Parlodel (bromocriptine mesylate) is a dopamine receptor agonist medication with established efficacy in managing hyperprolactinemic disorders and Parkinson’s disease. This ergot derivative exerts its therapeutic effects through selective stimulation of dopamine receptors in the anterior pituitary and central nervous system. Clinical applications include normalization of prolactin levels, restoration of gonadal function, and improvement of motor symptoms in Parkinsonian patients. The medication represents a cornerstone in endocrine and neurological therapeutics with decades of clinical validation supporting its use profile.

Features

• Contains bromocriptine mesylate as active pharmaceutical ingredient
• Available in 2.5mg scored tablets and 5mg capsules
• Dopamine D2 receptor agonist with high receptor affinity
• Rapid absorption with peak plasma concentrations within 1-3 hours
• Extensive hepatic metabolism via cytochrome P450 system
• Elimination half-life of approximately 12-15 hours

Benefits

• Effectively suppresses pathological prolactin secretion
• Restores ovulation and fertility in hyperprolactinemic women
• Improves motor function and reduces rigidity in Parkinson’s disease
• May reduce tumor size in prolactin-secreting pituitary adenomas
• Provides alternative therapy for acromegaly when surgery is contraindicated
• Established safety profile with extensive clinical experience

Common use

Parlodel is primarily indicated for the treatment of hyperprolactinemia-associated conditions, including amenorrhea, galactorrhea, infertility, and hypogonadism. In neurological practice, it is employed as adjunctive therapy in Parkinson’s disease, particularly in patients experiencing levodopa-related motor fluctuations. Off-label uses include management of neuroleptic malignant syndrome and type 2 diabetes mellitus (though the latter application utilizes quick-release formulation rather than standard Parlodel).

Dosage and direction

For hyperprolactinemia: Initiate with 1.25-2.5mg daily at bedtime with food. Titrate upward by 2.5mg increments every 3-7 days until optimal therapeutic response is achieved. Maintenance doses typically range from 2.5-15mg daily divided into 2-3 administrations.

For Parkinson’s disease: Begin with 1.25mg twice daily with meals. Gradually increase by 2.5mg daily every 2-4 weeks based on tolerance and response. Therapeutic range is generally 10-40mg daily in divided doses.

Always administer with food to minimize gastrointestinal adverse effects. Tablets should be swallowed whole without chewing or crushing.

Precautions

Monitor blood pressure regularly during initial dosage titration due to risk of orthostatic hypotension. Exercise caution when operating machinery until individual response is determined. Regular hepatic function assessments are recommended during prolonged therapy. Abrupt discontinuation should be avoided; taper gradually over several days. Use with caution in patients with history of psychiatric disorders, cardiovascular disease, or Raynaud’s phenomenon. Pregnancy testing is recommended before initiation in women of childbearing potential.

Contraindications

Hypersensitivity to ergot alkaloids or any component of the formulation. Uncontrolled hypertension, toxemia of pregnancy, or coronary artery disease. History of cardiac valvular disorders or fibrotic syndromes. Concurrent use with macrolide antibiotics or potent CYP3A4 inhibitors. Severe hepatic impairment. Untreated pituitary tumors with mass effect symptoms.

Possible side effect

Common: Nausea (40-50%), headache (15-30%), dizziness (15-25%), fatigue (10-20%), abdominal cramps (10-15%). Less frequent: Orthostatic hypotension (5-10%), nasal congestion (5-8%), constipation (5-7%). Rare: Digital vasospasm, confusion, hallucinations, pleural effusion, retroperitoneal fibrosis. Most adverse effects are dose-dependent and tend to diminish with continued therapy.

Drug interaction

Potent CYP3A4 inhibitors (ketoconazole, itraconazole, ritonavir) may significantly increase bromocriptine levels. Antipsychotics and other dopamine antagonists may reduce therapeutic efficacy. Concomitant use with antihypertensive agents may potentiate hypotensive effects. Ergot alkaloids and other dopamine agonists may increase risk of fibrosis. Serotonin agonists may theoretically increase risk of serotonin syndrome.

Missed dose

If a dose is missed, take it 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. Maintain regular dosing schedule to ensure stable dopamine receptor stimulation. If multiple doses are missed, consult healthcare provider for dosage re-titration recommendations.

Overdose

Symptoms may include severe nausea, vomiting, hypotension, confusion, hallucinations, and syncope. Management involves gastrointestinal decontamination if presented early, supportive care including blood pressure stabilization, and antiemetics for symptomatic relief. Dialysis is not effective due to extensive protein binding. There is no specific antidote; treatment should focus on symptomatic and supportive measures.

Storage

Store at controlled room temperature (20-25°C/68-77°F) in original container. Protect from light and moisture. Keep tightly closed and out of reach of children. Do not use beyond expiration date printed on packaging. Do not transfer to alternative containers as moisture protection may be compromised.

Disclaimer

This information is provided for educational purposes only and does not constitute medical advice. Individual therapeutic response and dosing requirements may vary. Healthcare providers should reference full prescribing information and clinical guidelines before initiating therapy. Patients should not alter dosage or discontinue medication without consulting their prescribing physician.

Reviews

Clinical studies demonstrate 70-80% success rate in normalization of prolactin levels within 4-8 weeks of therapy. Long-term follow-up studies show maintenance of efficacy in 60-70% of patients with microprolactinomas at 5-year follow-up. In Parkinson’s disease, Parlodel provides approximately 20-30% improvement in motor scores when used as adjunctive therapy. Patient satisfaction surveys indicate high tolerability with appropriate dose titration, though gastrointestinal side effects remain the most common reason for discontinuation.