Cabergoline was better tolerated than bromocriptine with 3 of women discontinuing cabergoline versus 12 stopping bromocriptine due to intolerance. Gastrointestinal symptoms were significantly less frequent, less severe, and of shorter duration in cabergoline treated patients.
Cabergoline stimulates D2 (a specific type of dopamine receptor) receptors in the anterior pituitary gland and prevents the production of the hormone prolactin. The approval of cabergoline has gradually decreased the use of bromocriptine (Cycloset) for the treatment of hyperprolactinemias (abnormally high levels of prolactin.
This drug may make you dizzy. Do not drive, use machinery, or do any activity that requires alertness until you are sure you can perform such activities safely. Limit alcoholic beverages.Do not double the dose to catch up. Storage Store at room temperature between 68-77.
Doses were halved during the first week. Since a possible dose-related effect was observed for nausea only, the four cabergoline treatment groups have been combined. The incidence of the most common adverse events during the placebo-controlled study is presented in the following table.
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Get medical help right away if you have any serious side effects, including: chest pain, signs of kidney problems (such as change in the amount of urine, lower back/flank pain). A very serious allergic reaction to this drug is rare.Pregnancy: available preliminary data indicates a.
Prolactinomas occur in both men and women but are more commonly diagnosed in women who are less than 50 years than in older women or men. Prolactinomas can usually be treated successfully with medication alone. The upper normal value for serum prolactin in most laboratories is about 20 ng/mL (20 mcg/L SI units). In premenopausal women, ovarian function returns, estrogen levels increase, menstrual periods return, and fertility returns.
Furthermore, some small adenomas (microadenomas) cannot be detected by MRI, and not all adenomas secrete prolactin or other hormones. Evaluating other causes Other causes of a high blood prolactin level include certain medications, especially those used to treat psychiatric conditions and estrogens taken by mouth, and.
Women When a high blood prolactin concentration interferes with the function of the ovaries in a premenopausal woman, secretion of estradiol, the main estrogen, decreases. Symptoms include irregular or absent menstrual periods, infertility, menopausal symptoms (hot flashes and vaginal dryness) and, after several years, osteoporosis.
When the adenoma affects vision, improvement in vision may begin within days of starting treatment. If the prolactin level decreases to normal or near normal levels, the effects of the elevated prolactin are reversed.
Because other conditions can cause an elevated prolactin, those causes must be evaluated as well. Measurement of prolactin The prolactin level can be measured in a single blood sample. The result can range from slightly elevated to a thousand times the upper limit of normal.
The prolactin levels decreased by 93.6 with normal levels obtained in 73 of patients at doses of mg per week. Three of 5 patients who had failed to normalize prolactin on prior dopamine agonists achieved normal levels.
The authors concluded that cabergoline is more effective and better tolerated than bromocriptine in women with hyperprolactinemic amenorrhea. In a United States multicenter study of patients with macroprolactinomas, we also found cabergoline to he effective and well tolerated.
Patient compliance is high, related to the few mild side effects and once-weekly dosing. References: Webster J, et al. 1994. Comparison of cabergoline and bromocriptine in the treatment of hyperprolactinemic amenorrhea.
Psychiatric effects and severe constipation sometimes occur, but they are uncommon. Unfortunately, starting with a low dose does not prevent them, and if they occur, they do not seem to get better with time.
It may be effective for treating prolactinomas that are resistant to bromocriptine. For all these reasons, cabergoline is the best first choice, except in women who are trying to become pregnant.
Medication lowers the prolactin level in the blood substantially, often to normal, and also usually reduces adenoma size. However, a minority of these adenomas do not respond to medication and must be treated with surgery or, less commonly, radiation therapy.
N Engl J Med. Biller BMK, et al. 1996. Treatment of prolactin secreting macroadenomas with once weekly agonist cabergoline. J Clin Endocrinol Metab. Updated BS and KKM.
A total of 459 women, the majority of whom had microprolactinomas or idiopathic hyperprolactinernia, were treated with either cabergoline or bromocriptine in a double blind study for 8 weeks, followed by an open label study for 16 weeks during which dose adjustments were made according.