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Brand name:

Parlodel

Pronounced: PAR-luh-del
Generic name: Bromocriptine mesylate

Why is this drug prescribed?

Parlodel inhibits the secretion of the hormone prolactin from the pituitary gland. It also mimics the action of dopamine, a chemical lacking in the brain of someone with Parkinson's disease. It is used to treat a variety of medical conditions, including:

• Infertility in some women
• Menstrual problems such as the abnormal stoppage or absence of flow, with or without excessive production of milk
• Growth hormone overproduction leading to acromegaly, a condition characterized by an abnormally large skull, jaw, hands, and feet
• Parkinson's disease
• Pituitary gland tumors

Some doctors also prescribe Parlodel to treat cocaine addiction, the eye condition known as glaucoma, erection problems in certain men, restless leg syndrome, and a dangerous reaction to major tranquilizers called neuroleptic malignant syndrome.

Most important fact about this drug

Notify your doctor immediately if you develop a severe headache that does not let up or continues to get worse. It could be a warning of the possibility of other dangerous reactions, including seizure, stroke, or heart attack.

How should you take this medication?

Parlodel should be taken with food. Take the first dose while lying down. You may faint or become dizzy due to lower blood pressure, especially following the first dose.

You may not feel the full effect of this medication for a few weeks. Do not stop taking Parlodel without first checking with your doctor.

--If you miss a dose...

Take it as soon as you remember if it is within 4 hours of the scheduled time. Otherwise, skip the dose you missed and go back to your regular schedule. Do not take 2 doses at once.

--Storage information...

Store at room temperature in a tightly closed, light-resistant container.

What side effects may occur?

The number and severity of side effects depend on many factors, including the condition being treated, dosage, and duration of treatment. Side effects cannot be anticipated. If any develop or change in intensity, inform your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking Parlodel.

• More common side effects may include:
  Abdominal cramps or discomfort, confusion, constipation, depression, diarrhea, dizziness, drop in blood pressure, drowsiness, dry mouth, fainting, fatigue, hallucinations (particularly in Parkinson's patients), headache, inability to sleep, indigestion, light-headedness, loss of appetite, loss of coordination, nasal congestion, nausea, shortness of breath, uncontrolled body movement, vertigo, visual disturbance, vomiting, weakness

• Less common side effects may include:
  Abdominal bleeding, anxiety, difficulty swallowing, frequent urination, heart attack, inability to hold urine, inability to urinate, nightmares, nervousness, rash, seizures, splotchy skin, stroke, swelling in feet and ankles, twitching of eyelids

Some of the above side effects are also symptoms of Parkinson's disease.

• Rare side effects may include:
  Abnormal heart rhythm, blurred vision or temporary blindness, cold feet, fast or slow heartbeat, hair loss, heavy-headedness, increase in blood pressure, lower back pain, muscle cramps, muscle cramps in feet and legs, numbness, pale face, paranoia, prickling or tingling, reduced tolerance to cold, severe or continuous headache, shortness of breath, sluggishness, tingling of ears or fingers

Why should this drug not be prescribed?

You should not be using Parlodel if you have high blood pressure that is not under control or if you are pregnant (unless your doctor finds it medically necessary). You should also not take Parlodel if you are allergic to it or to any other drugs containing ergot alkaloids, such as Bellergal-S and Cafergot.

Women who have severe heart conditions should not use Parlodel after they have had a baby unless it is medically necessary.

Special warnings about this medication

Your doctor will check your pituitary gland thoroughly before you are treated with Parlodel.

Since Parlodel can restore fertility and pregnancy can result, women who do not want to become pregnant should use a "barrier" method of contraception during treatment with this medication. Do not use the "Pill" or oral contraceptives, as they may prevent Parlodel from working properly.

Notify your doctor immediately if you become pregnant while you are being treated with Parlodel.

If you have kidney or liver disease, consult your doctor before taking Parlodel.

If you are being treated with Parlodel for endocrine problems related to a tumor and stop taking this medication, the tumor may grow back rapidly.

Use Parlodel with caution if you have had mental problems, any disease of the heart and circulatory system, peptic ulcer, or bleeding in the stomach and intestines.

If you are being treated for Parkinson's disease, the use of Parlodel alone or Parlodel with levodopa may cause hallucinations, confusion, and low blood pressure. If this happens, notify your doctor immediately.

If you have an abnormal heartbeat rhythm caused by a previous heart attack, consult your doctor before taking Parlodel.

If you experience a persistent watery nasal discharge while taking Parlodel, notify your doctor.

This drug may impair your ability to drive a car or operate potentially dangerous machinery. Do not participate in any activities that require full alertness if you are unsure about your ability to do so.

Your first dose of Parlodel may cause dizziness. If so, check with your doctor.

Possible food and drug interactions when taking this medication

Combining alcohol with Parlodel can cause blurred vision, chest pain, pounding heartbeat, throbbing headache, confusion, and other problems. Do not drink alcoholic beverages while taking this medication.

Certain drugs used for psychotic conditions, including Thorazine and Haldol, inhibit the action of Parlodel. It is important that you consult your doctor before taking these drugs while on Parlodel therapy.
Other drugs that may interact with Parlodel include:
Blood pressure-lowering drugs such as Aldomet and Catapres
Metoclopramide (Reglan)
Oral contraceptives
Other ergot derivatives such as Hydergine
Pimozide (Orap)

Special information if you are pregnant or breastfeeding

The use of Parlodel during pregnancy should be discussed thoroughly with your doctor. If Parlodel is essential to your treatment, your doctor will carefully monitor you throughout your pregnancy.

You should not take Parlodel while breastfeeding.

Recommended dosage

ADULTS

Excess Prolactin Hormone

If you are being treated for conditions associated with excess prolactin, such as menstrual problems, with or without excessive milk production, infertility, or pituitary gland tumors, the usual starting dose is one-half to 1 tablet daily. Your doctor may add a tablet every 3 to 7 days, until the treatment works. The usual longer term dose is 5 to 7.5 milligrams per day and ranges from 2.5 to 15 milligrams per day.

Growth Hormone Overproduction

Treatment for the overproduction of growth hormones is usually one-half to 1 tablet with food at bedtime for 3 days. Your doctor may add one-half to 1 tablet every 3 to 7 days. The usual treatment dose varies from 20 to 30 milligrams per day. The dose should not exceed 100 milligrams per day. Your doctor will do a monthly re-evaluation.

Parkinson's Disease

Parlodel taken in combination with levodopa may provide additional treatment benefits if you are currently taking high doses of levodopa, are beginning to develop a tolerance to levodopa, or are experiencing "end of dose failure" on levodopa therapy.

The usual starting dose of Parlodel is one-half tablet twice a day with meals. Your dose will be monitored by your doctor at 2-week intervals. If necessary, your doctor may increase the dose every 14 to 28 days by 1 tablet per day.

CHILDREN

Overdosage

Any medication taken in excess can have serious consequences. If you suspect an overdose of Parlodel, contact your doctor immediately or seek other medical attention.

• Symptoms of Parlodel overdose may include:
  Confusion, constipation, delusions, dizziness, drowsiness, feeling unwell, hallucinations, lethargy, nausea, pallor, severely low blood pressure, sweating, vomiting, yawning repeatedly.