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Infertility treatment makes use of different medications, depending on the type of infertility the woman is experiencing. Bromocriptine is a drug that’s used to treat women with hyperprolactinemia. In this condition, women can’t ovulate as their pituitary gland produces excessive amounts of the prolactin hormone. About 10% of anovulatory women experience menstrual disturbance due to hyperprolactinemia.

The misuse

Bromocriptine lowers the prolactin levels to normal (in most labs, the normal range is less than 20 ng/ml). It allows the ovary to become normal again. At times, some doctors also misuse bromocriptine; they use it even in the treatment of women who have marginally elevated prolactin levels, which isn’t really a good idea at all. Though this drug is an effective treatment for hyperprolactinemia, it has certain side-effects such as nausea and dizziness.

Women who are on this treatment experience these side-effects in the first few days of the treatment; however, it’s possible to reduce the  chances of these symptoms showing up, by starting out the patient on a very low dosage and then building up a maintenance dose  of 2-3 tablets daily. It’s best to take bromocriptine with meals.

This helps reduce its side-effects and patients are able to tolerate it much better when it’s taken just before bedtime, with dinner. If you aren’t able to tolerate the side-effects of this drug, you can request your doctor to prescribe an alternative medicine called cabergoline for you. This is usually easier to take.

Dosage

  • Dose: A 2.5 mg tablet is available; the starting dose is generally 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. This helps confirm that have been brought down to normal
  • If the levels are still elevated, the dose will have to be increased
  • Once the prolactin levels have come down to normal (some women need as much as 4-6 tablets a day to achieve this) this then becomes the maintenance dose
  • Once your prolactin blood level has reached the normal range, your periods should then become more regular and you should begin ovulating normally again

Keep in mind that bromocriptine only suppresses an increased prolactin level while you are taking it. It’s not really a cure for the problem. This is exactly why the tablets have to be taken every day until you get pregnant; they will have to be stopped after that. This medication is very expensive. Some pharma companies might just provide it at lower rates if your doctor requests them to do so, on your behalf.

Not happy with the attention you are getting from your IVF clinic? Need more information? Please send me your medical details by filling in the form at www.drmalpani.com/free-second-opinion so that I can guide you!

 

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