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[Pharmacology](https://durgical.com/en/pharmacology/) · Class

# Dopamine agonists

Drugs that stimulate dopamine receptors directly. Used in Parkinson disease, restless legs and high prolactin; they can trigger impulse-control disorders.

Updated 2026-11-01

## What they are

Two families: the ergot derivatives (bromocriptine, cabergoline), used mainly to lower prolactin, and the non-ergot agonists (pramipexole, ropinirole, rotigotine, apomorphine), used in Parkinson disease and restless legs syndrome. They act directly on D2-like receptors, so they do not need the dying dopamine neurons to work.

## Mechanism of action

They bind D2 and D3 receptors in the striatum (movement) and on pituitary lactotroph cells, where D2 stimulation switches off prolactin secretion.

Target: Dopamine D2 and D3 receptors

## Key points

- Impulse-control disorders (gambling, shopping, binge eating, hypersexuality) are a class effect: patients and families are asked about them at every visit.
- Sudden sleep attacks during daily activities (even driving), somnolence, hallucinations and orthostatic hypotension.
- Ergot agonists (cabergoline, bromocriptine) can cause cardiac valve disease and pleural, pulmonary or retroperitoneal fibrosis; echocardiography is used with cabergoline.
- Cabergoline and bromocriptine lower prolactin and shrink prolactinomas; they are first-line medical treatment for prolactinoma.
- Antipsychotics and metoclopramide (dopamine antagonists) cancel their effect.

## Drugs in this class

- [**Pramipexole** A non-ergot dopamine agonist for Parkinson disease and restless legs. Known for sudden sleep attacks and… Dopamine D3 and D2 receptors (D3 shown)](https://durgical.com/en/pharmacology/pramipexole/)
- [**Ropinirole** A non-ergot dopamine agonist for Parkinson disease and restless legs. Cleared by the liver (CYP1A2); causes sleep… Dopamine D2 receptor](https://durgical.com/en/pharmacology/ropinirole/)
- [**Cabergoline** A long-acting ergot dopamine agonist that lowers prolactin and shrinks prolactinomas. Valve disease and fibrosis are… Dopamine D2 receptor](https://durgical.com/en/pharmacology/cabergoline/)
- [**Bromocriptine** An ergot dopamine agonist that lowers prolactin and growth hormone. Used in prolactinoma, acromegaly and, less often… Dopamine D2 receptor](https://durgical.com/en/pharmacology/bromocriptine/)

## Others in the class

- Rotigotina (parche)
- Apomorfina
- Piribedil

## Test yourself

Think of the answer, then tap the question to see it.

## Which behavioural adverse effect must be asked about in every patient on a dopamine agonist?

Impulse-control disorders: pathological gambling, compulsive shopping, binge eating or hypersexuality.

## Which dopamine agonists carry a risk of valve disease and fibrosis?

The ergot derivatives, cabergoline and bromocriptine.

## Why do dopamine agonists lower prolactin?

Dopamine acting on D2 receptors of pituitary lactotrophs is the main brake on prolactin release.

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Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.

Sources: Goodman & Gilman's The Pharmacological Basis of Therapeutics, 14th ed., ch. 21 (McGraw Hill, 2023); Goodman & Gilman's The Pharmacological Basis of Therapeutics, 14th ed., ch. 46 (McGraw Hill, 2023); Farmacología básica y clínica (Katzung), 16.ª ed., cap. 28 (McGraw Hill, 2025); [DailyMed - PRAMIPEXOLE DIHYDROCHLORIDE tablet](https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=fb2260d6-204c-4d25-a331-0f8340d83a6e) (DailyMed (U.S. National Library of Medicine), 2026).

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