Bromocriptine

bromocriptine
Bromocriptine molecule

Bromocriptine is prescribed for women who have ovulation problems due to high levels of prolactin. Prolactin is a hormone that causes milk production. Women with ovulation problems caused by an excess of the hormone prolactin (hyperprolactinemia), which is produced by the pituitary gland, might benefit from this treatment (NCCWCH 2004: 66). Excess prolactin can be caused by a pituitary adenoma (a benign tumor on the pituitary gland), by a reduction in dopamine in the brain or by an unknown cause. Hyperprolactinemia is the cause of menstrual disturbance in about 10% of anovulatory women.

Side effects

Bromocriptine often causes nausea and dizziness during the first few days of treatment but the chances of these symptoms occurring can be reduced by starting the drug at a very low dose and gradually building up to a maintenance dose of 2 or 3 tablets daily.

Instructions

A 2.5 mg tablet is available; and the starting dose is usually 2.5 mg to 5 mg daily taken at bedtime. After starting bromocriptine, prolactin levels can be tested (after at least one week of medication) to confirm that they have been brought down to normal. If the levels are still elevated, the dose will need to be increased. Once normal prolactin levels have been achieved (and some women need as much as 4 to 6 tablets a day to achieve this) this is then the maintenance dose. Once your prolactin blood level is within the normal range, your periods should become more regular and you should start ovulating normally again.

Remember that bromocriptine only suppresses an elevated prolactin level while you are taking it, it does not "cure" the problem. This is why the tablets must be taken daily until a pregnancy occurs, after which they should be stopped. This is expensive medication–and some pharmaceutical companies may provide it at reduced rates if your doctor requests them to do so on your behalf.

NCCWCH. 2004. Fertility: assessment and treatment for people with fertility problems–full guideline. National Collaborating Centre for Women's and Children's Health. London: RCOG Press.


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