Long-term treatment with cabergoline, a new long-lasting ergoline derivate, in idiopathic or tumorous hyperprolactinaemia and outcome of drug-induced pregnancy

Abstract

Cabergoline (CAB), a new long-acting ergoline derivative, was shown to be very effective in reducing PRL levels in normal volunteers and in hyperprolactinemic patients. We evaluated the hormonal changes after discontinuation of long-term therapy with CAB as well as the safety of drug exposure during pregnancy both for mothers and babies. We therefore studied 48 patients (47 females and one male) with pathological hyperprolactinaemia (mean +/- SE, 117.2 +/- 15.2: median 73.2 micrograms/l), treated for 1-82 months (mean +/- SE, 28.3 +/- 3; median 18). After long-term treatment, CAB was withdrawn in 11 patients and PRL levels were persistently normal for almost 15 days and significantly lower (p < 0.05) than basal at 30, 45, 60, 90, 120 days. Three patients had normal PRL levels still at 45 days after treatment discontinuation. Nine patients became pregnant after 1-37 months (mean 12.4) of therapy. In two patients the pregnancy was interrupted spontaneously in one case and voluntarily in the other. In all but one patients after delivery or three-month breast feeding, PRL levels trended towards reduction. In two cases (one with microadenoma and one with idiopathic hyperprolactinaemia) PRL remained in the normal levels for 1-3 years after delivery. In conclusion CAB is able to inhibit plasma PRL levels for long time (up to 120 days) after withdrawal in patients with pathological hyperprolactinaemia treated with long-term therapy.

Cabergoline in the Treatment of Hyperprolactinemia: A Study in 455 Patients

“…However, recent data showed no detrimental effects of cabergoline on fetal outcome (17)(18)(19). In this study, we report 25 uneventful deliveries for patients treated with cabergoline at the time of conception.…”

Absence of major fibrotic adverse events in hyperprolactinemic patients treated with cabergoline

“…The long-acting ergot-derived D2-selective dopamine agonist cabergoline is frequently prescribed in this condition because of superiority in terms of both tolerability and efficacy compared with various other agents (1,2). Cabergoline is also used in acromegaly as an adjunctive agent for lowering GH levels (3).…”

Targeting the vascular endothelial growth factor system to prevent ovarian hyperstimulation syndrome

“…Doses of dopamine agonists much lower than those used in the tumour model (Mueller et al, 1976) are sufficient to activate the Dp-r2 pathway, since they decrease prolactin secretion by the pituitary gland (Shelesnyak, 1955). Thus, low dose dopamine agonists are employed to treat hyperprolactinemia in humans (Mornex et al, 1978;Bigazzi et al, 1979;Robert et al, 1996;Ciccarelli et al, 1997;Liu and Tyrrell, 2001). Interestingly, these low doses do not produce any anti-angiogenic activity: states of high level VEGR-2-dependent vascular activity, such as corpus luteum physiology (Zimmermann et al, 2001a) or pregnancy development (Pauli et al, 2005), are not affected (Mornex et al, 1978;Bigazzi et al, 1979;Robert et al, 1996;Ciccarelli et al, 1997;Liu and Tyrrell, 2001).…”