Bromocriptine !

An ergot dopamine agonist that lowers prolactin and growth hormone. Used in prolactinoma, acromegaly and, less often today, Parkinson disease.

Updated 2026-11-01

Class: Dopamine agonists
Receptor: Dopamine D2 receptor
ATC code: N04BC01

Dopamine D2 receptorBromocriptine

The figure shows bromocriptine bound to the human D2 receptor coupled to its Gi protein.

Target in 3D: Dopamine D2 receptor. PDB structure 7JVR (RCSB PDB, public domain). View the structure at RCSB PDB

Mechanism of action

Bromocriptine is an ergot derivative with potent agonist activity at D2 dopamine receptors. In the pituitary it inhibits prolactin release and, in acromegaly, can lower growth hormone; in the striatum it substitutes for missing dopamine.

Bromocriptine stimulates D2 receptors
Pituitary prolactin release is inhibited
Prolactinomas shrink; growth hormone can fall
In the striatum it eases Parkinson symptoms

Pharmacokinetics

Metabolism: Extensive liver metabolism by CYP3A4

Indications

Hyperprolactinaemia and prolactin-secreting adenomas (amenorrhoea, galactorrhoea, infertility, hypogonadism) Prolactinoma (hyperprolactinaemia) →
Acromegaly, alone or with surgery or radiotherapy Acromegaly and gigantism →
Parkinson disease, usually added to levodopa Parkinson disease →
Neuroleptic malignant syndrome, as an adjunct to stopping the antipsychotic and supportive care (off-label) Neuroleptic malignant syndrome →

Adverse effects

Common

Nausea, vomiting, headache
Dizziness and orthostatic hypotension
Nasal congestion and constipation
Hallucinations and confusion, more than with levodopa

Contraindications

Uncontrolled hypertension
Sensitivity to ergot alkaloids
Postpartum use in women with coronary or other severe cardiovascular disease

Key interactions

Erythromycin and other CYP3A4 inhibitors: Raise bromocriptine levels and adverse effects
Dopamine antagonists (antipsychotics, metoclopramide): Oppose its effect

What is monitored

Prolactin or growth hormone levels and pituitary imaging
Blood pressure, especially early and postpartum
Breathing, chest symptoms and kidney function with long use (fibrosis)
Pregnancy: treatment for hyperprolactinaemia is usually stopped when pregnancy is confirmed

Administration and safety

Given with food to reduce nausea
Started low and increased gradually
Not used to suppress normal postpartum lactation

Nursing care

Check blood pressure lying and standing, especially after the first dose
Teach to report severe headache, chest pain or vision changes
Discuss contraception: fertility can return quickly
Ask about impulse-control behaviours

Pregnancy and breastfeeding

In hyperprolactinaemia it is usually stopped when pregnancy is diagnosed, unless a growing macroadenoma needs it.

Test yourself

Think of the answer, then tap the question to see it.

What are three endocrine or neurological uses of bromocriptine?

Hyperprolactinaemia/prolactinoma, acromegaly and Parkinson disease.

Why is bromocriptine not used to stop normal breastfeeding after delivery?

Postpartum use has been linked to hypertension, stroke, seizures and myocardial infarction.

Which enzyme metabolizes bromocriptine, and what does that imply?

CYP3A4; inhibitors such as erythromycin can raise its levels.

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Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.

Sources: DailyMed - BROMOCRIPTINE MESYLATE capsule (DailyMed (U.S. National Library of Medicine), 2026); Bromocriptine: MedlinePlus Drug Information (MedlinePlus (U.S. National Library of Medicine), 2022); Goodman & Gilman's The Pharmacological Basis of Therapeutics, 14th ed., ch. 19 (McGraw Hill, 2023); ATCDDD - ATC/DDD Index (WHO Collaborating Centre for Drug Statistics Methodology, 2026).

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Representative model, for educational purposes only.