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Bromocriptine - used for treating high prolactin levels in infertile women

This is a drug which is used specifically to treat women with hyperprolactinemia - a condition in women fail to ovulate because the pituitary is producing too much of the hormone called prolactin. Hyperprolactinemia is the cause of menstrual disturbance in about 10% of anovulatory women. Bromocriptine lowers prolactin levels to normal (the normal range in most laboratories being less than 20 ng/ml) and allows the ovary to get back to normal.

Some doctors sometimes misuse bromocriptine by using it to treat marginally elevated prolactin levels. This is not a good idea.

Side effects: The drug often causes nausea and dizziness during the first few days of treatment but the chances of these symptoms occurring can be reduced by starting the drug at a very low dose and gradually building up to a maintenance dose of 2 or 3 tablets daily. It's best to take bromocriptine with meals to reduce the side effects; and it's usually easier to tolerate if taken before bed time with dinner.

If you cannot tolerate the side effects of bromocriptine, you can request your doctor to prescribe an alternative medicine called cabergoline for you. This is usually easier to take.

Dose: A 2.5 mg tablet is available ; and the starting dose is usually 2.5 mg to 5 mg daily - taken at bedtime. After starting bromocriptine, prolactin levels can be tested (after at least one week of medication) to confirm that they have been brought down to normal. If the levels are still elevated, the dose will need to be increased. Once normal prolactin levels have been achieved (and some women need as much as 4 to 6 tablets a day to achieve this) this is then the maintenance dose. Once your prolactin blood level is within the normal range, your periods should become more regular and you should start ovulating normally again. Remember that bromocriptine only suppresses an elevated prolactin level while you are taking it - it does not "cure" the problem. This is why the tablets must be taken daily until a pregnancy occurs, after which they should be stopped. This is expensive medication - and some pharmaceutical companies may provide it at reduced rates if your doctor requests them to do so on your behalf.

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