quinagolide hydrochloride: clinical use

Prescribing considerations

• Exclude or address other causes of hyperprolactinaemia and assess for a pituitary adenoma as clinically appropriate.
• Fertility may return; discuss reliable contraception where pregnancy is not intended.
• Use particular caution with previous psychotic episodes.
• Experience in children and older people is unavailable.
• Withdrawal symptoms such as apathy, anxiety, depression, fatigue, sweating, or pain have been reported with dopamine agonists.

Contraindications and cautions

• Hypersensitivity to quinagolide or the product ingredients
• Impaired hepatic function
• Impaired renal function

Monitoring

• Assess prolactin response and clinical tolerability.
• Check lying and standing blood pressure when hypotension risk is greatest and after treatment changes.
• Ask patients and carers about sleepiness, psychotic symptoms, and impulse-control disorders.
• If pregnancy occurs with a pituitary adenoma, arrange close specialist supervision.

Clinical pharmacology

Quinagolide is a selective, non-ergot dopamine D2-receptor agonist that inhibits anterior-pituitary prolactin secretion. It undergoes extensive first-pass metabolism, and metabolites are eliminated through urine and faeces.

Formulation and product differences

• The selected product is a whitish oral tablet supplied in aluminium blisters.
• It contains lactose; other authorised tablet strengths differ in colour.

Tablet

Route: Oral

Strengths: 25 micrograms, 50 micrograms, 75 micrograms