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Dopamine Agonist in Hyperprolactinemia

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Dopamine Agonist in Hyperprolactinemia, Dopamine Agonist in Type 2 Diabetes Mellitus, Bromocriptine, Parlodel, Cabergoline, Dostinex, Bromocriptine QR, Cycloset

  • Indications
  1. Bromocriptine (Parlodel)
    1. Larger safety database than Cabergoline (preferred in women trying to conceive)
    2. Start: 1.25 to 2.5 mg at bedtime
    3. Titrate: Increase by 2.5 mg every 3-7 days up to 15 mg daily
  2. Cabergoline (Dostinex)
    1. Fewer side effects than Bromocriptine
    2. Start: 0.25 orally twice weekly
    3. Titrate: Increase by 0.25 mg every month up to 1 mg twice daily
  1. Bromocriptine QR or Cycloset
    1. Adjunctive with Metformin (and other Oral Hypoglycemic agents)
    2. Dosing
      1. Start 0.8 mg each am
      2. May increase up to weekly by 0.8 mg/day, to a maximum of 4.8 mg daily
    3. Efficacy
      1. May lower Hemoglobin A1C 0.7 to 1.4%
    4. References
      1. Joe Weidner, MD (2018) email communication, received 11/10/2018
      2. Gardner (2013) Endocr Pract 19(1):100-6 +PMID:23337160 [PubMed]
      3. Chamarthi (2017) Postgrad Med 129(4):446-455 +PMID:28374645 [PubMed]
  • Adverse Effects
  1. Nausea or Vomiting
  2. Postural Hypotension
  3. Dizziness
  4. Headache
  5. Sedation
  6. Valvular disorders
    1. Reported with high dose Cabergoline (>4 mg daily)