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The first treatment of choice for people who have prolactinomas is dopamine agonist therapy (DA). This therapy, which includes the use of cabergoline (dostinex) and bromocriptine (parladel) to block the secretion of prolactin. This brings the level of prolactin in the blood down to normal levels and often shrinks the tumor.
After starting the dopamine agonist therapy, patients are followed up at one to three month intervals until they are stable. The dosage given is adjusted on the basis of how prolactin levels change in response. After two years of therapy, an endocrinologist may try to reduce the dosage.
Magnetic resonance imaging should be repeated after three to six months and then again as the patient's symptoms and conditions indicate.
Side Effects for Dopamine Agonist Therapy
This therapy can cause nausea, vomiting and a loss of blood pressure when standing. This can make a person feel light headed or dizzy.
A woman who is pregnant should consider bromoctiptine for the therapy rather than cabergoline. Bromoctiptine has been established as being safe to use during pregnancy, while cabergoline has not.