Bromocriptine mesylate, a long-acting dopamine agonist, is a semisynthetic ergot-derived alkaloid that has been used clinically since 1969.1 This drug has been effective in the management of patients with hyperprolactinemia with or without a demonstrable prolactin-secreting adenoma, growth hormone-secreting pituitary adenomas, postpartum lactation, and Parkinson's disease.2 The drug also has been safely used in the management of pregnant women harboring prolactin-secreting pituitary tumors.3 In addition, the drug has been tried in some patients with luteal-phase insufficiency, idiopathic edema, premenstrual tension syndrome, and hepatic encephalopathy, although the data supporting the use of the drug in these latter conditions either are incomplete or require substantiation.1
During the 20 years of clinical experience, bromocriptine has been found to be remarkably free of major side effects.4 Patients commonly develop nausea, occasionally with abdominal cramps and vomiting, and postural hypotension at the time therapy is initiated. These side effects can