Serious adverse drug reactions still occur with bromocriptine

(HealthDay)—Serious adverse drug reactions (ADRs) can occur after bromocriptine use in lactation inhibition, most of which could be avoided, according to a study published online March 11 in BJOG: An International Journal of Obstetrics & Gynecology.

Nathalie Bernard, Pharm.D., from the Hospices Civils de Lyon in France, and colleagues conducted an observational study involving serious ADRs reported between 1994 and 2010 in association with bromocriptine used for lactation inhibition in France. The authors confirmed the bromocriptine indication of each case, the seriousness of the ADR, and the modalities of bromocriptine use. Data were included for 105 serious ADRs, including two fatal cases.

The researchers found that the most frequent ADRs were cardiovascular (70.5 percent), neurological (14.3 percent), and psychiatric (8.6 percent) disorders. Cardiovascular disorders mainly consisted of ischemic manifestations: acute ischemic stroke, myocardial infarction, and reversible postpartum cerebral angiopathy. In 70.3 percent of cardiovascular disorders, misuse was identified, and mainly consisted of bromocriptine continuation, in spite of the occurrence of first symptoms indicating an ADR or absence of progressive bromocriptine titration. Cardiovascular predisposing factors were identified in about half of these women and included tobacco smoking, overweight or obesity, or a history of hypertension or preeclampsia.

"The use of bromocriptine should therefore be limited to cases where no other options are available to inhibit lactation," the authors write.

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