Last update: June 25, 2018
Poorly safe. Evaluate carefully.
Use safer alternative or interrupt breastfeeding 3 to 7 T ½ (elimination half-lives).
Read the Comment.
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 (Hopp 1996, Iffy 1996, Kirsch 2001, Bernard 2015, Seeman 2015, Fedrizzi 2015, Snellen 2016) and thereof the indication to suppress lactation has been questioned by medical societies (Oladapo 2009-2012 Marcellin 2015, Sénat 2016) withdrawn in many countries (Nguyen 2015), switching to cabergoline has been proposed (Eglash 2014) along with non-pharmacological measures (Wong 1985 , Prescrire Int. 2013)
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, a 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 galactorrhea-prolactinoma-hyperprolactinemia that were treated with a daily dose of 2.5 to 5 mg of Bromocriptine with no effects noticed on the infants (Canales 1981, Cheng 1996, Verma 2006).
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 on breastfeeding would be due to its ability for suppression of milk production, but not to a possible effect on the infant which is considered very unlikely.
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.
We do not have alternatives for Bromocriptine Mesilate.
Suggestions made at e-lactancia are done by APILAM´s pediatricians and pharmacists, and are based on updated scientific publications.
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