Permax (pergolide) / Eli Lilly - LARVOL DELTA

Drugs associated with retroperitoneal fibrosis: assessment of the 1969-2025 Food and Drug Administration (FDA) pharmacovigilance database. (PubMed, Pharmacol Rep) - "This pharmacovigilance analysis identified multiple medications, spanning different therapeutic classes, that demonstrated a disproportionate association with reports of RPF. Notably, some drugs with well-established safety profiles also emerged as potential signals, warranting increased clinical awareness. While this analysis reveals pharmacovigilance signals suggestive of drug-induced RPF, the observational nature of FAERS data limits causal inference. These findings underscore the need for further clinical research and mechanistic studies to better understand the etiopathogenic role of these agents in RPF development."

Adverse events • Journal • Fibrosis • Immunology • Inflammation • Nephrology • Renal Disease

Pituitary Pars Intermedia Dysfunction. (PubMed, Vet Clin North Am Equine Pract) - "Assessment of insulin regulation is also important, as insulin dysregulation occurs in at least one-third of PPID cases and is associated with laminitis risk. Management requires treatment with the dopamine agonist pergolide and an appropriate diet."

Journal • Review • Endocrine Disorders

Morphine and nicotine intake in high drinking in the dark mice is reduced by informatics-nominated and translationally relevant compounds. (PubMed, Front Psychiatry) - "We next tested whether the anti-inflammatory compounds terreic acid, pergolide, and apremilast would reduce morphine or nicotine intake (n = 11-14/sex/line/drug). These findings highlight the versatility of iHDID-1 and iHDID-2 mice for both the consumption of drugs of abuse and as a model to test potential therapeutics to reduce drug intake. The results here provide further evidence that targeting inflammatory signaling offers promise for reducing opioid and nicotine use."

Journal • Preclinical • Inflammation

Comparative Efficacy and Safety of Treatments for Parkinson's Disease With Depression: A Systematic Review and Bayesian Model-Based Network Meta-Analysis. (PubMed, Brain Behav) - "Our findings indicate that selective serotonin reuptake inhibitors (SSRIs), dopamine agonists, and rTMS suggest relative efficacy and an acceptable safety profile in treating PD with depression. However, given the limited evidence for several interventions, these findings should be interpreted cautiously and confirmed in larger, multicenter studies."

Clinical • Journal • Retrospective data • Review • CNS Disorders • Depression • Mood Disorders • Movement Disorders • Parkinson's Disease • Psychiatry

Association Between Ergot-Derived Dopamine Agonists and Valvular Heart Disease: A Systematic Review and Meta-Analysis. (PubMed, Cardiol Rev) - "The pooled risk ratio of VHD was significantly elevated in patients treated with pergolide [risk ratios (RR) 2.29, 95% confidence interval (CI): 1.62-3.24], cabergoline (RR 1.68, 95% CI: 1.21-2.34), and bromocriptine (RR 1.52, 95% CI: 1.02-2.27). Ergot-derived DAs are significantly associated with an increased risk of VHD. Close echocardiographic monitoring should be emphasised for patients receiving ergot-derived DAs, particularly those on long-term or high-dose therapy."

Journal • Retrospective data • Cardiovascular • CNS Disorders • Heart Failure • Movement Disorders • Parkinson's Disease

Drugs associated the most with Retroperitoneal Fibrosis: assessment of the 1969-2025 Food and Drug Administration (FDA) pharmacovigilance database (AUA 2026) - "Methysergide showed the strongest association (ROR: 5332.28; 95% CI: 4292.96 – 6623.21; PRR: 4604.65; chi-square: 429546.30; p<0.0001), followed by Pergolide (ROR: 923.85; 95% CI: 686.60 – 1243.09; PRR: 897.76; chi-square: 40148.64; p<0.0001) and Bromocriptine (ROR: 311.30; 95% CI: 224.78 – 431.13; PRR: 308.26; chi-square: 11201.91; p<0.0001). Several widely used medications such as Bisoprolol, Atenolol, and Metformin also showed significant, though less pronounced, associations (p<0.0001). The remaining drugs included Etanercept, Prednisone, Rituximab, Propranolol, and Cyclophosphamide, all of which exhibited significant levels of disproportionate reporting (p<0.0001). This analysis identified multiple drugs disproportionately associated with reports of RPF, including some with established safety profiles. Though limited by the observational nature of FAERS data, these findings suggest possible drug-induced patterns deserving clinical attention and..."

Adverse events • Fibrosis • Immunology • Inflammation • Nephrology • Renal Disease

Association Between Lifetime Hallucinogen Use and Valvular Heart Disease: Findings from the All of Us Research Program. (PubMed, J Psychoactive Drugs) - "Recent literature suggests potential associations between hallucinogen use and valvular heart disease (VHD) due to prolonged activation of serotonin 5-HT2B receptors, which may lead to valvular fibrosis - a condition also linked to drugs including fenfluramine and pergolide...This survey included questions about lifetime hallucinogen use (lysergic acid diethylamide [LSD], mushrooms/psilocybin, 3,4-Methylenedioxymethamphetamine [MDMA]/ecstasy, ketamine, phencyclidine [PCP])...However, after adjusting for confounders, models revealed modestly increased VHD odds (aOR = 1.08, 95% CI: 1.01-1.55, p = .017). This exploratory study found that hallucinogen use was associated with modestly increased VHD odds after adjustment, requiring confirmation through longitudinal research."

Journal • Cardiovascular • Fibrosis • Heart Failure • Immunology

Integrating Clinical and RNA-Seq Findings in a Mare with Recurrent Endocrinopathic Laminitis Linked to Equine Metabolic Syndrome. (PubMed, J Equine Vet Sci) - "Despite adding pergolide mesylate and resuming analgesic treatment, the mare's health continued to decline, and euthanasia was performed in November 2024...The pancreas was further analyzed by RNA sequencing and compared with a healthy animal, revealing clear transcriptomic differences. Continued research is necessary to better elucidate the mechanisms underlying EMS cases refractory to conventional treatment."

Journal • Endocrine Disorders • Genetic Disorders • Metabolic Disorders • Obesity • Pain

Parkinson's Disease & Cardiovascular Disease: A Narrative Review. (PubMed, Trends Cardiovasc Med) - "Dopamine agonists pergolide and cabergoline are associated with valve regurgitation, but this seems to be drug-related rather than caused by PD. Our review consolidates existing research to highlight the importance of recognizing cardiovascular manifestations in PD, which may present before motor symptoms. This has important implications for earlier diagnosis, better screening, and more effective management of PD."

Journal • Review • Atrial Fibrillation • Cardiomyopathy • Cardiovascular • CNS Disorders • Congestive Heart Failure • Coronary Artery Disease • Diabetes • Heart Failure • Hypertension • Hypotension • Inflammation • Metabolic Disorders • Movement Disorders • Parkinson's Disease

Integrating bulk and single-cell RNA sequencing data to dissect genetic links between periodontitis and obstructive sleep apnea. (PubMed, Sleep Breath) - "This study investigates genetic links between PD and OSA, identifying PECAM1, FCER1G, and THY1 as important diagnostic and therapeutic targets. Integrating multi-omics and machine learning provides a comprehensive approach to unravelling disease interplay and advancing treatment strategies."

Journal • Dental Disorders • Obstructive Sleep Apnea • Periodontitis • Respiratory Diseases • Sleep Disorder • CD31 • FCER1G • PECAM1 • THY1

Mechanotyping of Organoids for Assessing Drug-Induced Injuries. (PubMed, Adv Mater) - "Through experiments on organoids treated with drugs like pergolide and Cytochalasin-D, it is established that changes in organoid mechanotypes can serve as reliable indicators of drug-induced tissue injuries in vitro. These findings position the CeMeT platform as a potentially transformative tool for early-stage drug safety assessment through mechanotyping, with immediate applications extending to fundamental disease pathology research and drug efficacy testing using organoid models."

Journal • CNS Disorders • Psychiatry

Influence of Extended Photoperiod Using Blue Light Masks on Hypertrichosis, Coat Condition and General Health Parameters in Horses with Pituitary Pars Intermedia Dysfunction. (PubMed, Animals (Basel)) - "As 85% (44/52) of recruited study horses received pergolide medication, a second unmedicated PPID research herd (C2; n = 17) was recruited and remained under natural photoperiod...Improvements in coat condition (p = 0.043), clinical signs of PPID (p = 0.018), and general quality of life (p = 0.035) were reported in T only in a final study questionnaire. Blue light treatment merits further investigation as a complementary treatment for PPID."

Journal • Dermatology

Outcomes of two suture-mediated closure devices for transfemoral percutaneous access endovascular aortic procedures. (PubMed, J Cardiovasc Surg (Torino)) - "Both the older generation ProGlide™ and newer generation ProStyle™ closure devices demonstrated high technical success rates with few access vessel complications. Severe calcification and large sheath sizes could potentially impact technical success negatively."

Clinical • Journal • Retrospective data • Cardiovascular

Equine Pituitary Pars Intermedia Dysfunction. (PubMed, Vet Sci) - "Alternatively, pharmacological management can be employed, and the dopamine-2 receptor agonist pergolide is licensed/approved for the treatment of equine PPID. This should be prescribed in combination with dietary recommendations based on the body condition score and insulin sensitivity status of the individual animal."

Journal • Review • CNS Disorders • Dermatology • Infectious Disease • Infertility • Muscular Atrophy • Obesity • POMC-null Obesity • Sexual Disorders

Integrative bioinformatics analysis and experimental validation reveals key genes and regulatory mechanisms in the development of gout. (PubMed, Front Genet) - "Molecular docking suggested pergolide as a therapeutic candidate...PTGS2 knockdown enhanced cell viability and reduced apoptosis, while overexpression promoted inflammatory cytokine production and NF-κB pathway activation. This study systematically elucidated the pivotal roles of CXCL8, PTGS2, and IL10 in gout pathogenesis, providing valuable molecular targets for therapeutic development."

Journal • Gout • Inflammatory Arthritis • Rheumatology • CEBPB • CXCL8 • IL10 • KCNQ1OT1 • MIR98 • PACERR • PTGS2 • RELA • STAT3

Long-Term Response of Equids With Pituitary Pars Intermedia Dysfunction to Treatment With Pergolide. (PubMed, J Vet Intern Med) - "Long-term treatment of PPID-affected equids with pergolide produces clinical improvement in nearly all affected animals and normalization of endocrine test results in some cases. Furthermore, this extended treatment study determined that equids can respond favorably long-term to the initial pergolide dose, rather than needing a progressive increase in dose over time."

Journal • Cushing’s Disease • Endocrine Disorders

Effects of Dopamine Agonists on the Estradiol-Induced Prolactin Surge in Ovariectomized Female Wistar Han Rats. (PubMed, Toxicol Sci) - "We investigated the effects of 2 D2/D3 DAs, pergolide and rotigotine, on the estradiol (E2)-induced prolactin surge in ovariectomized (OVX) female Wistar Han rats...This study demonstrates the utility of the OVX rat model in evaluating the effects of DAs on the E2-induced prolactin surge. These results support the use of rotigotine, a DA with a long history of safe human use without significant endocrine-related adverse events, as a positive control at a dose level of 5.0 mg/kg/day for future nonclinical toxicity studies investigating the effects of novel DAs on reproductive hormones in rats."

Journal • Preclinical • CNS Disorders • Endocrine Cancer • Movement Disorders • Oncology • Parkinson's Disease • Restless Legs Syndrome • Sleep Disorder

Effect of pergolide treatment on insulin dysregulation in horses and ponies with pituitary pars intermedia dysfunction. (PubMed, Equine Vet J) - "Pergolide had no effect on tissue insulin sensitivity. However, the results suggest that postprandial hyperinsulinaemia may be limited by this dopamine receptor agonist in animals with PPID plus ID."

Journal

Pergolide mesylate administration does not decrease blood thyroid hormone concentrations and thyroid function in horses. (PubMed, Am J Vet Res) - "Protein-bound agents do not necessarily affect thyroid hormone concentrations. In horses with pituitary pars intermedia dysfunction, low thyroid hormone concentrations are likely due to the condition itself, not pergolide treatment."

Journal • Endocrine Disorders

Ergot alkaloid control in biotechnological processes and pharmaceuticals (a mini review). (PubMed, Front Toxicol) - "We reviewed analytical approaches for the determination of ergopeptines (including their dihydro- and bromine derivatives) and semisynthetic ergot-derived medicines such as cabergoline, necergoline and pergolide, including precursors for their synthesis. Both rapid methods and liquid chromatography remain in demand in routine practice, with rapid analysis evolving toward higher accuracy owing to improved analytical performance and new equipment. New composite electrochemical sensors (including disposable sensors) have demonstrated potential for real-time process control."

Journal • Review

Equine Pergolide Toxicity: A Case Series. (PubMed, Cureus) - "Veterinary medication ingestion presents a unique challenge to clinicians as the drug may have limited human toxicity data and/or recommended animal dosing may differ greatly from human dosing. Case reports of human toxicity may assist with anticipating the clinical course and guiding medical decision-making."

Journal • Cardiovascular • CNS Disorders • Cushing’s Disease • Endocrine Disorders • Heart Failure • Movement Disorders • Parkinson's Disease

In silico off-target profiling for enhanced drug safety assessment. (PubMed, Acta Pharm Sin B) - "Using the withdrawn drug Pergolide as an example, we elucidate the mechanisms underlying ADRs at the target level, contributing to the exploration of the potential clinical relevance of newly predicted off-target interactions. Overall, our work facilitates the early assessment of compound safety/toxicity based on off-target identification, deduces potential ADRs of drugs, and ultimately promotes the secure development of drugs."

Journal

Retrospective assessment of the use of extended-release cabergoline in the management of equine pituitary pars intermedia dysfunction. (PubMed, Front Vet Sci) - "Dopaminergic agonists are accepted as the most effective treatment for pituitary pars intermedia dysfunction. Clinical and endocrinological responses were consistent with results of previous reports of oral pergolide treatment. Weekly injection of ERC may be an effective alternative to pergolide; the 0.005 mg/kg dose appeared to be as effective, with less risk of inappetence, than the 0.01 mg/kg dose that has been reported previously."

Journal • Retrospective data

Metabolic and Endocrine Insights in Donkeys. (PubMed, Animals (Basel)) - "In donkeys with clinical signs of ID (obesity or recurrent laminitis) or PPID (hypertrichosis, regional adiposity, laminitis and weight loss), where these hormones are in the normal or non-diagnostic range (donkey-specific cut-off values and reference ranges need to be established), dynamic tests are recommended (oral sugar test or thyrotropin-releasing hormone, respectively). Equine treatment protocols apply to donkeys, although pharmacological studies for most drugs, except pergolide, are lacking."

Journal • Review • CNS Disorders • Dermatology • Endocrine Disorders • Genetic Disorders • Infectious Disease • Metabolic Disorders • Obesity

Microdosing psychedelics and the risk of cardiac fibrosis and valvulopathy: Comparison to known cardiotoxins. (PubMed, J Psychopharmacol) - "Concerningly, both LSD and psilocybin share structural similarities with medications which raise the risk of cardiac fibrosis and valvulopathy when taken regularly, including methysergide, pergolide, and fenfluramine. In this review, we evaluate the evidence that microdosing LSD, psilocybin, and other psychedelics for several months or more could raise the risk of cardiac fibrosis. We discuss the relationship between drug-induced cardiac fibrosis and the 5-HT2B receptor, and we make recommendations for evaluating the safety of microdosing psychedelics in future studies."

Journal • Review • Cardiovascular • Fibrosis • Immunology