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How to Treat Prolactinoma?

Medical Treatment:
Dopamine agonist therapy is the treatment of choice.
* Bromocriptine, oral, 1.25 mg at bedtime with a snack.
  • Initial maintenance dose: increase dose to 2.5 mg 12 hourly with food and check prolactin 4 weeks later.
  • Higher doses may be needed.
    GIT side effects are minimised by giving doses with food.
  • If total dose of 10 mg does not normalise prolactin, refer.

When to refer:
  • All tumours, once causes of secondary hyperprolactinaemia have been sought and excluded.
  • Intolerance to bromocriptine.