Patients with few symptomsfor example, an occasional missed menstrual periodmay not require treatment. These patients tend to have tumours that do not grow and tend to have mild hyperprolactinemia that does not increase.
Side-effects include milk loss post-partum 4. Recommended dose for estrus induction is 10 - 20 IU/kg/day intramuscularly for 5 consecutive days, followed by an additional single injection of 25 IU/kg of human chorionic gonadotrophin on the fifth day.
Cabergoline at lower doses than those employed in Parkinson s disease is widely used in patients with prolactinomas, because of its high efficacy and tolerability; however, its safety with regard to cardiac valve disease is unknown.
Side effects: Nausea, headache, dizziness and constipation.Research. The researchers now plan to carry out trials to investigate whether cabergoline will have the same effect on women. Another medical study by the Federico University, in Naples, Italy published in the European Journal of Endocrinology showed cabergoline.
Stimulating dopamine receptors reduces the production of the pituitary hormone prolactin, reduces the levels of growth hormone in people with acromegaly, and improves symptoms of Parkinson s. The FDA approved bromocriptine on June 28, 1978.Your doctor may start you on 0.375 mg and adjust your.
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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. 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.
Figure 1. The decline in serum prolactin level in a patient treated with cabergoline. The dotted line indicates the normal range. Webster, et al. conducted a European study comparing cabergoline to bromocriptine in the treatment of hyperprolactinemic amenorrhea.
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.
Side effects were minimal, with no patients discontinuing the medication due to intolerance. Subsequent studies have confirmed the effectiveness of cabergoline for the treatment of prolactinomas, with few side effects in most patients.
Fifteen patients (8 women, 7 men) ages 18-76 years were followed in an open label, 48-week dose escalation trial of cabergoline administered once weekly. Eleven patients had received prior therapy with other dopamine agonists.
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.
Seventy-two percent of cabergoline-treated women attained ovulatory cycles or became pregnant during therapy in contrast to only 52 of those treated with bromocriptine. Amenorrhea persisted in 7 of women treated with cabergoline versus 16 of women treated with bromocriptine.
It is now considered first-line therapy, except in patients with contraindications, such as in women who are pregnant or desire to become pregnant, and patients with psychiatric disease. There have also been studies to suggest that in a minority of patients, impulsivity and risk-taking behaviors.
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.
Newsletter Archive by Beverly M.K. Biller, M.D. The most interesting feature of cabergoline in terms of patient comphance is its extremely long half-life. Most patientscan be treated with a single weekly dose, is in contrast to the 1-3 times daily administration required for brornocriptine.