Quinagolide

Pronunciation: kwin-AG-oh-lide.

Generic name
quinagolide
Drug class
Non-ergot selective dopamine D2-receptor agonist; prolactin inhibitor
Form
Tablet, 25/50/75/150 microgram strengths (titration/starter pack combines 25 and 50 microgram tablets)
Route
Oral
Legal status
Prescription-only in every market where it is confirmed authorised (not approved in the United States)

Supply Rules Vary

Trade names by country: United Kingdom · Canada · Australia

Australia: Norprolac (5) (4) · Full directory

What quinagolide is and how it works

Quinagolide is a non-ergot dopamine agonist that lowers prolactin levels by directly stimulating dopamine D2 receptors in the pituitary gland. It is used to treat hyperprolactinaemia -- an abnormally high blood level of the hormone prolactin -- whether the cause is unknown (idiopathic) or due to a prolactin-secreting pituitary tumour (microadenoma or macroadenoma). (1) (7) (4)

Quinagolide is not approved for use in the United States. Where it is prescribed, treatment always starts at a very low dose using a titration (starter) pack and is increased gradually under a clinician's direction, because dopaminergic stimulation can cause a drop in blood pressure on standing (orthostatic hypotension) that has, rarely, led to fainting (syncope). There is also a genuine, disclosed global supply concern: the manufacturer has reported that no other company currently manufactures Norprolac, and supply has already been discontinued in some countries. Anyone currently taking quinagolide should discuss ongoing availability and alternative options with their prescriber.

Mechanism of action: how quinagolide works

Quinagolide is a selective, non-ergot dopamine D2-receptor agonist. It inhibits prolactin secretion without reducing normal levels of other pituitary hormones. Prolactin reduction begins within 2 hours of ingestion, peaks at 4-6 hours, and is maintained for about 24 hours (duration is dose-dependent). Long-term treatment reduces the size of, or limits growth of, prolactin-secreting pituitary macro- and microadenomas. Elimination half-life is approximately 11 hours (single dose) and 17 hours at steady state; protein binding is approximately 90%. (1) (2)

What quinagolide is used for

Hyperprolactinaemia (idiopathic)

Used to treat abnormally high blood prolactin levels when no underlying cause has been identified. (1) (2)

Hyperprolactinaemia due to a prolactin-secreting pituitary tumour

Used to treat high prolactin levels caused by a prolactin-secreting pituitary microadenoma or macroadenoma, and has been shown to reduce the size of, or limit further growth of, these tumours with long-term treatment. (1) (2)

Before taking quinagolide

Do not take / not appropriate for

  • Do not take if you have severely impaired liver or kidney function. (all countries where authorised) (1) (2)
  • Do not take if you have a known hypersensitivity to quinagolide or any excipient. (all countries where authorised) (1) (2)
  • Not to be taken by patients with rare hereditary problems of galactose intolerance, Lapp lactase deficiency, or glucose-galactose malabsorption, due to the lactose content. (United Kingdom, Ireland/European Union) (2)

Tell your clinician about

  • Whether you have any history of heart disease, since orthostatic blood pressure changes with a reflex increase in heart rate may be relevant in patients with severe heart disease.
  • Whether you have any personal or family history of psychotic illness, since acute psychosis (usually reversible on stopping treatment) has been reported.
  • Whether you are pregnant, trying to conceive, or breastfeeding.
  • Whether you have experienced excessive daytime sleepiness or sudden sleep onset with any medicine.
  • All other medicines you take, since no formal drug interaction studies have been performed with quinagolide.
(1) (2)

How to take quinagolide

  • Treatment must always be started and adjusted by your prescriber using the titration (starter) pack -- never start at the usual maintenance dose.
  • Take the tablet once daily in the evening, with food.
  • Because dopaminergic stimulation can cause a drop in blood pressure on standing, your clinician may check your blood pressure lying down and standing up during the first days of treatment and after any dose increase.
  • Do not increase your own dose -- dose increases are made gradually and only under clinical direction, based on your prolactin levels and how well you tolerate the medicine.
(1) (2)

Procedures and treatment changes

Tell the treating team before surgery, procedures, or any medicine change. Do not alter treatment without the responsible clinician. (1) (2) (3) (4) (5) (6) (7)

Missed dose

If you miss a dose, do not take a double dose to make up for it. Contact your pharmacist or prescriber if you are unsure what to do, since restarting after a missed dose or a gap in treatment may need to be done gradually, the same way treatment was originally started.

Overdose

Limited experience of overdose exists. Expected effects include nausea, vomiting, headache, dizziness, drowsiness, low blood pressure, and hallucinations. Contact a doctor, hospital emergency department, or your local poison control service immediately if an overdose is suspected -- treatment is symptomatic and may include gastric lavage or activated charcoal if clinically justified. (2)

Side effects

Side effects and their urgency vary; report severe, persistent, or concerning symptoms.

Nausea and vomiting.

What to notice: Nausea and vomiting.

What to do: Discuss persistent or troublesome symptoms with the treating clinician or pharmacist. (1) (2)

Headache, dizziness, and fatigue.

What to notice: Headache, dizziness, and fatigue.

What to do: Discuss persistent or troublesome symptoms with the treating clinician or pharmacist. (1) (2)

Reduced appetite (anorexia), abdominal pain, constipation, or diarrhoea.

What to notice: Reduced appetite (anorexia), abdominal pain, constipation, or diarrhoea.

What to do: Discuss persistent or troublesome symptoms with the treating clinician or pharmacist. (2)

Insomnia.

What to notice: Insomnia.

What to do: Discuss persistent or troublesome symptoms with the treating clinician or pharmacist. (2)

Serious warnings

Orthostatic hypotension and syncope — high caution

Symptoms: Feeling faint, dizzy, or light-headed on standing up, or actually fainting (syncope), particularly during the first days of treatment or after a dose increase.

Action: Sit or lie down immediately if you feel faint or dizzy. Report these symptoms to your prescriber, who may check your blood pressure lying and standing and adjust your dose or titration schedule. (1) (2)

Acute psychosis — high caution

Symptoms: New confusion, hallucinations, delusions, or other signs of psychosis, including in people with no previous history of mental illness.

Action: Contact your prescriber promptly. Acute psychosis associated with quinagolide is usually reversible when the medicine is stopped, but needs urgent clinical assessment. (1) (2)

Somnolence and sudden sleep onset — high caution

Symptoms: Excessive daytime sleepiness or sudden episodes of falling asleep without warning.

Action: Do not drive or operate machinery if you experience these symptoms, and tell your prescriber -- a dose reduction or stopping treatment may be considered. (1) (2)

Impulse control disorders — high caution

Symptoms: New or worsening pathological gambling, increased libido or hypersexuality, compulsive spending or buying, or binge eating.

Action: Tell your prescriber if you or a family member notices these behaviours -- dose reduction or a gradual (tapered) stop may be recommended; do not stop abruptly without guidance. (1) (2)

Signs of a severe allergic (hypersensitivity) reaction — emergency

Symptoms: Swelling of the face, lips, tongue, or throat; difficulty breathing; widespread rash or hives.

Action: Seek emergency medical help immediately. (2)

Interactions

  • No formal drug interaction studies have been performed with quinagolide. On theoretical grounds, medicines with strong dopamine-antagonist activity (e.g. some antipsychotics/neuroleptics) may reduce quinagolide's prolactin-lowering effect. (1) (2)
  • Tolerability may be reduced by alcohol. (1) (2)
  • Caution is recommended when combining quinagolide with other medicines, particularly strong inhibitors of drug-metabolising enzymes, since data on quinagolide's own metabolism and interaction potential is limited. Tell your prescriber about all other medicines and supplements you take. (2)

Pregnancy, breastfeeding, kidney/liver function, age

Pregnancy

Animal studies showed no evidence of embryotoxic or teratogenic potential, but clinical experience in pregnant women is limited. If you are trying to conceive, quinagolide is usually stopped once pregnancy is confirmed unless your prescriber has a specific medical reason to continue it; no increased rate of miscarriage was observed after stopping at this point. If pregnancy occurs while a pituitary tumour is present and quinagolide has been stopped, close supervision throughout pregnancy is essential. (1) (2) (3) (4) (5) (6) (7)

Breastfeeding

Breastfeeding is usually not possible during treatment because quinagolide suppresses lactation. No published data exist on quinagolide levels in breast milk or effects on a nursing infant. (1) (2) (3) (4) (5) (6) (7)

Children

Clinical experience in children is limited. A small number of children aged 7-17 have been treated for prolactinoma at doses of 75-600 micrograms/day for 1-5 years and tolerated treatment well, but this is not sufficient to establish routine paediatric dosing guidance -- use in children must be directed by a specialist. (1) (2) (3) (4) (5) (6) (7)

Elderly

Clinical experience in elderly patients is limited. A small number of elderly patients have been treated at doses of 50-300 micrograms/day for pituitary adenomas and tolerated treatment well. (1) (2) (3) (4) (5) (6) (7)

Hepatic_impairment

Contraindicated in severely impaired hepatic function; no data are available on quinagolide use in patients with impaired hepatic function otherwise. (1) (2) (3) (4) (5) (6) (7)

Renal_impairment

Contraindicated in severely impaired renal function; no data are available on quinagolide use in patients with impaired renal function otherwise. (1) (2) (3) (4) (5) (6) (7)

Monitoring

Before starting

  • Baseline blood pressure (lying and standing)
  • Assessment of hepatic and renal function
  • Review of psychiatric history

During treatment

  • Blood pressure checked lying and standing during the first days of therapy and after each dose increase, because of the orthostatic hypotension/syncope risk.
  • Regular monitoring for signs of impulse control disorders (gambling, hypersexuality, compulsive spending/eating).
  • Serum prolactin levels monitored to guide dose titration and assess treatment response.
  • Ongoing assessment for psychiatric symptoms, excessive sleepiness, or sudden sleep episodes.
(1) (2)

Storage

Store below 25 degrees C, in the original package to protect from light and moisture. Keep out of reach of children. Do not use after the expiry date.

Professional information

Clinician-facing context only, sourced from the current live UK EMC SPC and the Ireland HPRA SPC; verify against the current full label before prescribing.

United Kingdom / Ireland (European Union, representative)

Indication: Hyperprolactinaemia (idiopathic or due to a prolactin-secreting pituitary microadenoma/macroadenoma)

Dose summary: Titration pack: 25 mcg/day (days 1-3), 50 mcg/day (days 4-6), 75 mcg/day from day 7. Maintenance 75-150 mcg/day; up to 300+ mcg/day in some patients, titrated in 75 mcg steps at intervals of at least 1 week (or 4 weeks for higher increments). Once daily, evening, with food.

Renal context: Contraindicated in severely impaired renal function; no dose-adjustment data for lesser degrees of impairment. (1) (2)

Mechanism of action

Hepatic guidance

Contraindicated in severely impaired hepatic function; pharmacokinetics have not been studied in patients with hepatic impairment.

Overdose note

Limited overdose experience; expected effects are nausea, vomiting, headache, dizziness, drowsiness, hypotension, and hallucinations. Treat symptomatically; gastric lavage or activated charcoal if clinically justified. (1) (2)

Frequently asked questions

Is quinagolide (Norprolac) available in the United States?

No. Quinagolide is not approved for marketing in the United States by the FDA. It is authorised in the United Kingdom and across the European Union under the brand Norprolac (and as a generic 'Quinagolide Tablets' product in the UK), and was historically authorised in Australia and Canada. (7) (1)

Why does quinagolide need to be started with a special 'titration' or 'starter' pack?

Quinagolide can cause a drop in blood pressure on standing (orthostatic hypotension), which has rarely led to fainting. Starting at a very low dose and increasing it gradually over about a week, with blood pressure checks lying and standing, reduces this risk. (1) (2)

Is quinagolide still being manufactured?

There is a genuine, disclosed global supply concern. The manufacturer has reported that the third-party company that made quinagolide has ceased production and that no other manufacturer of Norprolac currently exists. Supply was reported discontinued in Canada from 2021, and Australia's Endocrine Society advised in 2025 that Australian stock was expected to run out by mid-2025, with new patients not being started on it. Current supply in the UK and EU was not confirmed as interrupted at the time of this review, but anyone taking quinagolide should check ongoing availability with their pharmacist or prescriber and discuss alternatives such as cabergoline or bromocriptine if needed. (4) (6)

Can I breastfeed while taking quinagolide?

Breastfeeding is usually not possible during treatment because quinagolide suppresses lactation. There is no published data on quinagolide levels in breast milk or its effects on a nursing infant, so it should not be assumed safe for breastfeeding. (7) (2)

What is the mechanism of action of quinagolide?

Quinagolide is a selective, non-ergot dopamine D2-receptor agonist. It inhibits prolactin secretion without reducing normal levels of other pituitary hormones. Prolactin reduction begins within 2 hours of ingestion, peaks at 4-6 hours, and is maintained for about 24 hours (duration is dose-dependent). Long-term treatment reduces the size of, or limits growth of, prolactin-secreting pituitary macro- and microadenomas. Elimination half-life is approximately 11 hours (single dose) and 17 hours at steady state; protein binding is approximately 90%. (1) (2)

What is the generic name of Quinagolide?

The generic name is quinagolide. (1) (7)

What class of drug is quinagolide?

Quinagolide is classed as: Non-ergot selective dopamine D2-receptor agonist; prolactin inhibitor. (1) (7)

References

  1. Norprolac (quinagolide) 75 microgram tablets -- Summary of Product Characteristics (SmPC)UK Medicines and Healthcare products Regulatory Agency (via the electronic Medicines Compendium, emc) · United Kingdom · accessed 2026-07-31 · source 1
  2. Norprolac 75 microgram tablets -- Summary of Product Characteristics (PA1009/020/002)Ireland Health Products Regulatory Authority (HPRA) · Ireland / European Union · dated 2015-11-01 · accessed 2026-07-31 · source 2
  3. List of nationally authorised medicinal products -- quinagolide (PSUSA/00002590/201707)European Medicines Agency (EMA), Human Medicines Evaluation Division · European Union / EEA · dated 2018-04-12 · accessed 2026-07-31 · source 3
  4. Availability of Norprolac (Quinagolide) -- advisory on discontinuationEndocrine Society of Australia · Australia · accessed 2026-07-31 · source 4
  5. NORPROLAC quinagolide 75 micrograms (as hydrochloride) tablet blister pack -- ARTG entry 48991Therapeutic Goods Administration (TGA) · Australia · accessed 2026-07-31 · source 5
  6. Quinagolide Discontinuation -- BackgroundmedSask, University of Saskatchewan (medication information service), citing the Health Canada Drug Product Database · Canada · dated 2021-07-16 · accessed 2026-07-31 · source 6
  7. Quinagolide -- Drugs and Lactation Database (LactMed)U.S. National Institutes of Health, National Library of Medicine -- LactMed database (NCBI Bookshelf) · United States · accessed 2026-07-31 · source 7

Brand names by country

Single-ingredient quinagolide names are shown separately by country. Product availability, strengths, and supply rules can change; combination products are not included here.

Priority countries

United Kingdom

  • Norprolac (1) (3)current authorised prescription medicine · 25 micrograms, 50 micrograms, 75 micrograms, 150 micrograms · Ferring Pharmaceuticals (PL 03194/0099 for the 150 microgram strength)
  • Quinagolide Tablets (generic) (3)current authorised prescription medicine · 25 micrograms, 50 micrograms, 75 micrograms · Aspire Pharma Limited (PL 35533/0062-0064)

Canada

  • NORPROLAC

Australia

  • Norprolac (5) (4)being discontinued stock depletion · 75 micrograms · Ferring Pharmaceuticals Pty Ltd (ARTG 48991)
View brands in additional countries.

European Union

Norprolac (Ferring) (2) (3)

This page provides general reference information about quinagolide (Norprolac) and is not a substitute for advice from the clinician managing your treatment. Quinagolide is not approved in the United States, carries a genuine orthostatic hypotension/syncope risk requiring gradual clinician-directed titration, and its ongoing global supply has been genuinely affected by a manufacturer discontinuation in some markets -- always confirm current availability and any treatment changes with your own prescriber or pharmacist.

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