How can hyperprolactinaemia be treated? i-checksum="38929" ends

Since 1976, bromocriptine, which inhibits prolactin secretion by the pituitary, has been the drug of choice (Q6.21) and ovulation rates of 90 per cent and pregnancy rates of 75 per cent have been reported. There would not appear to be any adverse effects on pregnancy outcome following cessation of bromocriptine or even if bromocriptine is continued throughout pregnancy; we advise that treatment be stopped as soon as pregnancy is confirmed.

The standard dose of bromocriptine is 2.5mg twice daily although much higher doses are sometimes required to achieve normal prolactin levels. Side effects frequently occur and include headache, nausea and diarrhoea. These problems can be reduced by prescribing a gradually escalating regime starting with half a tablet at night and increasing at four day intervals. Occasionally the vaginal route of administration proves to be better tolerated.

Recently there have been some new agents that may prove to be better tolerated than bromocriptine. Cabergoline may become the drug of choice although it is currently relatively expensive.

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