Dopamine Agonist Calculator
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Select what matters most to you to find your optimal dopamine agonist
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Key Reasons
Comparison Summary
| Factor | Parlodel | Best Match |
|---|---|---|
| Dosing Frequency | 2-3x daily | |
| Cost (monthly) | $15-$30 | |
| Prolactin Reduction | 30-40% | |
| Key Side Effects | Nausea, dizziness |
Quick Takeaways
- Parlodel (bromocriptine) is effective but requires multiple daily doses.
- Cabergoline offers once‑weekly dosing with higher prolactin‑lowering potency.
- Quinagolide is a non‑ergot dopamine agonist with fewer hormonal side effects.
- Cost, side‑effect profile, and kidney function are the main decision factors.
- For Parkinson’s disease, newer agents like pramipexole may outperform bromocriptine.
If you’re weighing Parlodel (bromocriptine) against other options, you want a clear view of how each drug stacks up on efficacy, safety, convenience, and price. Below you’ll find a step‑by‑step rundown that helps you decide which dopamine agonist fits your condition and lifestyle.
What is Parlodel?
Parlodel is the brand name for bromocriptine, an ergot‑derived dopamine agonist. It was first approved in the late 1970s for treating hyperprolactinemia, a condition where excess prolactin leads to menstrual disturbances, infertility, or galactorrhea. Over time, doctors also began using it for Parkinson’s disease and for certain cases of type‑2 diabetes (the quick‑release formulation).
How does bromocriptine work?
The drug binds to dopamine D2 receptors in the pituitary gland, suppressing prolactin secretion. In the brain’s basal ganglia, the same dopamine stimulation helps restore motor function, which is why it benefits Parkinson’s patients. Think of dopamine as the “brake” for prolactin production; bromocriptine steps on that brake.
When is Parlodel prescribed?
- Primary hyperprolactinemia (microadenomas, idiopathic cases)
- Adjunct therapy for Parkinson’s disease when levodopa alone is insufficient
- Off‑label: type‑2 diabetes management (quick‑release formulation)
Dosage typically starts at 1.25mg daily and can be titrated up to 10mg per day, split into multiple doses to maintain steady plasma levels.
Key criteria for picking a dopamine agonist
Before you dive into alternatives, line up the factors that matter most to you:
- Frequency of dosing - fewer pills mean better adherence.
- Prolactin‑lowering potency - a higher percentage drop per week is desirable.
- Side‑effect profile - nausea, orthostatic hypotension, valvular heart disease, and impulse‑control issues vary by agent.
- Renal and hepatic clearance - important for patients with kidney disease or liver impairment.
- Cost & insurance coverage - generic bromocriptine is cheap, but newer agents may be pricey.
- Regulatory status - some alternatives are not available in every country.
Alternatives to Parlodel
Below are the most commonly prescribed dopamine agonists that can replace bromocriptine for prolactin suppression or Parkinson’s management.
- Cabergoline - a long‑acting ergot derivative, taken once or twice weekly.
- Quinagolide - a non‑ergot oral agent, usually dosed once daily.
- Pergolide - once‑daily ergot agonist, withdrawn in many regions due to valvular heart risk.
- Pramipexole - a non‑ergot agent preferred for Parkinson’s, taken three times daily.
- Rotigotine - a transdermal patch delivering continuous dopamine stimulation.
Side‑by‑side comparison
| Drug | Typical Dose (Prolactin) | Frequency | Prolactin ↓ (average %) | Common Side‑effects | Cost (USD per month*) |
|---|---|---|---|---|---|
| Parlodel (bromocriptine) | 1.25‑10mg | 2‑3 times daily | ≈30‑40% | Nausea, dizziness, low blood pressure | $15‑30 |
| Cabergoline | 0.25‑1mg | Once or twice weekly | ≈70‑80% | Headache, constipation, rare valvulopathy | $80‑120 |
| Quinagolide | 25‑300µg | Once daily | ≈55‑65% | Dry mouth, insomnia, mild hypotension | $45‑70 |
| Pramipexole | 0.125‑1.5mg | Three times daily | ≈60‑70% (Parkinson’s motor scores) | Sleep attacks, impulse control, nausea | $120‑180 |
| Rotigotine | 2‑16mg/24h patch | Continuous (patch changed daily) | ≈65‑75% (motor improvement) | Skin irritation, dizziness, insomnia | $150‑210 |
*Costs are approximate US retail prices in 2025 and can vary by insurance.
Which drug is best for which scenario?
- Hyperprolactinemia with tight budget: Bromocriptine remains the cheapest option; its multiple‑daily dosing is the trade‑off.
- Patients who dislike taking pills often: Cabergoline’s weekly schedule dramatically improves adherence.
- Concerned about ergot‑related heart valve issues: Quinagolide or non‑ergot agents (pramipexole, rotigotine) sidestep that risk.
- Parkinson’s disease requiring rapid motor control: Pramipexole and rotigotine give smoother dopamine coverage than bromocriptine.
- Kidney impairment: Reduce bromocriptine dose; cabergoline is cleared hepatically, making it safer for renal patients.
Practical tips and common pitfalls
- Start low, go slow. All dopamine agonists can cause nausea. Begin with the lowest possible dose and titrate up over weeks.
- Monitor blood pressure. Orthostatic hypotension is frequent with bromocriptine and quinagolide, especially in the elderly.
- Check prolactin levels after 4-6 weeks. If the reduction is <15%, consider switching to a more potent agent like cabergoline.
- Beware of drug interactions. Bromocriptine can enhance the effect of antihypertensives; pramipexole may amplify sedatives.
- Watch for impulse‑control disorders. Pramipexole and cabergoline have documented links to gambling or compulsive shopping; screen patients regularly.
Bottom line
For a low‑cost, well‑studied option, Parlodel still has its place, especially when insurance favors generics. But if you value convenience, higher efficacy, or a safer cardiac profile, cabergoline or quinagolide often win. For Parkinson’s disease, newer non‑ergot agents such as pramipexole and rotigotine offer smoother symptom control.
Frequently Asked Questions
Can I switch from bromocriptine to cabergoline without a washout period?
Yes. Because both drugs act on the same dopamine receptors, most clinicians transition directly, tapering bromocriptine over 1‑2 weeks while introducing a low dose of cabergoline. Always confirm with your endocrinologist.
Is quinagolide available in the United States?
Currently, quinagolide is not FDA‑approved, so it’s unavailable in the U.S. market. It is, however, marketed in Europe and some Asian countries.
Do dopamine agonists cause weight gain?
Weight change is not a major side effect. Some patients report mild weight loss due to nausea, while others experience modest gain from improved appetite. Monitoring is advised.
How often should prolactin be retested after changing medication?
Recheck levels 4-6 weeks after any dose adjustment or drug switch. If the target range (<20ng/mL for women, <15ng/mL for men) isn’t reached, discuss further titration or an alternative.
Are there special precautions for pregnant women on bromocriptine?
Bromocriptine is classified as Category B in many regions, indicating no proven risk in animal studies. In humans, it’s used to treat prolactin‑induced infertility and is generally considered safe during early pregnancy, but always follow obstetric guidance.
Amanda Turnbo
October 12, 2025 AT 13:45Parlodel might be cheap, but the dosing nightmare makes it a poor first‑line choice.
Cassidy Strong
October 15, 2025 AT 22:59While cost considerations are undeniably important, one must also weigh the pharmacokinetic profile, the frequency of administration, and the associated adherence challenges; bromocriptine, despite its affordability, demands multiple daily doses, which may compromise therapeutic consistency. Moreover, the side‑effect spectrum-nausea, orthostatic hypotension, and potential hepatic interactions-cannot be dismissed lightly, especially in patients with comorbidities. Consequently, a holistic assessment that integrates both economic and clinical parameters is essential before defaulting to the lowest‑priced option.
Anil Karwal
October 19, 2025 AT 08:13The article does a solid job laying out the numbers; I appreciate the clear tables. Still, the real‑world experience of juggling three pills a day often gets overlooked.
ADETUNJI ADEPOJU
October 22, 2025 AT 17:27One could argue that the ergot‑derived ligands, such as bromocriptine, suffer from a legacy of receptor‑biased signaling, which ostensibly engenders a higher propensity for valvulopathic sequelae. Nevertheless, the pharmacodynamic ceiling is modest, rendering it suboptimal for aggressive prolactin suppression. In short, the jargon‑laden discourse masks a rather pedestrian efficacy profile.
Janae Johnson
October 26, 2025 AT 02:40Contrary to popular belief, the cheapest option is not always the most pragmatic; adherence suffers when patients are forced to remember multiple daily intakes. Thus, a weekly regimen, albeit pricier, may yield superior long‑term outcomes.
Kayla Charles
October 29, 2025 AT 11:54Let me walk you through why picking the right dopamine agonist is more nuanced than simply looking at the price tag.
First, consider the dosing frequency – fewer doses generally mean better adherence, especially for patients with busy lives or cognitive challenges.
Second, evaluate the efficacy; while bromocriptine offers a respectable 30‑40% reduction in prolactin, agents like cabergoline can achieve up to 80%, which may translate to faster symptom relief.
Third, side‑effect profiles matter – nausea and dizziness are common with bromocriptine, whereas cabergoline's headache and constipation are often milder.
Fourth, renal and hepatic function can influence drug selection; bromocriptine is cleared renally, making dose adjustments necessary in kidney disease, while cabergoline is hepatically metabolized.
Fifth, cost remains a factor – generic bromocriptine is inexpensive, but insurance coverage for newer agents can offset out‑of‑pocket expenses.
Sixth, consider the patient's preference for route of administration – some may favor a weekly oral tablet over multiple daily pills, while others might opt for a transdermal patch like rotigotine for continuous delivery.
Seventh, be aware of rare but serious risks such as valvular heart disease associated with ergot derivatives; regular cardiac monitoring may be warranted for long‑term users.
Eighth, keep in mind drug‑drug interactions – bromocriptine can potentiate hypotensive effects of antihypertensives, requiring dose titration.
Ninth, for Parkinson’s disease, non‑ergot agents like pramipexole or rotigotine often provide smoother motor control with fewer hormonal side effects.
Tenth, the speed of titration is crucial; a slow “start low, go slow” approach minimizes gastrointestinal upset for most patients.
Eleventh, patient education is paramount – informing them about potential side effects and the importance of adherence improves outcomes.
Twelfth, follow‑up labs, especially prolactin levels at 4‑6 weeks, help gauge effectiveness and guide dose adjustments.
Thirteenth, consider the psychosocial impact – frequent dosing can affect quality of life, potentially leading to non‑compliance.
Fourteenth, always individualize therapy; what works for one patient may not be ideal for another.
Finally, keep the dialogue open with your healthcare provider to reassess the regimen as needs evolve.