Bromocriptine Mesilate

An ergot derivative alkaloid which is a prolactin inhibitor with dopaminergic activity, indicated for the treatment of prolactinomas and Parkinson's disease. Inhibits milk production by lowering prolactin level (Eglash 2014). Oral administration two to three times a day.

Severe and frequent side effects, that are even increased in the postpartum, are: hypertension, seizures, stroke, myocardial infarction and psychiatric disorders ^{(Snellen 2016, Bernard 2015, Seeman 2015, Fedrizzi 2015, Kirsch 2001, Hopp 1996, Iffy 1996))} and thereof the indication to suppress lactation has been questioned by medical societies ^{(Sénat 2016, Marcellin 2015, Oladapo 2012-2009)} withdrawn in many countries ^{(Nguyen 2015)}, switching to cabergoline has been proposed ^{(Eglash 2014)} along with non-pharmacological measures. ^{(Prescrire Int. 2013, Wong 1985)}

Pharmacokinetic data (moderately high molecular weight and high binding capacity to plasma proteins) explain the observed almost zero excretion into breastmilk ^{(Peters 1985)} or below detection limits (<0.2 micrograms / L).

In addition, its low oral bioavailability makes insignificant its absorption from breastmilk to the infant’s plasma.

A successful breastfeeding has been described on about 30 cases of hypergalactia-prolactinoma-hyperprolactinemia that were treated with a daily dose of 2.5 to 5 mg of Bromocriptine with no effects noticed on the infants. ^{(Liu 2018, Verma 2006, Cheng 1996, Canales 1981)}

Nor side effects occurred on 14 infants whose mothers received 2.5 mg of bromocriptine from 5th to 8th day after birth to treat an alleged galactorrhea. ^{(Peters 1985)}

The risk to breastfeeding is due to its ability to suppress milk production, not to the effects it may have on the infant, which have not been observed.

If Bromocriptine was eventually administered to suppress lactation but afterwards the mother is willing to resuming breastfeeding, the mother can do it immediately, trying to minimize the drug effect by frequent suckling the child to stimulate milk production.

See below the information of this related product:

• Hypergalactia; Hyperlactation (Fairly safe. Mild or unlikely adverse effects. Compatible under certain circumstances. Follow-up recommended. Read Commentary.)