In a recent response to Chris about the mother with the huge oversupply,
I mentioned that Parlodel (bromocriptine) would be okay to use in such a
situation if it was determined that the mother had a prolactin-secreting
tumor.  I neglected to mention that Dostinex (cabergoline) is now
considered the safer alternative due to fewer side effects.  This was my
oversight simply because I have never prescribed the new medication and
I have used parlodel for years in my practice with women (non-pregnant)
who have prolactinomas.  By the way, although I am aware that Parlodel
carries a risk of seizures and strokes and that is why it is no longer
approved for routine suppression of normal lactation, I have used it
with no ill effects in a number of women and (until learning about
Dostinex) felt that the risk of these adverse effects was outweighed by
the risk of not using the Parlodel in the clinical setting of a
pituitary tumor.  I'm sure that the next time I have a mother with such
a diagnosis I will prescribe Dostinex.  Just wanted to clarify for
anyone who might have wondered.  Regards, Alicia Dermer, MD, IBCLC.

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