine, dasatinib, digoxin, dihydroergotamine, diltiazem, disopyramide, enoxacin, eplerenone, ergotamine, eszopiclone, everolimus, fluconazole, fluoxetine, fluvastatin, gatifloxacin, HMG-CoA reductase inhibitors, imatinib, itraconazole, ketoconazole, lomefloxacin, lorazepam, lovastatin, methadone, methylprednisolone, methysergide, midazolam, mizolastine, moxifloxacin, nitrazepam, norfloxacin, ofloxacin, paroxetine, pimozide, pravastatin, quinolones, ranolazine, repaglinide, rupatadine, sertraline, sildenafil, simvastatin, sparfloxacin, sulpiride, tacrolimus, terfenadine, triazolam, troleandomycin, vardenafil, verapamil, vinblastine, warfarin, zaleplon, zolpidem, zuclopenthixol... 

Half-life 2 hours (immediate release) 5 days (sustained release). Clinically important, potentially hazardous interactions with bromocriptine, cyclosporine, insulin... 

Bromocriptine (PARLODEL) is the dopamine-receptor agonist against which newer agents are compared. Bromocriptine is a semisynthetic ergot alkaloid that interacts with dopamine receptors to inhibit spontaneous and TRH-induced release of prolactin to a lesser extent, it also activates Dj receptors. Bromocriptine normalizes serum prolactin levels in 70-80% of patients with prolactinomas and decreases tumor size in more than 50fo of patients, including those with macroadenomas. 

Eiythromycin markedly increases bromocriptine plasma levels, and a case of toxicity has been reported. Bromocriptine toxicity also occurred in a patient given josamycin. Clarithromycin increases cabeigoline levels, and erythromycin would be expected to interact similarly. Eiythromycin had no effect on lisuride levels. 

A single case describes worsening mobility, which was attributed to an interaction between lansoprazole and bromocriptine. The... 

The authors attribute this case to a possible interaction between lansoprazole and bromocriptine, although any mechanism is unclear, especially as omeprazole was given without problems. 

Angles A, Bagheri H, Saivin S, Montastruc JL. Interaction between lansq>razole and bromocriptine in a patient with Paricinsai s disease. Therapie (2002) 57,408-10. 

Kulig K, Mbore LL, Kirk M, Smith D, Stallworth J, Rumack B. Bromocriptine-associated headache possible life-threatening sympathomimetic interaction. Obstet Gynecol (1991) 78, 941-3. 

A study in 20 patients with Parkinson s disease taking levodopa/carbidopa found that overall there was no difference in plasma levodopa levels after bromocriptine was also taken, although some patients had either significant elevations or significant reductions in levels. However, the only adverse clinical change found was an increase in dyskinesias in the patients with elevated levodopa levels. An earlier study found no pharmacokinetic interaction between levodopa/carbidopa and bromocriptine, but it should be noted that this was a single-dose study and may not reflect long-term concurrent use. ... 

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