Infertility and Bromocriptine
Trade Name: Parlodel
Bromocriptine (Parlodel) is a fertility medication that belongs to a class of drugs called dopamine receptor agonists. It has some of the same effects as dopamine, a neurotransmitter which occurs naturally in your body. Bromocriptine works by suppressing the the production of prolactin, a hormone produced by your pituitary gland.
High levels of prolactin disrupts the production of follicle stimulating hormone (FSH) and luteinizing hormone (LH), the hormones that play an important part in ovulation.
Effect of Bromocriptine on Infertility
Bromocriptine may enhance fertility in women with prolactin disorders. Bromocriptine works by mimicking the action of certain neurotransmitters. By doing so, excess production of prolactin is prevented. Bromocriptine acts like neurotransmitters, causing your pituitary gland to stop prolactin production. When prolactin is within normal range, secretion of hormones for ovulation will resume, making it easier to get pregnant.
Research Evidence on Bromocriptine
Over decades, several studies were done to determine the efficacy of Bromocriptine in prolactin-related disorders. Many of these studies prove that Bromocriptine treatment helps in restoring menstruation and ovulation. Use of bromocriptine has also been linked to increased pregnancy rate.
In the mid-70's a small study conducted by Finnish scientists showed that 2-5 mg twice daily dose of Bromocriptine was effective for patients with amennorhea (absence of menstrual bleeding), secondary to abnormal prolactin levels. The investigators reported that Bromocripine therapy resulted in restoration of menstrual cycle and ovulation. The most common reported side-effects were nausea and vertigo which lessened after adjusting the dose.
Bromocriptine has also been found to prevent miscarriage in patients with abnormal prolactin levels. This study was conducted by Dr. Fumiki Hirahara and his colleagues from Yokohama City University School of Medicine. From 352 women with recurrent spontaneous abortion, the investigators identified 64 patients with a prolactin disorder that was not associated with any other abnormalities, including ovarian or endocrinologic disturbances, polycystic ovaries, hypersecretion of LH, galactorrhea, or thyroid disorders. The investigators noted that the percentage of successful pregnancies was higher in the patients who were given Bromocriptine than in the group that were not on Bromocriptine therapy (85.7% versus 52.4%, P < .05). The prolactin levels during early pregnancy were significantly higher in patients who had miscarriage than in patients whose pregnancies were successful. The investigators concluded that sufficient circulating levels of prolactin may play an important role in maintaining early pregnancy, especially in patients who had recurrent miscarriages caused by hyperprolactinemia.
How to Use Bromocriptine
Bromocriptine is available in tablets. Initial dose recommendation is 2.5 milligrams per day. The tablet is taken by mouth. The dosage can be increased by your doctor if lower doses do not seem to produce desired effects.
Typically, it takes about six to eight weeks for Bromocriptine to begin to work, it is therefore important that you do not stop taking this medication too early. Bromocriptine should be taken until you get pregnant. Bromocriptine can be taken vaginally if its side effects become intolerable.
Side Effects and Warnings
#What are the precautions when taking this medicine?
• If you are 65 or older, use this medicine with caution. You could have more side effects.
• Check medicines with healthcare provider. This medicine may not mix well with other medicines.
• You may not be alert. Avoid driving, doing other tasks or activities until you see how this medicine affects you.
• Avoid alcohol (includes wine, beer, and liquor) or other medicines and natural products that slow your actions and reactions.
• Avoid grapefruit and grapefruit juice.
• Use birth control that you can trust to prevent pregnancy while taking this medicine.
#What are some possible side effects of this medicine?
• Feeling lightheaded, sleepy, having blurred vision, or a change in thinking clearly. Avoid driving, doing other tasks or activities that require you to be alert or have clear vision until you see how this medicine affects you.
• Feeling dizzy. Rise slowly over several minutes from sitting or lying position. Be careful climbing.
• Nausea or vomiting. Small frequent meals, frequent mouth care, sucking hard, sugar-free candy, or chewing sugar-free gum may help.
• Inability to sleep.
#Reasons to call healthcare provider immediately
• If you suspect an overdose, call your local poison control center or emergency department immediately.
• Signs of a life-threatening reaction. These include wheezing; chest tightness; fever; itching; bad cough; blue skin color; fits; or swelling of face, lips, tongue, or throat.
• Severe dizziness.
• Significant change in balance.
• Significant change in thinking clearly and logically.
• Severe nausea or vomiting.
• Any rash.
• No improvement in condition or feeling worse.
- Current Medical Research and Opinion 1986, Vol. 10, No. 3, Pages 172-195
- Seppalå M, Hirvonen E, Ranta T. Lancet. Bromocriptine treatment of secondary amenorrhoea.1976 May 29;1(7970):1154-6.
- Hirahara, F., et al. Hyperprolactinemic recurrent miscarriage and results of randomized bromocriptine treatment. Department of Obstetrics and Gynecology, Yokohama City University School of Medicine, Yokohama, Japan. 1998.