What medicine should I take for high prolactin

Patients with high prolactin levels will usually cause many unnecessary complications. In order to prevent this from happening, they need to relieve the symptoms by taking medication. This can speed up the recovery of qi and blood in the body and promote physical health. In principle, patients with high prolactin levels must master the correct method of medication. The specific type of medication needs to be selected and judged based on the patient's condition, and they cannot take medication privately according to the situation.

Treatment points (I) Principle of mass

The principle of treatment is that hyperprolactinemia should be treated promptly after diagnosis, mainly with drug therapy, supplemented by surgery and radiotherapy.

(II) Specific treatment methods

1. Medication

(1) Bromocriptine: Start with a low dose of 1.25 mg/d, increase the dose every 3 days, and gradually increase to 2.5 mg each time in 7-10 days, twice a day, with meals, and measure PRL every 1-2 months. Except for patients with very large tumors, the maximum dose is generally 7.5 mg, which can be taken for a long time. Once the disease is under maximum control, the dose of bromocriptine can be gradually reduced to a small dose. Some patients have tolerated bromocriptine treatment for up to 10 years very well. Vaginal administration of bromocriptine can significantly reduce gastrointestinal reactions, and the dosage is the same as that of oral administration.

(2) Pergolide mesylate: single dose of 50-150ug/d, and then gradually increase the dose as needed. This drug works similarly to bromocriptine.

(3) Octahydrobenzylquinoline (Nogonin): It has a stronger PRL inhibitory effect than bromocriptine, and has relatively fewer and milder adverse reactions. For the first 3 days, 25ug/d, then 50ug/d, and 75ug/d from the 7th day onwards. The dose can then be gradually increased as needed. The maintenance dose is generally 75-150ug/d. For a few patients, it can be increased to 1mg/d. The dose is given once a day before bedtime. The duration of use is similar to that of bromocriptine, but this drug is not FDA-approved in the United States for the treatment of high PRL.

(4) Cabergoline: a dopamine (DA) agonist with a very long half-life. It only needs to be administered 1-2 times a week, 0.5-2 mg each time. It has a stronger PRL-lowering effect than bromocriptine and has fewer adverse reactions. It can also be administered vaginally.

(5) Vitamin B6: 300-600 mg/d, taken orally in 3 divided doses, inhibits PRL secretion through the central nervous system.

2. Surgical treatment is applicable to: ① when pituitary tumors produce obvious compression symptoms; ② when drug treatment is ineffective. The goal is to reduce the size of very large tumors, not to cure them. Taking bromocriptine for a short period of time before surgery can shrink the tumor and facilitate surgery.

3. Radiotherapy is used as a complementary therapy for patients who are unsatisfactory with drug treatment or whose PRL cannot be reduced to normal after surgery and have residual tumor tissue, or for patients who are not suitable for surgery or refuse surgery for other reasons. Normalization of PRL levels after radiotherapy usually occurs 5-15 years after radiotherapy. The main adverse reaction of radiotherapy is hypopituitarism, with an incidence of 93%; other complications include secondary malignant transformation, cerebrovascular accident, radiation-induced brain damage, etc.