Prolactinoma Medication

  • Author: Venkatesh Babu Segu, MD, MBBS, DM; Chief Editor: George T Griffing, MD   more...
 
Updated: Apr 14, 2011
 

Medication Summary

The drugs that are effective in the treatment of hyperprolactinemia are DA agonists. DA is the primary physiologic inhibitor of PRL secretion; however, DA is not used for treatment, because it does not cross the blood-brain barrier. Therefore, drugs that mimic the action of DA on the lactotrophs are used in the medical management of prolactinoma.

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Dopamine agonists

Class Summary

Salutary effects on inhibition of PRL synthesis and secretion. These agents are also effective for reducing tumor size.[24]

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Bromocriptine (Parlodel)

 

DOC for prolactinoma. Bromocriptine is the DA-receptor agonist with the longest record of use for hyperprolactinemia.

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Cabergoline (Dostinex)

 

Now available in the United States for use in prolactinoma. Cabergoline is a long-acting DA agonist with efficacy and adverse effects that are similar to those of BEC.

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Pergolide (Permax)

 

Pergolide withdrawn from US market. Potent DA-receptor agonist at D1 and D2 receptor sites. Pergolide is approximately 10-1000 times more potent than BEC on a mg-per-mg basis.

This agent inhibits the secretion of PRL; it causes a transient rise in serum concentrations of GH and decreases serum concentrations of luteinizing hormone.

Quinagolide (CV 205-502)

 

Specific DA-receptor (type 2) agonist with a relatively long duration of action. Quinagolide is not available in the United States.

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Contributor Information and Disclosures
Author

Venkatesh Babu Segu, MD, MBBS, DM  Endocrinologist, Medical Specialists Centers of Indiana, Munster

Venkatesh Babu Segu, MD, MBBS, DM is a member of the following medical societies: American Association of Clinical Endocrinologists, American Diabetes Association, and Endocrine Society

Disclosure: Nothing to disclose.

Specialty Editor Board

Robert A Gabbay, MD, PhD  Associate Professor of Medicine, Division of Endocrinology, Diabetes and Metabolism, Laurence M Demers Career Development Professor, Penn State College of Medicine; Director, Diabetes Program, Penn State Milton S Hershey Medical Center; Executive Director, Penn State Institute for Diabetes and Obesity

Robert A Gabbay, MD, PhD is a member of the following medical societies: American Association of Clinical Endocrinologists, American Diabetes Association, and Endocrine Society

Disclosure: Novo Nordisk Honoraria Speaking and teaching; Merck Honoraria Speaking and teaching

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Senior Pharmacy Editor, eMedicine

Disclosure: eMedicine Salary Employment

Yoram Shenker, MD  Chief of Endocrinology Section, Veterans Affairs Medical Center of Madison; Interim Chief, Associate Professor, Department of Internal Medicine, Section of Endocrinology, Diabetes and Metabolism, University of Wisconsin at Madison

Yoram Shenker, MD is a member of the following medical societies: American Heart Association, Central Society for Clinical Research, and Endocrine Society

Disclosure: Nothing to disclose.

Mark Cooper, MBBS, PhD, FRACP  Head, Diabetes & Metabolism Division, Baker Heart Research Institute, Professor of Medicine, Monash University

Disclosure: Nothing to disclose.

Chief Editor

George T Griffing, MD  Professor of Medicine, St Louis University School of Medicine

George T Griffing, MD is a member of the following medical societies: American Association for the Advancement of Science, American College of Medical Practice Executives, American College of Physician Executives, American College of Physicians, American Diabetes Association, American Federation for Medical Research, American Heart Association, Central Society for Clinical Research, Endocrine Society, International Society for Clinical Densitometry, and Southern Society for Clinical Investigation

Disclosure: Nothing to disclose.

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