Parlodel Side Effects

Generic Name: bromocriptine

Note: This page contains side effects data for the generic drug bromocriptine. It is possible that some of the dosage forms included below may not apply to the brand name Parlodel.

It is possible that some side effects of Parlodel may not have been reported. These can be reported to the FDA here. Always consult a healthcare professional for medical advice.

For the Consumer

Applies to bromocriptine: oral capsule, oral tablet

As well as its needed effects, bromocriptine (the active ingredient contained in Parlodel) may cause unwanted side effects that require medical attention.

Some serious side effects have occurred during the use of bromocriptine to stop milk flow after pregnancy or abortion. These side effects have included strokes, seizures (convulsions), and heart attacks. Some deaths have also occurred. You should discuss with your doctor the good that this medicine will do as well as the risks of using it.

If any of the following side effects occur while taking bromocriptine, check with your doctor immediately:

More common
  • Dizziness or lightheadedness, especially when getting up from a lying or sitting position
  • nausea
Less common—reported more often in patients with Parkinson's disease
  • Confusion
  • hallucinations (seeing, hearing, or feeling things that are not there)
  • uncontrolled movements of the body, such as the face, tongue, arms, hands, head, and upper body
Rare—reported more often in patients taking large doses
  • Abdominal or stomach pain (continuing or severe)
  • increased frequency of urination
  • loss of appetite (continuing)
  • lower back pain
  • runny nose (continuing)
  • weakness
Rare
  • Black, tarry stools
  • bloody vomit
  • chest pain (severe)
  • convulsions (seizures)
  • fainting
  • fast heartbeat
  • headache (unusual)
  • increased sweating
  • nausea and vomiting (continuing or severe)
  • nervousness
  • shortness of breath (unexplained)
  • vision changes (such as blurred vision or temporary blindness)
  • weakness (sudden)

Some bromocriptine side effects may not need any medical attention. As your body gets used to the medicine these side effects may disappear. Your health care professional may be able to help you prevent or reduce these side effects, but do check with them if any of the following side effects continue, or if you are concerned about them:

Less common
  • Constipation
  • diarrhea
  • drowsiness or tiredness
  • dry mouth
  • leg cramps at night
  • loss of appetite
  • mental depression
  • stomach pain
  • stuffy nose
  • tingling or pain in the fingers and toes when exposed to cold
  • vomiting

Some side effects may be more likely to occur in patients who are taking bromocriptine for Parkinson's disease, acromegaly, or pituitary tumors since they may be taking larger doses.

For Healthcare Professionals

Applies to bromocriptine: compounding powder, oral capsule, oral tablet

Gastrointestinal

Gastrointestinal side effects have included nausea (18% to 49%), constipation (3% to 14%), vomiting (2% to 5%), abdominal cramps (5%), indigestion/dyspepsia (4%), anorexia (4%), diarrhea (3%), gastrointestinal bleeding (less than 2%), abdominal discomfort, anorexia, dry mouth, and peptic ulcers have been reported.[Ref]

Nervous system

Nervous system side effects have included headache (19%), dizziness (17%), fatigue (7%), lightheadedness (5%), and drowsiness/tiredness (3%). Other side effects occurring less frequently (less than 2%) have included faintness, vertigo, paresthesia, insomnia, decreased sleep requirement, heavy headedness, sluggishness, reduced tolerance to cold, asthenia, tingling of ears, and numbness. A syndrome resembling neuroleptic malignant syndrome has been reported on abrupt withdrawal of bromocriptine (the active ingredient contained in Parlodel) [Ref]

Cardiovascular

Syncope and symptomatic hypotension (decreases in supine systolic and diastolic pressures of greater than 20 mm and 10 mm Hg, respectively) have been reported in approximately 30% of postpartum patients.

Seizures and/or strokes have been reported with bromocriptine (the active ingredient contained in Parlodel) administration. Many of the patients experiencing seizures and/or strokes reported developing a continuous headache, often progressively severe, hours to days prior to the acute event. In addition, visual disturbances (blurred vision and transient cortical blindness) have been reported to also precede stroke and/or seizure events. If a patient experiences severe, progressive, or unremitting headache (with or without visual disturbance), or evidence of CNS toxicity develops, bromocriptine therapy should be discontinued and the patient should be evaluated promptly.[Ref]

Cardiovascular side effects have included postural/orthostatic hypotension (6%), digital vasospasm (3%), syncope (less than 2%), seizures, stroke, and myocardial infarction. Rare cardiovascular side effects including arrhythmia, pleural and pericardial effusions, constrictive pericarditis, ventricular tachycardia, bradycardia, and vasovagal attack have been reported.

A case of severe dilated cardiomyopathy has been reported in a 31-year-old African American female one month after initiating treatment of a microprolactinoma with bromocriptine 5 mg orally daily. An echocardiogram showed a markedly dilated left ventricle with severe reduction in the left-ventricular ejection fraction. The patient returned to NYHA Class I four weeks after bromocriptine was stopped.[Ref]

Respiratory

Respiratory side effects have included nasal congestion (3%) and shortness of breath. Pulmonary infiltrates, pleural effusion, and thickening of the pleura have been reported with long-term administration (6 months to 36 months) of bromocriptine (the active ingredient contained in Parlodel) doses ranging from 20 mg to 100 mg daily. Upon termination of bromocriptine therapy, these changes slowly reverted towards normal.[Ref]

Rare cases of cerebrospinal fluid rhinorrhea have been reported in patients who have received previous transphenoidal surgery and/or pituitary radiation, and who were receiving bromocriptine for tumor recurrence.[Ref]

Musculoskeletal

Musculoskeletal side effects have included muscle cramps, facial pallor, abnormal involuntary movements, ataxia, edema of the feet and ankles, and erythromelalgia.[Ref]

Rare musculoskeletal side effects including tingling of fingers, cold feet, numbness, muscle cramps in feet and legs, and exacerbation of Raynaud's Syndrome have been reported during bromocriptine therapy.[Ref]

Psychiatric

Parkinsonian patients may manifest mild degrees of dementia, therefore, caution should be used when treating such patients.

Bromocriptine (the active ingredient contained in Parlodel) alone or in combination with levodopa, may cause hallucinations (visual or auditory). Hallucinations usually resolve with dosage reduction; occasionally, discontinuation of the drug is required. Rarely, after high doses, hallucinations have persisted for several weeks after discontinuation of the drug.[Ref]

Psychiatric side effects have included delusional psychosis, paranoia, depression, anxiety, confusion, "on-off" phenomenon, and nightmares. High doses of bromocriptine may be associated with confusion and mental disturbances (hallucinations). Postmarketing reports suggest that patients treated with antiparkinson medications can experience intense urges to gamble, increased sexual urges, intense urges to spend money uncontrollably, and other intense urges. Patients may be unable to control these urges while taking the medications used for the treatment of Parkinson's disease and that increase central dopaminergic tone.[Ref]

Ocular

Ocular side effects have included visual disturbance and blepharospasm. Secondary deterioration of visual field may develop in patients receiving treatment for hyperprolactinemia due to chiasmal herniation. The visual field defect may improve on reduction of bromocriptine (the active ingredient contained in Parlodel) dosage.[Ref]

Genitourinary

Genitourinary side effects have included urinary frequency, urinary incontinence, and urinary retention.[Ref]

Dermatologic

Dermatologic side effects have included mottling of skin and skin rash.[Ref]

Other

Other side effects have included hair loss, alcohol potentiation, reduced tolerance to cold, tingling of the ears, sign and symptoms of ergotism such as tingling of the fingers, cold feet, numbness, muscle cramps of feet and legs or exacerbation of Raynaud's syndrome.[Ref]

Local

Local side effects have included retroperitoneal fibrosis in a few patients receiving long-term therapy (2 to 10 years) with bromocriptine (the active ingredient contained in Parlodel) in doses ranging from 30 to 140 mg daily.[Ref]

Oncologic

Studies have shown that Parkinson's patients have an approximately 2 to 6 fold higher risk of developing melanoma than the general population. It is not clear whether this increased risk was due to Parkinson's disease or other factors, such as drugs used to treat Parkinson's disease.

References

1. "Product Information. Parlodel (bromocriptine)." Sandoz Pharmaceuticals Corporation, East Hanover, NJ.

2. Larrazet F, Spaulding C, Lobreau HJ, Weber S, Guerin F "Possible bromocriptine-induced myocardial infarction." Ann Intern Med 118 (1993): 199-200

3. Kaushik P, Vatsavai SR, Banda VR, Sanghi PK, Ahmad M, Kaushik R "Acute onset of severe dilated cardiomyopathy during bromocriptine therapy." Ann Pharmacother 38 (2004): 1219-21

4. Champagne SP, Coste E, Peyriere H, Nigond J, Mania E, Pons M, HillaireBuys D, Balmes P, Blayac JP, Davy JM "Chronic constrictive pericarditis induced by long-term bromocriptine therapy: Report of two cases." Ann Pharmacother 33 (1999): 1050-4

5. Bende M, Bergman B, Sjogren C "Nasal mucosal congestion after treatment with bromocriptine." Laryngoscope 103 (1993): 1142-4

6. Leiguarda R, Merello M, Sabe L, Starkstein S "Bromocriptine-induced dystonia in patients with aphasia and hemiparesis." Neurology 43 (1993): 2319-22

7. Boyd A "Bromocriptine and psychosis: a literature review." Psychiatr Q 66 (1995): 87-95

8. Dorevitch A, Aronzon R, Stark M "Psychotic exacerbation attributed to low-dose bromocriptine treatment of galactorrhea and hyperprolactinemia." Acta Obstet Gynecol Scand 70 (1991): 375-6

9. Peter SA, Autz A, Jean-Simon ML "Bromocriptine-induced schizophrenia." J Natl Med Assoc 85 (1993): 700-1

10. Couldwell WT, Weiss MH "Visual loss associated with bromocriptine." Lancet 340 (1992): 1210-411

11. Fabre N, Montastruc JL, Rascol O "Alopecia: an adverse effect of bromocriptine." Clin Neuropharmacol 16 (1993): 266-8

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