Endocrine: Dopamine-receptor agonists

Question 1

Bromocriptine is used for what? (5)

Answer 1

1. Treatment of galactorrhoea, infertility and hypogonadism.
2. Treatment of prolactinomas (when it reduces both plasma prolactin concentration and tumour size).
3. Acromegaly as it inhibits the release of growth hormone but somatostatin analogues such as octreotide are more effective.
4. Parkinson’s disease
5. suppression/prevention of lactation.

Question 2

What is the important safety information regarding Bromocriptine?

Answer 2

1. Fibrotic reactions:
   Associated with pulmonary, retroperitoneal, and pericardial fibrotic reactions.

ESR, CXRAY and monitored for chest pain etc.

2. Impulse control disorders

Question 3

Quinagolide has actions and uses similar to that of ergot-derived dopamine agonists, but it differs how?

Answer 3

Side effects are different.

Question 4

Although bromocriptine and cabergoline are licensed to suppress lactation, are they used routinely?

Answer 4

Although bromocriptine and cabergoline are licensed to suppress lactation, they are not recommended for routine suppression (or for the relief of symptoms of postpartum pain and engorgement) that can be adequately treated with simple analgesics and breast support.

Question 5

Of the two licensed options for suppressing lactation that are dopamine receptor agonists, which is the preferred option?

Answer 5

If a dopamine-receptor agonist is required, cabergoline is preferred. Quinagolide is not licensed for the suppression of lactation.