Is Bromocriptine safe while breastfeeding?
Here is what NIH LactMed, the U.S. National Library of Medicine's authority on medicines and breastfeeding, reports about Bromocriptine. This is a summary of that source — not our own verdict.
Effects on the breastfed infant
No adverse effects were noticed in 14 breastfed infants of mothers who were given oral bromocriptine 2.5 mg once daily for 3 days beginning on day 5 postpartum to decrease overproduction of milk.[ 8 ] A mother who was receiving bromocriptine (dosage not stated) for hyperprolactinemia from a pituitary macroadenoma breastfed her infant partially for 2 days and then exclusively from the third day onward (duration not stated). The infant had no observable side effects. She had regained her birthweight on day 10 and had gained weight adequately at 5 months.[ 9 ]
Effects on milk supply
With doses of 2.5 mg 1 to 3 times daily (usually twice daily), there is a marked reduction in serum prolactin, no increase in serum prolactin following nipple stimulation and little or no breast engorgement. Treatment is usually given for 14 days. A meta-analysis of published studies found evidence that bromocriptine is more effective than placebo for lactation suppression during the first week postpartum, but evidence is insufficient to comment on the acceptability of such therapy.[ 10 ] Rebound lactation after cessation of therapy may be controlled with a dose of 2.5 mg once daily for 1 additional week.[ 11 ] Bromocriptine also prevents puerperal fever caused by either breast engorgement or infection among women who do not nurse their newborn infants.[ 12 ] The indication of postpartum breast engorgement was removed in the United States in 1994 because of serious maternal toxicity, including stroke (some fatal), convulsions, myocardial infarction (some fatal) and severe hypertension. One study found that seizure risk was decreased in the early puerperium, but increased slightly later.[ 13 ] Cerebral angiopathy, stroke and seizures continue to be reported from countries where bromocriptine is still used to suppress lactation.[ 14 - 16 ] An early double-blind study in 60 women who were less than 24 hours postpartum found bromocriptine to be as effective as diethylstilbestrol in suppressing postpartum lactation. Bromocriptine was given in a dosage of 5 mg twice daily for 6 days followed by 5 mg three times daily for 3 days. Diethylstilbestrol dosage was 20 mg twice daily for 3 days, followed by 10 mg twice daily for 3 days, then 10 mg daily for 3 days.[ 17 ] Hyperprolactinemia and galactorrhea have been reported occasionally after withdrawal of long-term therapy with high doses (5 to 10 mg 3 times daily) of bromocriptine for treatment of parkinsonism.[ 18 ] In women given bromocriptine immediately postpartum, the composition of milk is altered from the milk of normal
Levels in milk
Maternal Levels. In 14 women given bromocriptine 2.5 mg once daily, the drug was undetectable ( 0.2 mcg/L) in breastmilk on consecutive 3 days, but the times with respect to the doses were not stated.[ 8 ] Infant Levels. Relevant published information was not found as of the revision date.
Source: NIH LactMed (National Library of Medicine).
Educational summary of an authoritative source — not medical advice. Never start, stop, or change a medicine while breastfeeding without confirming with your doctor.