Lethal cardiovascular complications in patients receiving bromocriptine for ablactation.

Three cases, involving lethal circulatory collapse in patients who received bromocriptine mesylate (Parlodel) for the suppression of lactation, are reported. These accidents expand the scope of severe side-effects that appear to be attributable to a widely used pharmacological approach to ablactation during puerperium. The circumstances that surrounded the maternal deaths in these instances are consistent with previous clinical observations and epidemiological research, suggesting that pregnancy induced hypertension increases the risks for severe untoward effects from bromocriptine. The common denominator in these side-effects appears to be vasospasm; a paradoxical reaction to a drug, the primary pharmacological effect of which is vasodilation. The reported cases came to the attention of the author through medicolegal inquiries. This underlines the potential value of malpractice reviews, as a research tool, for the critical analysis of rare adverse occurrences and unsuspected complications in the clinical practice of medicine.