Hyperprolactinemia
Chronic elevation of blood prolactin. Causes: pituitary prolactinoma, medications (antipsychotics, PPIs), hypothyroidism. Manifests as galactorrhoea, menstrual cycle disorders, infertility, erectile dysfunction.
ICD-10 E22.12 drugs
Also known as: Elevated prolactin
Drugs used for this condition
- ABromocriptineSecond line · Dopamine D2 receptor agonist, ergot derivativeBromocriptine is a second-line dopamine agonist for hyperprolactinemia and pituitary microadenomas. SEEN recommends cabergoline as first choice (better tolerability and twice-weekly dosing); bromocriptine remains an option in pregnancy and when cabergoline is unavailable. Effect over 1–3 months, dose titrated from 1.25 mg twice daily.
- ACabergolineFirst line · Long-acting dopamine D2 receptor agonist, ergot derivativeCabergoline is first-line dopamine agonist for hyperprolactinemia and pituitary micro- and macroprolactinomas. SEEN recommends cabergoline due to better tolerability and convenient dosing (once or twice weekly 0.25–0.5 mg). Effect over 2–4 weeks. Less used in Parkinson disease due to high-dose valvulopathy risk.
How to read tiers A–F
Evidence tiers belong to the drug-indication pair, not to the drug as a whole: the same substance can be A for one condition and F for another.
- AStrong evidence – first or second line in international guidelines
- BRecommended in selected cases
- CStudy data contradict each other
- DBenefit not proven, no documented harm
- FDocumented harm, or risk without benefit