Drug Action
Quinagolide is a non-ergot dopamine D2 agonist.
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Drug reference
Quinagolide is a non-ergot dopamine D2 agonist.
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Hyperprolactinaemia ▶BY MOUTH ▶Adult: Initially 25 micrograms once daily for 3 days, dose to be taken at bedtime, increased in steps of 25 micrograms every 3 days; usual dose 75–150 micrograms daily, for doses higher than 300 micrograms daily increase in steps of 75–150 micrograms at intervals of not less than 4 weeks l UNLICENSED USE Not licensed for the suppression of lactation.
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Acute porphyrias p. 1120. history of psychotic illness. history of serious mental disorders CAUTIONS, FURTHER INFORMATION ▶Hyperprolactinemic patients In hyperprolactinaemic patients, the source of the hyperprolactinaemia should be established (i.e. exclude pituitary tumour before treatment).
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Quinagolide should not be used in patients with hypersensitivity to quinagolide (does not apply to hypersensitivity to ergot alkaloids).
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→Appendix 1: dopamine receptor agonists
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▶Common or very common Abdominal pain. appetite decreased. constipation. diarrhoea. dizziness. fatigue. flushing. headache. hypotension. insomnia. nasal congestion. nausea. oedema. syncope. vomiting ▶Rare or very rare Acute psychosis. drowsiness
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Advise non-hormonal contraception if pregnancy not desired.
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Discontinue when pregnancy confirmed unless medical reason for continuing (specialist advice needed).
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Suppresses lactation.
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Manufacturer advises avoid (no information available).
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Avoid—no information available.
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Monitor blood pressure for a few days after starting treatment and following dosage increase.
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There can be variation in the licensing of different medicines containing the same drug. Tablet CAUTIONARY AND ADVISORY LABELS 10, 21 ▶Quinagolide (Non-proprietary) Quinagolide 50microgram tablets and Quinagolide 25microgram tablets | 6 tablet P £30.00–£37.50 DT = £37.50 Quinagolide (as Quinagolide hydrochloride) 25 microgram Quinagolide 25microgram tablets | 3 tablet P s Quinagolide (as Quinagolide hydrochloride) Endocrine system 50 microgram Quinagolide 50microgram tablets | 3 tablet P s Quinagolide (as Quinagolide hydrochloride) 75 microgram Quinagolide 75microgram tablets | 30 tablet P £81.18 DT = £81.18 ▶Norprolac (Ferring Pharmaceuticals Ltd) Quinagolide (as Quinagolide hydrochloride) 25 microgram Norprolac 25microgram tablets | 3 tablet P s Quinagolide (as Quinagolide hydrochloride) 50 microgram Norprolac 50microgram tablets | 3 tablet P s Gonadotrophin responsive conditions Gonadotrophins Gonadotrophin-affecting drugs Danazol p. 783 is licensed for the treatment of endometriosis and for the relief of severe pain and tenderness in benign fibrocystic breast disease where other measures have proved unsatisfactory. It may also be effective in the long-term management of hereditary angioedema[unlicensed indication]. Cetrorelix p. 778 and ganirelix p. 778 are luteinising hormone releasing hormone antagonists, which inhibit the release of gonadotrophins (luteinising hormone and follicle stimulating hormone). They are used in the treatment of infertility by assisted reproductive techniques. Gonadorelin analogues Gonadorelin analogues are used in the treatment of endometriosis, precocious puberty, infertility, male hypersexuality with severe sexual deviation, anaemia due to uterine fibroids (together with iron supplementation), breast cancer, prostate cancer and before intra-uterine surgery. Use of leuprorelin acetate and triptorelin for 3 to 4 months before surgery reduces the uterine volume, fibroid size and associated bleeding. Breast pain (mastalgia) Once any serious underlying cause for breast pain has been ruled out, most women will respond to reassurance and reduction in dietary fat; withdrawal of an oral contraceptive or of hormone replacement therapy may help to resolve the pain. Mild, non-cyclical breast pain is treated with simple analgesics; moderate to severe pain, cyclical pain or symptoms that persist for longer than 6 months may require specific drug treatment. Danazol is licensed for the relief of severe pain and tenderness in benign fibrocystic breast disease which has not responded to other treatment. Tamoxifen p. 1005 may be a useful adjunct in the treatment of mastalgia [unlicensed indication] especially when symptoms can definitely be related to cyclic oestrogen production; it may be given on the days of the cycle when symptoms are predicted. Treatment for breast pain should be reviewed after 6 months and continued if necessary. Symptoms recur in about 50% of women within 2 years of withdrawal of therapy but may be less severe. PITUITARY AND HYPOTHALAMIC HORMONES AND ANALOGUES › ANTI-GONADOTROPHIN- RELEASING HORMONES
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Driving and skilled tasks Sudden onset of sleep Excessive daytime sleepiness and sudden onset of sleep can occur with dopamine-receptor agonists. Patients starting treatment with these drugs should be warned of the risk and of the need to exercise caution when driving or operating machinery. Those who have experienced excessive sedation or sudden onset of sleep should refrain from driving or operating machines until these effects have stopped occurring. Management of excessive daytime sleepiness should focus on the identification of an underlying cause, such as depression or concomitant medication. Patients should be counselled on improving sleep behaviour. Hypotensive reactions Hypotensive reactions can be disturbing in some patients during the first few days of treatment with dopamine-receptor agonists, particular care should be exercised when driving or operating machinery.
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Initially 25 micrograms once daily for 3 days,
First-line fragment. Read the complete Indications and Dose section above.
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