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The magnitude that prolactin is elevated can be used as an indicator of the etiology of the hyperprolactinemia diagnosis. Prolactin levels over 250 ng/mL may suggest prolactinoma. Prolactin levels less than 100 ng/mL may suggest drug-induced hyperprolactinemia, macroprolactinemia, nonfunctioning pituitary adenomas, or systemic disorders.
Prolactin inhibitors are mainly used to treat hyperprolactinemia (high prolactin levels). [1] Agonists of the dopamine D 2 receptor such as bromocriptine and cabergoline are able to strongly suppress pituitary prolactin secretion and thereby decrease circulating prolactin levels, and so are most commonly used as prolactin inhibitors. [1]
[74] [75] After two weeks of repeated administration (30 mg/day in both cases), the increase in prolactin levels produced by domperidone was reduced (53.2 ng/mL; 6.6-fold above baseline), but the increase in prolactin levels produced by metoclopramide, conversely, was heightened (179.6 ng/mL; 24.3-fold above baseline).
Prolactin has a wide variety of effects. It stimulates the mammary glands to produce milk (): increased serum concentrations of prolactin during pregnancy cause enlargement of the mammary glands and prepare for milk production, which normally starts when levels of progesterone fall by the end of pregnancy and a suckling stimulus is present.
Mammoplasia can be an effect or side effect of various drugs, including estrogens, [2] [13] antiandrogens such as spironolactone, [14] cyproterone acetate, [15] bicalutamide, [16] [17] and finasteride, [18] [19] growth hormone, [20] [21] and drugs that elevate prolactin levels such as D 2 receptor antagonists like antipsychotics (e.g ...
A prolactinoma is a tumor of the pituitary gland that produces the hormone prolactin.It is the most common type of functioning pituitary tumor. [1] Symptoms of prolactinoma are due to abnormally high levels of prolactin in the blood (hyperprolactinemia), or due to pressure of the tumor on surrounding brain tissue and/or the optic nerves.
Cabergoline, sold under the brand name Dostinex among others, is a dopaminergic medication used in the treatment of high prolactin levels, prolactinomas, Parkinson's disease, and for other indications. [3] It is taken by mouth. Cabergoline is an ergot derivative and a potent dopamine D 2 receptor agonist. [4]
Prolactin-lowering medication has also been reported to reduce the risk of recurrence. [23] In cases of drug-induced hyperprolactinemia such as antipsychotics, prolactin-sparing medication can be tried. [4] Methotrexate alone or in combination with steroids has been used with good success. Its principal mechanism of action is immunomodulating ...