CABERGOLINE - A NEW DRUG FOR THE TREATMENT OF HYPERPROLACTINEMIA

Recent clinical studies performed with the novel long-acting dopamine agonist cabergoline in the inhibition and suppression of puerperal lac tation and in the treatment of hyperprolactinaemic disorders are revie wed, Inhibition of puerperal lactation is achieved with a single 1.0 m g oral administration of the drug, with better efficacy and tolerabili ty results in comparison with bromocriptine, 2.5 mg twice daily for 14 days; 1.0 mg cabergoline (given as 0.25 mg twice daily for 2 days to minimize adverse events) is also effective and well tolerated for the suppression of established lactation, In the treatment of hyperprolact inaemic amenorrhoea, 1-2 mg weekly doses of cabergoline (given on a tw ice weekly schedule) compare favourably with 5-10 mg daily bromocripti ne (given on a twice daily schedule) both for biochemical (normalizati on of serum prolactin concentrations) and clinical efficacy (resumptio n of ovulatory cycles) as well as for tolerability, The results of the se double-blind, reference therapy-controlled studies have been confir med by several open studies, that also showed tumour shrinkage in most patients with macroprolactinomas and many patients with microprolacti nomas. Persistence of normal or at least lower than pretreatment serum prolactin concentrations for several months after cabergoline withdra wal, together with persistence of cyclic ovulatory menses, has been al so demonstrated, It is therefore suggested that cabergoline should bec ome the drug of choice when inhibition or suppression of puerperal lac tation is required and for the treatment of hyperprolactinaemic disord ers.