LONG-ACTING REPEATABLE BROMOCRIPTINE IN P ROLONGED TREATMENT OF PROLACTINOMAS

BACKGROUND: The presentations of intravenous or depot bromocriptine (b romocriptine LA or long acting, Pariodel LA(R) and bromocriptine LAR o r long acting repeteable, Parlodel LAR(R)) have improved the efficacy and the tolerance of oral bromocriptine. In contrast to bromocriptine LA, bromocriptine LAR may be repeatedly administered intramuscularly. METHODS: Five patients with macroprolactinoma and 4 with microprolacti noma were included in the study. A 50 mg bottle of bromocriptine LAR w as administered intramuscullarly every month, over a minimum period of 6 months. PRL was determined prior to the study, 1, 3, 7, 14, and 28 days following the initial dose of bromocriptine and thereafter with m onthly periodicity. RESULTs: The PRL values decreased in those patient s with macroprolactinomas following the administration of bromocriptin e LAR; in 2 patients the monthly dosis of bromocriptine LAR was increa sed to 100 mg since the month after the initial dose PRL remained grea ter than 200 ng/ml with serum RPL normalizing in most of the patients at 6 months of treatment. In two of the three patients who presented v isual changes a clear improvement was observed and in all the cases a reduction in the size of the macroprolactinoma was found upon CAT cont rol at 6 months. The PRL values also decreased in the patients with mi croprolactinomas following administration of bromocriptine LAR, althou gh the response was not as homogeneous as in the patients with macropr olactinomas due to that at 6 months 2 patients continued to have sligh tly elevated serum PRL levels. The microadenoma persisted in the contr ol CAT at 6 months except in one case. Local and general tolerance to bromocriptine LAR was very good. CONCLUSIONS: This study indicates goo d tolerance to bromocriptine LAR, being a therapeutic option in the tr eatment of macroprolactinomas.