Bromocriptine mesylate or cabergoline for infertility

Examples

---

Brand Name	Chemical Name
Parlodel	bromocriptine mesylate

Brand Name	Chemical Name
Dostinex	cabergoline

Bromocriptine should be taken with food, 1 to 4 times daily.

Cabergoline is taken 1 to 2 times weekly.

How It Works

---

Bromocriptine and cabergoline reduce the body's amount of prolactin, a hormone produced by the pituitary gland. Excess prolactin makes a woman stop ovulating; in a man, it reduces sperm production, impairs sex drive, and causes impotence (erectile dysfunction).

Why It Is Used

---

Bromocriptine or cabergoline may be used when a woman is not ovulating because she has high levels of prolactin in her blood.

Bromocriptine may be used to treat a man whose reproductive functions are impaired because he has abnormally high levels of prolactin.

High prolactin is commonly produced by a pituitary tumor. If you have elevated prolactin levels, you will need further testing to find whether a tumor is present. Bromocriptine is used to treat male infertility only if it is associated with a prolactin-producing pituitary tumor; the medication helps to normalize interactions between the pituitary gland and the testicles.

How Well It Works

---

Among women who have ovulation problems due to excess prolactin, 70% to 90% will begin having menstrual periods on a regular cycle and 50% to 75% will begin ovulating normally while taking these medications.¹

Note:

Ovulation rates do not reflect the fact that well-timed intercourse is necessary to conceive, and some pregnancies miscarry. In any group of women, ovulation rates are higher than pregnancy rates, which are higher than live birth rates.

Side Effects

---

Cabergoline causes few side effects, the most common being headache.

Bromocriptine can cause mild to moderate side effects, including:

• Nasal stuffiness.
• Nausea.
• Diarrhea.
• Headache.
• Dizziness, lightheadedness.
• Fatigue.

Side effects from bromocriptine can be minimized by building up slowly to a full dose or by administering tablets vaginally rather than orally.

Cabergoline causes minimal side effects compared to bromocriptine, but its effects on the fetus are not as fully researched.

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

What To Think About

---

While you are taking bromocriptine, avoid alcohol and use care when driving or operating machinery.

Some women are resistant to bromocriptine or cannot tolerate it. About 70% to 85% of these women have good results with cabergoline as a treatment for increased prolactin levels.¹

If ovulation does not begin after 2 months of bromocriptine or cabergoline treatment, clomiphene, recombinant human FSH, or human menopausal gonadotropin (hMG) treatment may be added.

Complete the new medication information form (PDF) (What is a PDF document?) to help you understand this medication.

References

---

Citations

1. Speroff L, Fritz MA (2005). Induction of ovulation. In Clinical Gynecologic Endocrinology and Infertility, 7th ed., pp. 1175–1213. Philadelphia: Lippincott Williams and Wilkins.

Credits

---

Author	Shannon Erstad, MBA/MPH
Author	Lila Havens
Editor	Kathleen M. Ariss, MS
Associate Editor	Michele Cronen
Associate Editor	Pat Truman
Associate Editor	Terrina Vail
Primary Medical Reviewer	Joy Melnikow, MD, MPH - Family Medicine
Primary Medical Reviewer	Kathleen Romito, MD - Family Medicine
Specialist Medical Reviewer	Kirtly Jones, MD - Obstetrics and Gynecology
Last Updated	April 7, 2006