Parlodel (bromocriptine mesylate) represents a cornerstone in the pharmacological management of hyperprolactinemic disorders. As a dopamine receptor agonist, it directly addresses the underlying neuroendocrine imbalance responsible for elevated prolactin levels. This comprehensive product card provides healthcare professionals with detailed information about Parlodel’s mechanism, clinical applications, and safety profile to support informed prescribing decisions and optimal patient outcomes.

Features

• Active ingredient: Bromocriptine mesylate
• Mechanism: Dopamine D2 receptor agonist
• Formulations: 2.5mg tablets and 5mg capsules
• Half-life: Approximately 15 hours
• Bioavailability: 28% when taken orally
• Metabolism: Hepatic, primarily via CYP3A4
• Excretion: Primarily biliary (85%), renal (3-6%)

Benefits

• Rapid normalization of elevated prolactin levels within weeks of initiation
• Restoration of gonadal function and fertility in both male and female patients
• Reduction or elimination of galactorrhea in appropriate patient populations
• Effective tumor size reduction in prolactin-secreting pituitary adenomas
• Well-established safety profile with decades of clinical use
• Flexible dosing options allowing for individualized treatment regimens

Common use

Parlodel is primarily indicated for the treatment of hyperprolactinemia associated with prolactin-secreting adenomas or idiopathic hyperprolactinemia. It is extensively used in managing amenorrhea-galactorrhea syndrome, infertility associated with hyperprolactinemia, and hypogonadism in both sexes. Additionally, it finds application in acromegaly as adjunctive therapy and in Parkinson’s disease management, though these uses represent secondary indications. The medication works by activating dopamine receptors in the anterior pituitary, thereby inhibiting prolactin secretion and synthesis.

Dosage and direction

Initial therapy typically begins with 1.25-2.5mg once daily, preferably with food to minimize gastrointestinal side effects. The dosage should be gradually increased by 2.5mg increments at 3-7 day intervals until optimal therapeutic response is achieved. Most patients require 5-7.5mg daily divided into 2-3 doses, though some may need up to 15mg daily. For Parkinson’s disease, higher doses up to 100mg daily may be used. Administration should occur at the same time(s) each day to maintain stable serum concentrations. Patients should be advised not to crush or chew the tablets.

Precautions

Patients should undergo comprehensive cardiovascular evaluation before initiation, particularly those with history of myocardial infarction or coronary artery disease. Regular monitoring of blood pressure is recommended, especially during dosage titration. Hepatic and renal function should be assessed periodically. Patients should be cautioned about potential dizziness or syncope, particularly when rising quickly from sitting or lying positions. Use with caution in patients with psychiatric disorders, as exacerbation may occur. Pregnancy testing is recommended before initiation in women of childbearing potential.

Contraindications

Parlodel is contraindicated in patients with hypersensitivity to ergot alkaloids or any component of the formulation. It should not be used in patients with uncontrolled hypertension, toxemia of pregnancy, or coronary artery disease. Contraindications include severe ischemic heart disease, peripheral vascular disorders, and history of psychotic disorders. Concomitant use with other dopamine antagonists is generally contraindicated. The medication is not recommended in patients with hepatic impairment severe enough to affect drug metabolism.

Possible side effect

Common adverse reactions (≥10%) include nausea, headache, dizziness, fatigue, and vomiting. Less frequent side effects (1-10%) comprise orthostatic hypotension, nasal congestion, constipation, and abdominal cramps. Rare but serious adverse events (<1%) may include cardiac arrhythmias, pleural effusion, pulmonary fibrosis, and psychotic reactions. Approximately 5% of patients may experience digital vasospasm. Most side effects are dose-dependent and often diminish with continued therapy or dosage reduction. Patients should report any unusual visual disturbances, shortness of breath, or chest pain immediately.

Drug interaction

Parlodel demonstrates significant interactions with several medication classes. Concomitant use with macrolide antibiotics, azole antifungals, or protease inhibitors may increase bromocriptine levels through CYP3A4 inhibition. Dopamine antagonists such as phenothiazines, butyrophenones, and metoclopramide may diminish therapeutic efficacy. Hypotensive agents may potentiate orthostatic hypotension. Ergot alkaloids or sympathomimetics may increase the risk of vasoconstriction. Serotonergic drugs may increase the risk of serotonin syndrome. Careful monitoring is required when co-administering with any of these agents.

Missed dose

If a dose is missed, patients should take it as soon as remembered unless it is nearly time for the next scheduled dose. In that case, the missed dose should be skipped and the regular dosing schedule resumed. Patients should never double the dose to make up for a missed administration. Consistent timing is important for maintaining stable prolactin suppression. Healthcare providers should educate patients about the importance of adherence and develop strategies to minimize missed doses, particularly during the initial titration phase.

Overdose

Symptoms of overdose may include nausea, vomiting, dizziness, hypotension, and hallucinations. Severe cases may present with confusion, seizures, or cardiovascular collapse. Management involves immediate gastric lavage if ingestion occurred within two hours, followed by activated charcoal administration. Supportive care including IV fluids and vasopressors may be necessary for hypotension. There is no specific antidote; treatment should focus on symptomatic management and supportive measures. Patients should be monitored for cardiac arrhythmias and provided with appropriate cardiac support if needed.

Storage

Store at controlled room temperature (20-25°C or 68-77°F) in the original container protected from light and moisture. Keep tightly closed and away from excessive heat or humidity. Do not store in bathroom cabinets where moisture levels may fluctuate. Keep out of reach of children and pets. Do not use if the medication appears discolored or shows signs of deterioration. Proper disposal of unused medication should follow local regulations for pharmaceutical waste.

Disclaimer

This information is provided for educational purposes only and does not constitute medical advice. Healthcare professionals should consult full prescribing information before initiating therapy. Individual patient response may vary, and treatment decisions should be based on clinical judgment and patient-specific factors. The manufacturer and distributors are not liable for any errors or omissions in this information or for any outcomes resulting from its use.

Reviews

Clinical studies demonstrate Parlodel’s efficacy in normalizing prolactin levels in 80-90% of patients with microprolactinomas and 60-70% of those with macroprolactinomas. Long-term follow-up studies show maintained efficacy with continuous therapy over several years. Patient satisfaction surveys indicate improved quality of life measures related to restoration of menstrual function and fertility. Specialist reviews highlight its established position as first-line therapy for hyperprolactinemia, though newer agents may offer improved tolerability in some patient populations. Ongoing research continues to support its role in endocrine management.