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Drug Interactions between bromocriptine and Lamprene

This report displays the potential drug interactions for the following 2 drugs:

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Interactions between your drugs

Major

bromocriptine clofazimine

Applies to: bromocriptine and Lamprene (clofazimine)

Consumer information for this interaction is not currently available.

ADJUST DOSE: Coadministration with moderate inhibitors of CYP450 3A4 may significantly increase the plasma concentrations of bromocriptine. Orally administered bromocriptine is extensively metabolized in the gastrointestinal tract and liver by CYP450 3A4, with approximately 93% of the absorbed dose undergoing first-pass metabolism and only the remaining 7% reaching systemic circulation. As such, inhibitors of CYP450 3A4 may markedly reduce the metabolic clearance of bromocriptine. The interaction has been studied with erythromycin, a moderate CYP450 3A4 inhibitor. When a single 5 mg oral dose of bromocriptine was given following a 4-day treatment of erythromycin estolate 250 mg four times a day in five male volunteers, mean bromocriptine peak plasma concentration (Cmax) and systemic exposure (AUC) increased by 4.6- and 3.7-fold, respectively, compared to administration of bromocriptine alone. High bromocriptine plasma levels may increase the frequency and/or severity of adverse effects such as nausea, headache, dizziness, somnolence (e.g., episodes of sudden sleep onset), hypotension, syncope, and impulse control problems or compulsive behaviors (e.g., gambling or sexual urges; uncontrolled spending).

MANAGEMENT: Caution and close monitoring for development of adverse effects are advisable during coadministration of bromocriptine with moderate CYP450 3A4 inhibitors. Bromocriptine dosage may need to be reduced to avoid toxicity. The prescribing information for Cycloset, a bromocriptine product indicated for use in adults with type 2 diabetes mellitus to improve glycemic control, recommends limiting the dose to 1.6 mg daily during concomitant use of a moderate CYP450 3A4 inhibitor.

References

  1. Nelson MV, Berchou RC, Kareti D, Le Witt PA (1990) "Pharmacokinetic evaluation of erythromycin and caffeine administered with bromocriptine." Clin Pharmacol Ther, 47, p. 694-7
  2. (2001) "Product Information. Parlodel (bromocriptine)." Sandoz Pharmaceuticals Corporation
  3. von Rosenstiel NA, Adam D (1995) "Macrolide antibacterials. Drug interactions of clinical significance." Drug Saf, 13, p. 105-22
  4. Cerner Multum, Inc. "UK Summary of Product Characteristics."
  5. Cerner Multum, Inc. "Australian Product Information."
  6. Periti P, Mazzei T, Mini E, Novelli A (1992) "Pharmacokinetic drug interactions of macrolides." Clin Pharmacokinet, 23, p. 106-31
  7. (2018) "Product Information. Cycloset (bromocriptine)." Valeant Pharmaceuticals
View all 7 references

Drug and food interactions

Moderate

bromocriptine food

Applies to: bromocriptine

Alcohol can increase the nervous system side effects of bromocriptine such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience impairment in thinking and judgment. You should avoid or limit the use of alcohol while being treated with bromocriptine. Do not use more than the recommended dose of bromocriptine, and avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medication affects you. Talk to your doctor or pharmacist if you have any questions or concerns.

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Moderate

bromocriptine food

Applies to: bromocriptine

Nicotine may increase the effects of bromocriptine in narrowing the blood vessels and decreasing blood flow. A severe decrease in blood flow to the brain and other parts of the body can lead to dangerous side effects. Contact your doctor immediately if you experience coldness, paleness, discoloration, numbness, tingling, or pain in your hands or feet; muscle pain or weakness; severe or worsening headache; blurred vision; severe abdominal pain; chest pain; or shortness of breath while using these medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

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Therapeutic duplication warnings

No warnings were found for your selected drugs.

Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.


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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.