What medicine is good for hyperprolactinemia

Hyperprolactinemia is a very common disease that seriously affects the physical and mental health of patients and makes them very distressed. Therefore, its treatment method is of concern to patients. So what medicine is good for hyperprolactinemia?

1. Quinajiaolin (Nuoguoning):

It is a non-ergot alkaloid dopamine agonist and a new generation of specific, highly effective and long-acting anti-PRL drugs. The plasma half-life is 22h. CV205-502 is a powerful dopamine receptor (D1, D2) agonist. It inhibits PRL production at the level of PRL cells in the hypothalamus-pituitary axis by enhancing dopamine receptor function. It has strong and lasting effects, good tolerance and mild side effects. Headache, dizziness, nausea, vomiting, etc. may occur at high doses. It has no adverse effects on heart, lung, liver, kidney and blood functions. Patients tolerate quinacrine well, and the chance of discontinuation due to adverse reactions is 7%, which is better than bromocriptine.

Quinacolin is used to treat patients who are intolerant to bromocriptine, those who are ineffective in treatment, and those who have relapsed. The dosage range is 0.04-0.1 mg/d. The therapeutic effect is dose-related. For example, oral administration of 0.04 mg/d reduces PRL by >50% and lasts for 8 hours; oral administration of 0.06 mg/d reduces PRL by 66% and lasts for 24 hours. It still reduces PRL by 47% after 36 hours, and the sleep PRL peak disappears. Quinacolin inhibits TSH synthesis and release, but does not affect FSH, LH, T. and adrenal axis function. Quinacolin increases the release of GH-RH and inhibits the release of GH-IH. Plasma GH temporarily increases after taking the drug, but GH remains normal at night.

Quinacolin treatment should start with a low dose, 0.025 mg per day for the first 3 days, 0.050 mg/d for the next 3 days, and then 0.075 mg/d. The dose is then adjusted based on the treatment response, reaching 0.1 mg/d in 3 months. Prolactin levels begin to decrease in most patients after 1 month of treatment, and patients tolerate it well.

After treatment with quinacrine, the average volume of pituitary giant adenomas shrank by 324 mm3 (46%), and that of microadenomas shrank by 73 mm3 (57%). The average plasma prolactin level of giant adenomas decreased by 163 μg/L (65%), and that of microadenomas decreased by 113 μg/L (73%). 107 cases were observed in 27 medical centers in France, and significant clinical efficacy appeared after 2 years of treatment. Schultz (2000) observed (50 cases, dose of 100 μg/d, average treatment of 31.6 months) that the rate of prolactin recovery to normal was 82% for non-tumor hyperprolactinemia, 73% for microadenomas, and 67% for giant adenomas. The rate of tumor volume reduction was 55% for microadenomas and 75% for giant adenomas, and vision improved or returned to normal. The pregnancy rate was 26%. Nobels (2000) found that high-dose quinacridone could not effectively inhibit the growth of non-functional pituitary tumors, and its effect may be related to the expression of dopamine receptors in the tumor.

DiSarno (2000) first used quinagoline (0.075-0.6 mg/d, 12 months), and then used cabergoline (0.5-1.5 mg/time, twice a week, 12 months). The rate of prolactin recovery to normal was 100% for microadenomas and 87.5% for macroadenomas. The tumor volume reduction rate was more than 80%, 21.7% for microadenomas and 25% for macroadenomas. All patients had recurrence of hyperprolactinemia 15 to 60 days after stopping quinagoline. Both drugs were well tolerated. Some patients may experience nausea and postural hypotension in the first week of quinagoline treatment, but the symptoms disappeared naturally in the third week of treatment.

2. Thiopropene:

It is a new generation of safe, inexpensive, well-tolerated anti-prolactin drugs. It is the first choice for the treatment of giant pituitary adenomas. The dosage is 0.05-0.5 mg/d. After 12 months of treatment (3-36 months), PRL decreased by 88%, 86% of pituitary tumors shrank by 25%, 77% shrank by more than 50%, and 45% shrank by more than 75%. Most patients' visual fields returned to normal (Orrego, 2000).

The above drugs have good therapeutic effects on the treatment of hyperprolactinemia.