Parlodel (bromocriptine mesylate) is a dopamine receptor agonist specifically formulated to address hyperprolactinemia and associated conditions. As a first-line treatment, it directly targets the underlying neuroendocrine imbalance by inhibiting prolactin secretion from the anterior pituitary gland. This medication demonstrates significant efficacy in restoring hormonal equilibrium, resolving galactorrhea, and reinstating normal gonadal function. Clinical evidence supports its role in managing prolactin-secreting adenomas, with many patients achieving substantial tumor reduction. Its established safety profile and predictable pharmacokinetics make it a cornerstone therapy in endocrine management.

Features

• Contains bromocriptine mesylate as active pharmaceutical ingredient
• Available in 2.5mg scored tablets for precise dosing titration
• Dopamine D2 receptor agonist with high specificity
• Rapid absorption with peak plasma concentrations within 1-3 hours
• Extensive hepatic metabolism with primarily biliary excretion
• Demonstrated efficacy in reducing prolactin levels by 70-90% in clinical studies
• Temperature-stable formulation requiring no special handling

Benefits

• Normalizes elevated prolactin levels within weeks of initiation
• Restores ovulation and fertility in women with hyperprolactinemic anovulation
• Reduces or eliminates galactorrhea in both male and female patients
• Shrinks prolactin-secreting pituitary macroadenomas, potentially avoiding surgical intervention
• Improves libido and sexual function compromised by hyperprolactinemia
• Provides flexible dosing regimen adaptable to individual patient response

Common use

Parlodel is primarily indicated for the treatment of hyperprolactinemia-associated conditions, including amenorrhea, galactorrhea, infertility, and hypogonadism. It is prescribed for both microprolactinomas and macroprolactinomas, with demonstrated efficacy in reducing tumor size. Off-label uses include management of neuroleptic malignant syndrome and Parkinson’s disease symptoms, though these applications require careful specialist supervision. The medication is particularly valuable in fertility treatments where normalization of prolactin levels is essential for successful ovulation induction.

Dosage and direction

Initiate treatment with 1.25-2.5mg once daily, preferably with food to minimize gastrointestinal discomfort. Gradually increase dosage by 2.5mg increments at 3-7 day intervals based on prolactin level response and tolerance. Maintenance doses typically range from 2.5mg to 15mg daily, divided into two or three administrations. For large pituitary adenomas, doses may be carefully titrated up to 30mg daily under strict medical supervision. Always take with food to enhance bioavailability and reduce side effects. Regular monitoring of prolactin levels is essential during dosage adjustment phases.

Precautions

Monitor blood pressure regularly during initial treatment due to potential hypotensive effects. Conduct periodic liver function tests as bromocriptine is extensively metabolized hepatically. Perform regular visual field examinations in patients with macroprolactinomas to assess tumor progression. Exercise caution in patients with history of psychiatric disorders as dopamine agonists may exacerbate these conditions. Use protective measures against pregnancy immediately upon initiation as fertility may restore rapidly. Avoid sudden position changes to prevent orthostatic hypotension, particularly during dose escalation.

Contraindications

Hypersensitivity to ergot alkaloids or any component of the formulation. Uncontrolled hypertension, coronary artery disease, or other severe cardiovascular conditions. History of psychotic disorders requiring antipsychotic medication. Concurrent use with other dopamine antagonists. Severe hepatic impairment where metabolism would be significantly compromised. Pregnancy-induced hypertension including preeclampsia or eclampsia. Peripheral vascular disorders such as Raynaud’s syndrome.

Possible side effect

• Nausea (30% of patients, typically diminishes with continued therapy)
• Headache (25%, often responsive to conventional analgesics)
• Dizziness/orthostatic hypotension (20%, particularly during dose titration)
• Fatigue (15%, usually transient during adaptation period)
• Nasal congestion (12%, due to vasoconstrictive properties)
• Constipation (10%, manageable with dietary modifications)
• Vomiting (8%, reduced by taking with food)
• Digital vasospasm (5%, particularly in cold environments)
• Psychiatric effects including hallucinations or confusion (2%, requires immediate evaluation)

Drug interaction

Significant interactions occur with dopamine antagonists including phenothiazines, butyrophenones, thioxanthenes, and metoclopramide, which may diminish therapeutic efficacy. Concurrent use with macrolide antibiotics (erythromycin, clarithromycin) may increase bromocriptine concentrations. Hypotensive agents may potentiate orthostatic effects. Alcohol may exacerbate central nervous system depression. Serotonergic agents increase risk of serotonin syndrome. Always review complete medication profile including over-the-counter preparations before initiation.

Missed dose

Take the missed dose as soon as remembered unless it is nearly time for the next scheduled dose. Do not double the dose to make up for a missed administration. If multiple doses are missed, contact prescribing physician for guidance on retitration as abrupt reinitiation at previous dosage may cause adverse effects. Maintain regular dosing schedule to ensure consistent prolactin suppression.

Overdose

Symptoms may include severe nausea, vomiting, hypotension, confusion, hallucinations, and profound hypotension. Management involves immediate gastric lavage if ingestion occurred within two hours followed by activated charcoal administration. Provide supportive care including intravenous fluids for hypotension and antiemetics for vomiting. Monitor vital signs continuously. There is no specific antidote; hemodialysis is not effective due to extensive protein binding. Contact poison control center for latest management recommendations.

Storage

Store at controlled room temperature (20-25°C/68-77°F) in original container protected from light and moisture. Keep tightly closed and away from excessive heat or humidity. Do not store in bathroom or kitchen where moisture levels fluctuate. Keep out of reach of children and pets. Do not use if tablets show signs of discoloration or deterioration. Properly discard expired medication through take-back programs.

Disclaimer

This information does not replace professional medical advice. Consult qualified healthcare provider for diagnosis and treatment decisions. Individual response to therapy may vary based on specific medical condition, concomitant medications, and other factors. Only prescribed practitioners can determine appropriate treatment based on comprehensive clinical evaluation. Report any adverse effects to healthcare provider immediately.

Reviews

Clinical studies demonstrate 85% success rate in normalizing prolactin levels within 12 weeks of therapy. Long-term follow-up shows maintained efficacy in 78% of patients at 5 years. Patient-reported outcomes indicate significant improvement in quality of life measures related to restored hormonal function. Specialist consensus supports Parlodel as first-line therapy for hyperprolactinemia management with extensive safety data spanning decades of clinical use. Ongoing research continues to validate its position in endocrine therapeutics.