Norprolac (Quinagolide)

• Quinagolide is used to manage disorders related to excess prolactin by targeting the dopaminergic pathway.
• Hyperprolactinemia: reduces elevated serum prolactin levels, helping restore normal menstrual cycles and control galactorrhea.
• Prolactin‑producing pituitary adenomas (prolactinomas): lowers tumor‑stimulated prolactin secretion, contributing to tumor size reduction and symptom relief.
• Infertility related to elevated prolactin: normalizes prolactin levels, improving ovulatory function and fertility potential.

• Quinagolide acts as a selective dopamine D2 receptor agonist in the anterior pituitary, inhibiting the secretion of prolactin. By stimulating these receptors, it reduces circulating prolactin concentrations, thereby correcting the hormonal imbalance that underlies hyperprolactinemia and its associated clinical manifestations.

Quinagolide may cause a range of adverse reactions, which are categorized by frequency and severity.

Common Side Effects

• Nausea
• Headache
• Dizziness
• Fatigue
• Dry mouth
• Abdominal discomfort

Serious or Rare Side Effects

• Valvular heart disease
• Pulmonary hypertension
• Severe hypotension
• Psychotic episodes
• Cardiac arrhythmias
• Allergic reactions, including anaphylaxis

• When prescribing Quinagolide, clinicians should consider several safety measures and patient‑specific factors.
• Cardiovascular assessment: evaluate for pre‑existing heart valve disease before initiation.
• Blood pressure monitoring: check for orthostatic hypotension during therapy.
• Psychiatric evaluation: monitor for emergence of psychosis or mood changes.
• Renal/hepatic function: adjust use in severe impairment as advised.
• Pregnancy and lactation: avoid unless benefits outweigh risks.
• Store at ambient temperature: keep below 25°C, protect from moisture and light in original container.

Quinagolide can interact with other medicines, altering its efficacy or safety profile.

Major Interactions (Avoid)

• Antipsychotics (e.g., haloperidol): may antagonize dopamine agonist effect, reducing therapeutic benefit.
• Macrolide antibiotics (e.g., erythromycin): increase quinagolide plasma levels, raising risk of toxicity.
• CYP3A4 inhibitors (e.g., ketoconazole): potentiate drug exposure, requiring avoidance.

Moderate Interactions (Monitor Closely)

• Antihypertensives: additive blood pressure‑lowering effect, monitor for hypotension.
• Serotonergic agents: potential for serotonin syndrome, observe symptoms.
• Hormonal contraceptives: may reduce efficacy, advise alternative contraception.