Prolactinoma medical therapy: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{Prolactinoma}} | {{Prolactinoma}} | ||
{{CMG}} {{AE}}{{Faizan}} | {{CMG}} {{AE}}{{Anmol}},{{Faizan}} | ||
==Overview== | ==Overview== | ||
Medical therapy for prolactinoma includes [[dopamine agonists]] (either [[Cabergoline]] or [[Bromocriptine]]). The goal of treatment is to return [[prolactin]] secretion to normal, reduce [[tumor]] size, correct any [[visual]] abnormalities and restore normal [[pituitary]] function. | Medical therapy for prolactinoma includes [[dopamine agonists]] (either [[Cabergoline]] or [[Bromocriptine]]). | ||
The goal of treatment is to return [[prolactin]] secretion to normal, reduce [[tumor]] size, correct any [[visual]] abnormalities and restore normal [[pituitary]] function.<ref name="pmid21296991">{{cite journal| author=Melmed S, Casanueva FF, Hoffman AR, Kleinberg DL, Montori VM, Schlechte JA et al.| title=Diagnosis and treatment of hyperprolactinemia: an Endocrine Society clinical practice guideline. | journal=J Clin Endocrinol Metab | year= 2011 | volume= 96 | issue= 2 | pages= 273-88 | pmid=21296991 | doi=10.1210/jc.2010-1692 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21296991 }} </ref> | |||
==Medical Therapy== | ==Medical Therapy== | ||
Medical therapy for prolactinoma includes [[dopamine]] agonists ([[ | Medical therapy for prolactinoma includes [[dopamine]] agonists ([[cabergoline]] or [[bromocriptine]]). | ||
* Preferred regimen: [[Cabergoline]]: 0.25 mg PO twice weekly | * Preferred regimen: [[Cabergoline]]: 0.25 mg PO twice weekly or 0.5 mg PO once weekly. | ||
:* The dose may be gradually increased every 4 weeks as needed, up to 1 mg twice weekly. | :* The dose may be gradually increased every 4 weeks as needed, up to 1 mg twice weekly. | ||
* Alternative regimen: [[Bromocriptine]]: 25 mg PO once daily for 1 week | * Alternative regimen: [[Bromocriptine]]: 1.25 mg PO once daily at bedtime for 1 week | ||
:* The dose may be gradually increased every 3 to 7 days as needed. | :* The dose may be gradually increased every 3 to 7 days as needed. | ||
These [[drug]]s reduce the [[tumor]] size and return [[prolactin]] concentration to normal in approximately 80% of patients. Both drugs have been approved by the U.S Food and Drug Administration for the treatment of hyperprolactinemia. | These [[drug]]s reduce the [[tumor]] size and return [[prolactin]] concentration to normal in approximately 80% of patients. Both drugs have been approved by the U.S Food and Drug Administration for the treatment of hyperprolactinemia. | ||
Revision as of 19:43, 21 July 2017
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Anmol Pitliya, M.B.B.S. M.D.[2],Faizan Sheraz, M.D. [3]
Overview
Medical therapy for prolactinoma includes dopamine agonists (either Cabergoline or Bromocriptine).
The goal of treatment is to return prolactin secretion to normal, reduce tumor size, correct any visual abnormalities and restore normal pituitary function.[1]
Medical Therapy
Medical therapy for prolactinoma includes dopamine agonists (cabergoline or bromocriptine).
- Preferred regimen: Cabergoline: 0.25 mg PO twice weekly or 0.5 mg PO once weekly.
- The dose may be gradually increased every 4 weeks as needed, up to 1 mg twice weekly.
- Alternative regimen: Bromocriptine: 1.25 mg PO once daily at bedtime for 1 week
- The dose may be gradually increased every 3 to 7 days as needed.
These drugs reduce the tumor size and return prolactin concentration to normal in approximately 80% 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 concentration. Depending on the size and location of the tumor, radiation is delivered either in low doses over the course of 5 to 6 weeks or in a single high dose. Radiation therapy is effective in approximately 30% of cases.
References
- ↑ Melmed S, Casanueva FF, Hoffman AR, Kleinberg DL, Montori VM, Schlechte JA; et al. (2011). "Diagnosis and treatment of hyperprolactinemia: an Endocrine Society clinical practice guideline". J Clin Endocrinol Metab. 96 (2): 273–88. doi:10.1210/jc.2010-1692. PMID 21296991.