Phenylpropanolamine Bromocriptine

A healthy postpartum woman taking bromocriptine developed very severe headache and marked hypertension after also taking phenylpropanolamine. Similarly another woman developed seizures with cerebral vasospasm, and a third developed a severe headache, hypertension and severe cardiac dysfunction after also taking isometheptene. A further patient taking bromocriptine developed psychosis when pseudoephedrine was added. 

Chan JCN, Critchley JAJH, Cockram CS. Pos >aitum hypertension, bromocriptine and phenylpropanolamine Drug Invest ( 994) 8,254-6. 

A 32-year-old woman took two 5-mg doses of bromocriptine for milk suppression without any adverse effects following the birth of a child. Within 2 hours of taking a third dose with phenylpropanolamine 50 mg she awoke with a very severe headache and was found to have a blood pressure of 240/140 mmHg. She was given 5 mg of intramuscular morphine and her blood pressure became normal within 24 hours. Another 5-mg dose of bromocriptine taken 48 hours after the original dose of phenylpropanolamine had the same effect, but the blood pressure rise was less severe (160/120 mmHg). ... 

Not understood. Severe hypertension occasionally occurs with either bromocriptine or phenylpropanolamine given alone. Shortly after giving birth some individuals show increased vascular reactivity, and it could be that all of these factors conspired together to cause these adverse effects. Psychosis occasionally occurs after giving birth or on bromocriptine alone, so that in the latter case the addition of pseudoephedrine may have been coincidental. ... 

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