Effectiveness and Tolerability of Treatment with Cabergoline in Hyperprolactinemic Patients

Cabergoline (CAB) is a new oral dopaminergic compound showing a very long-lastingPRL-lowering activity. The Purpose of this study is to evaluate the efficacy, side effectand tolerability of the treatment with CAB in female hyperprolactinemic patients.We conducted a cross-sectional study on hyperprolactinemic women. The patients underwent the treatment with either Bromocriptine or Cabergoline over a period of 6 months.The initial dose of Cabergoline to be taken by the patients was 0.5 mg once a week andsubsequently increased to 1-2 mg. per week. The initial prescribed dose of Bromocriptinewas 1.25 mg/d, which was subsequently increased to 7.5 mg/d. Then, throughoutthe study, the effectiveness and tolerability of the treatment with both Bromocriptine andCabergoline were evaluated in the patients with hyperprolactinemia.Treatment with Bromocriptine normalized the serum PRL level (< 20 mcg/L) in 48% ofthe patients while in the Cabergoline group, the serum PRL level declined to normal in77.7% of the patients. The comparison of the two groups showed that Cabergoline wassignificantly more effective than Bromocriptine in suppressing PRL secretion (P<0.001).The clinical efficacy of the drugs was clearly demonstrated by the resumption of mensesin 68% and 83.3% of the patients in the Bromocriptine and Cabergoline groups, respectively(P<0.01).Six months after the therapy, a computed tomographic scan was performed on 15 patientswith either microadenoma or macroadenoma. The results showed reduced size of the adenomain 33.3% and 55.5% of the patients in the Bromocriptine and Cabergoline groups,respectively (P<0.01). In the Cabergoline group, side effects were noted in 44.4% of thepatients, but only 11.1% of them discontinued the therapy because of side effects. Thecomparison of the two groups showed that the number of patients requiringdiscontinuation of Bromocriptine was significantly higher (36% vs. 11.1%, P< 0.001).We conclude that CAB is an effective treatment for hyperprolactinemia and often bettertolerated than Bromocriptine. Its efficacy, tolerability, and long duration of action makeit the drug of choice for patients with hyperprolactinemia.