Quinagolide
A non-ergot dopamine D2 agonist for hyperprolactinaemia, dosed once daily. As a non-ergot compound it avoids ergot-related fibrotic valve risks and is used in PED contexts to control prolactin from 19-nor steroids.
01 Overview
Quinagolide (Norprolac) is a non-ergot-derived, selective dopamine D2 agonist licensed for hyperprolactinaemia. Its once-daily dosing and non-ergot structure make it a useful alternative for patients intolerant of bromocriptine or concerned about the cardiac valve fibrosis associated with ergot agonists.
Steroid users occasionally choose it, like cabergoline, to suppress prolactin elevated by progestogenic nandrolone and trenbolone compounds, though it is less widely available than the ergot agents.
02 Mechanism
Non-ergot selective dopamine D2 receptor agonist: inhibits pituitary lactotroph prolactin secretion without significant ergot-related serotonin receptor activity.
03 Dosing
| Tier | Dose | Route | Notes |
|---|---|---|---|
| Prolactin control | 0.025–0.075 mg/day | Oral | Off-label low dosing with 19-nor compounds. |
| Hyperprolactinaemia | 0.075–0.15 mg/day | Oral | Titrated from 25 mcg at bedtime over several days. |
04 Effects
| Effect | Magnitude | Evidence | |
|---|---|---|---|
| Prolactin suppressionSelective D2 agonism inhibits prolactin secretion. | Normalised prolactin | Clinical | |
| Avoids ergot valve riskNon-ergot structure lacks the serotonin receptor activity linked to cardiac valve fibrosis. | No 5-HT2B agonism | Observational |
05 Side effects
| Effect | Severity | Frequency | Evidence | Countermeasures |
|---|---|---|---|---|
| Nausea and dizzinessNausea, headache and orthostatic dizziness, mainly during titration. | Mild | Common | Clinical | |
| Psychiatric effectsMood changes or impulse-control effects seen with dopamine agonists. | Moderate | Rare | Observational |