Evaluation of the efficacy of cabergoline in the treatment of hyperprolactinemia

Cabergoline is a highly potent dopamine D2 receptor agonist and is recognized as the drug of choice for the treatment of hyperprolactinemia (hyperprolactinemia). Its mechanism of action is to inhibit the activity of prolactin-secreting cells in the pituitary gland, causing prolactin levels to drop rapidly, thus improving women's menstrual disorders, amenorrhea, lactation overflow and infertility problems. It can also improve symptoms such as decreased gonadal function and loss of sexual desire in men. Compared with older generation drugs such as bromocriptine, cabergoline is more selective, better tolerated, and has fewer side effects, so it is widely recommended in global guidelines.

In terms of therapeutic effect, cabergoline can significantly reduce serum prolactin concentration in most patients, and the therapeutic success rate can reach 80%~90%. Most patients experience a significant decrease in prolactin within a few weeks of starting treatment, their menstrual cycles can resume within a few months, and their sex hormone levels gradually improve. For hyperprolactinemia caused by pituitary prolactinoma, cabergoline can also effectively reduce tumor volume. In some patients, the tumor size can be reduced by more than 50%, and long-term maintenance treatment can reduce the risk of tumor recurrence.

In terms of safety, cabergoline is better tolerated than other similar drugs. Common side effects include mild nausea, dizziness, fatigue, and hypotension, which are mostly short-term and usually resolve as the dose stabilizes. In order to further reduce discomfort, a low-dose starting regimen of 1~2 times a week is often used clinically, and then gradually adjusted. Cabergoline has a lower risk of gastrointestinal discomfort and valvular heart disease than older generation drugs, but long-term use of high doses still requires regular evaluation of cardiac ultrasound, especially in patients who require higher maintenance doses.

Overall, cabergoline has shown efficient and stable efficacy in reducing prolactin levels, improving reproductive function, and shrinking pituitary tumors, and is one of the standard treatments for hyperprolactinemia. Most patients can successfully restore normal endocrine function after standard treatment, and their long-term quality of life is also significantly improved. Regularly monitoring prolactin levels, adjusting doses based on efficacy, and paying attention to heart and blood pressure conditions will ensure the drug works best and remains safe.

Reference materials:https://www.nlm.nih.gov/