Bromocriptine Sympathomimetics

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... 

INDIRECT BROMOCRIPTINE Case reports of severe, symptomatic t BP when coadministered with indirect sympathomimetics Likely additive effect both can cause t BP Monitor BP closely watch for t BP... 

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... 

Direct information seems to be limited to these four cases, but the severity of the reactions suggests that it might be prudent for postpartum patients to avoid sympathomimetics like these wtdle taking bromocriptine. Note that bromocriptine is not recommended for the routine suppression of lactation postpartum. 

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. 

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