How to manage intolerance to dopamine agonist in patients with prolactinoma

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dc.contributorSistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.authorSTUMPF, Matheo Augusto Morandi
dc.contributor.authorPINHEIRO, Felipe Moura Maia
dc.contributor.authorSILVA, Gilberto Ochman
dc.contributor.authorCESCATO, Valter Angelo Sperling
dc.contributor.authorMUSOLINO, Nina Rosa Castro
dc.contributor.authorCUNHA-NETO, Malebranche Berardo Carneiro
dc.contributor.authorGLEZER, Andrea
dc.date.accessioned2023-08-16T18:05:03Z
dc.date.available2023-08-16T18:05:03Z
dc.date.issued2023
dc.description.abstractPurposeDopamine agonists (DA) are the gold-standard for prolactinoma and hyperprolactinemia treatment. Intolerance to DA leading to drug drop out occurs in 3 to 12% of cases. We provide here a review of published data about DA intolerance and present a case report concerning the use of intravaginal cabergoline.MethodsWe review the literature on the definition, the pathogenesis, frequency and management of DA intolerance. In addition, the review provides strategies to enhance tolerability and avoid precocious clinical treatment withdrawal.ResultsCabergoline is often cited as the most tolerable DA and its side effects tend to ameliorate within days to weeks. Restarting the same drug at a lower dose or switching to another DA can be used in cases of intolerance. The vaginal route can be tried specifically if there are gastrointestinal side effects in the oral administration. Symptomatic treatment could be attempted, although mainly based on a strategy used in other diseases.ConclusionsDue to limited data, no guidelines have been developed for the management of intolerance in DA treatment. The most frequent management is to perform transsphenoidal surgery. Nevertheless, this manuscript provides data derived from published literature and expert opinion, suggesting new approaches to this clinical issue.eng
dc.description.indexMEDLINE
dc.description.indexPubMed
dc.description.indexWoS
dc.description.indexScopus
dc.identifier.citationPITUITARY, v.26, n.2, p.187-196, 2023
dc.identifier.doi10.1007/s11102-023-01313-8
dc.identifier.eissn1573-7403
dc.identifier.issn1386-341X
dc.identifier.urihttps://observatorio.fm.usp.br/handle/OPI/54920
dc.language.isoeng
dc.publisherSPRINGEReng
dc.relation.ispartofPituitary
dc.rightsrestrictedAccesseng
dc.rights.holderCopyright SPRINGEReng
dc.subjectProlactinomaeng
dc.subjectHyperprolactinemiaeng
dc.subjectCabergolineeng
dc.subjectBromocriptineeng
dc.subjectDopamine agonisteng
dc.subjectIntoleranceeng
dc.subjectCorticosteroideng
dc.subject.othercv 205-502eng
dc.subject.otherhyperprolactinemic patientseng
dc.subject.othervaginal bromocriptineeng
dc.subject.otherlong-termeng
dc.subject.othercabergoline treatmenteng
dc.subject.otherdouble-blindeng
dc.subject.otherserum prolactineng
dc.subject.othercross-overeng
dc.subject.othertolerabilityeng
dc.subject.otherresistanteng
dc.subject.wosEndocrinology & Metabolismeng
dc.titleHow to manage intolerance to dopamine agonist in patients with prolactinomaeng
dc.typearticleeng
dc.type.categoryoriginal articleeng
dc.type.versionpublishedVersioneng
dspace.entity.typePublication
hcfmusp.citation.scopus3
hcfmusp.contributor.author-fmusphcMATHEO AUGUSTO MORANDI STUMPF
hcfmusp.contributor.author-fmusphcFELIPE MOURA MAIA PINHEIRO
hcfmusp.contributor.author-fmusphcGILBERTO OCHMAN DA SILVA
hcfmusp.contributor.author-fmusphcVALTER ANGELO SPERLING CESCATO
hcfmusp.contributor.author-fmusphcNINA ROSA DE CASTRO MUSOLINO
hcfmusp.contributor.author-fmusphcMALEBRANCHE BERARDO CARNEIRO DA CUNHA NETO
hcfmusp.contributor.author-fmusphcANDREA GLEZER
hcfmusp.description.beginpage187
hcfmusp.description.endpage196
hcfmusp.description.issue2
hcfmusp.description.volume26
hcfmusp.origemWOS
hcfmusp.origem.pubmed37027090
hcfmusp.origem.scopus2-s2.0-85152082930
hcfmusp.origem.wosWOS:000963566200001
hcfmusp.publisher.cityNEW YORKeng
hcfmusp.publisher.countryUNITED STATESeng
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