• Half-life: 2-8 hours (short)

• Extensive first-pass hepatic metabolism

Dosing

• Starting: 1.25 mg at bedtime with snacks

• After 1 week: morning dose of 1.25 mg may be added

Indications

• For acromegaly at high doses

• For Parkinson’s disease at high doses

Indications

First line of treatment for patients with prolactinomas who wish to become pregnant

Indications

Decreases tumor size in >50% of patients

Toxicity

• Nausea, vomiting

• Headache

• Postural hypotension

Indications

• Less common: nasal congestion, psychosis, hallucinations, nightmare, insomnia

• Ergot derivative

• Least expensive

Dosing

• Starting: 0.25 mg at bedtime

• Increased gradually to a max daily dose of 0.5 mg

Indications

• Treatment of Parkinson’s disease

• Hyperprolactinemia (off-label)

• Longest duration of action

• Half-life: 65 hours

Has higher affinity and 4x greater selectivity for the D2 receptor than Bromocriptine

Dosing

• Initiated at 0.25 mg twice weekly or 0.5 mg once weekly orally or vaginally

Indications

Treatment of hyperprolactinemia

Toxicity

• Lower tendency to induce nausea, hypotension, and dizziness

• Safe in pregnant women with macroadenomas

• Newer non-ergot derivative with high D2 receptor affinity for hyperprolactinemia

• Half-life: 22 hours

Dosing

• Once daily dose of 0.1-0.5 mg/day

DOPAMINE AGONISTS

Bromocriptine

Cabergoline

DOPAMINE AGONISTS

Quinagolide

Pramipexole

Ropinirole

- Newer, non-ergot D2 agonist

- Used in Parkinson’s disease

- Reported to interfere with lactation, but are NOT approved for use in hyperprolactinemia