Prolactinoma medical therapy
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Faizan Sheraz, M.D. [2]
Overview
Medical therapy for prolactinoma includes dopamine agonists. The goal of treatment is to:
- Return prolactin secretion to normal
- Reduce tumor size
- Correct any visual abnormalities
- Restore normal pituitary function
Medical Therapy
Medical therapy for prolactinoma includes dopamine agonists (bromocriptine or cabergoline).
Bromocriptine: 25 mg PO OD for 1 week The dose is gradually increased every 3 to 7 days as needed.
Cabergoline: .25 mg PO twice a week The dose may be increased every 4 weeks as needed, up to 1 mg two times a week.
These drugs shrink the tumor and return prolactin levels to normal in approximately 80 percent of patients. Both drugs have been approved by the U.S. Food and Drug Administration for the treatment of hyperprolactinemia.
Radiation Therapy
Rarely, radiation therapy is used if medical therapy and surgery fail to reduce prolactin levels. Depending on the size and location of the tumor, radiation is delivered in low doses over the course of 5 to 6 weeks or in a single high dose. Radiation therapy is effective about 30 percent of the time.