DOPAMINE AGONISTS AND MACROLIDES

Erythromycin markedly increases bromocriptine plasma levels (by more than 4-fold), and a case of toxicity has been reported. Bromocriptine toxicity has also occurred in a patient given josamycin. Clarithromycin increases the bioavailability of cabergoline by about 2- to 4-fold.
Concurrent use should be well monitored if macrolides that affect CYP3A4 are given (e.g. clarithromycin, erythromycin, telithromycin, see macrolides, for further details). It has been suggested that the bromocriptine dose may need to be reduced by 50% to avoid toxicity.
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