Comparison of the Effects of Cabergoline and Bromocriptine on Prolactin Levels in Hyperprolactinemic Patients.

Abstract

Objective It is well knownthat bromocriptine has a suppressive effect on the prolactin release in hyperprolactinemic patients. But it also has someadverse effects. The new, long-acting dopaminergic drug, cabergoline, has been reported to be an effective agent in these patients. However, there are relatively few reports comparing the beneficial and adverse effects of these drugs in the treatment of hyperprolactinemic patients. Therefore, here we studied and compared the efficacy and tolerability of cabergoline with bromocriptine in hyperprolactinemic patients.Patients Seventeen patients (7 with microprolactinoma, 4 with macroprolactinoma, 6 with idiopathic hyperprolactinemia) were given bromocriptine at a dose of 2.5 mg (or 5 mgfor macroprolactinomas) twice daily, and 17 patients (8 with microprolactinoma, 4 with macroprolactinoma, 5 with idiopathic hyperprolactinemia) were given cabergoline at a dose of 0.5 mg twice weekly for 12 weeks. Results At the end of the study, the prolactin reduction was significantly greater in the cabergoline group than in the bromocriptine group (-93 vs. -87.5%, respectively, p<0.05). Normalization of prolactin levels was achieved in 10 of 17 patients (59%) in the bromocriptine group, and in 14 of 17 patients (82%) in the cabergoline group (p=0.13).Twopatients (50%) with macroprolactinoma in the bromocriptine group and three patients (75%) with macroprolactinoma in the cabergoline group demonstrated a normalization of their serum prolactin levels. Adverse events were noted in 53%of bromocriptine patients and in 12% of cabergoline patients (p<0.01). Conclusion These data indicate that cabergoline is a very effective agent for lowering the prolactin levels in hyperprolactinemic patients and that it appears to offer considerable advantage over bromocriptine in terms of efficacy and tolerability.

Cabergoline versus bromocriptine in the treatment of hyperprolactinemia: a systematic review of randomized controlled trials and meta-analysis

“…With regards to representations of meta-analyses with only one study [24], there was no statistically significant difference in any of the …”

“…Fifteen of them were excluded due to the following reasons: one randomized study compared cabergoline versus placebo [9] and other randomized study compared different doses of cabergoline [10]; five references were cases series [11][12][13][14][15]; four were only controlled studies [16][17][18][19]; three were retrospectives series [5,20,21] and; one was a cohort study [22]. Therefore, four publications were included in the review and in the final analysis [23][24][25][26].…”

“…Sabuncu et al [24] evaluated 34 patients of both genders, mean age of 21 and 20 years in the bromocriptine and cabergoline groups, respectively. In this study, the dose of bromocriptine was 5 mg/day in microprolactinomas and 10 mg/day in macroprolactinomas, while the cabergoline dose was 1.0 mg/week, independent of the tumor size, and the patients were followed during 12 weeks.…”

“…Sabuncu et al [24] analyzed clinical symptoms, adverse effects and serum prolactin levels. Pascal-Vigneron et al [25] evaluated the total or partial normalization of prolactin levels, clinical and biochemical parameters (menstruation, ovulatory cycle and pregnancy) and adverse effects.…”

Estados hiperprolactinêmicos: inter-relações com o psiquismo

“…A redução dos prolactinomas também ocorre com o tratamento com bromocriptina (Passos et al, 2002). A cabergolina, mais recente agonista dopaminérgico, apresenta eficácia comparada à da bromocriptina e com maior tolerabilidade pelos reduzidos efeitos colaterais (Webster et al, 1994;Verhelst et al, 1999;Sabuncu et al, 2001 …”