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Cabergoline

    Brands

    DAE Class; Rx

    Common Brand Names; Dostinex

    • Hyperprolactinemia

    Oral ergoline-derived dopamine agonist
    Used for the treatment of hyperprolactinemia (idiopathic or due to pituitary adenomas); used off-label for treating selected patients with Cushing’s syndrome
    Evaluate cardiac status before initiation; periodically evaluate risk of cardiac valvulopathy during use

    Indicated for hyperprolactinemic disorders of either idiopathic or pituitary adenoma origin

    Uncontrolled hypertension

    Hypersensitivity to ergot derivatives

    Severe hepatic disease

    Concurrent use with D2 antagonists

    History of pulmonary, pericardial, or retroperitoneal fibroti disorders

    Women planning to nurse

    History of cardiac valvular disorders as suggested by anatomical evidence of valvulopathy of any valve, determined by pretreatment evaluation including echocardiographic demonstration of valve leaflet thickening, valve restriction, or mixed valve restriction-stenosis

    >10%

    Nausea (27%)

    Headache (26%)

    Dizziness (15%)

    1-10%

    Asthenia (9%)

    Fatigue (7%)

    Abdominal pain (5%)

    Somnolence (5%)

    Postural hypotension (4%)

    Depression (3%)

    Dyspepsia (2%)

    Nervousness (2%)

    Abnormal vision (1%)

    Breast pain (1%)

    Dysmenorrhea (1%)

    Hot flashes (1%)

    Paresthesia (1%)

    Constipation (10%)

    <1%

    Aggression

    Fibrosis

    Gastric ulcer

    Valvulopathy

    Gastric ulcer

    Pleural effusion

    Psychosis

    Initial doses >1 mg may produce orthostatic hypotension

    Concomitant antihypertensives

    May cause somnolence; avoid performing tasks that require mental alertness

    Reportedly can cause cardiac damage

    May cause orthostatic hypotension; avoid concurrent use with antihypertensives

    Rare cases of retroperitoneal fibrosis reported

    Hepatic impairment

    Inhibits lactation

    Impulse control/compulsive behaviors reported in patients receiving therapy; this has been generally reversible upon reduction of dose or treatment discontinuation; prescribers should consider dose reduction or stopping medication if a patient develops such urges while receiving therapy

    Pregnancy Category: B

    Lactation: excretion in milk unknown; not recommended

    Adults

    The usual maximum for hyperprolactinemia is 1 mg PO twice per week, but doses of 3 mg/week have been reported. Max off-label dose reported for Cushing’s syndrome: 7 mg/week PO.

    Geriatric

    The usual maximum for hyperprolactinemia is 1 mg PO twice per week, but doses of 3 mg/week have been reported. Max off-label dose reported for Cushing’s syndrome: 7 mg/week PO.

    Adolescents

    Safety and efficacy have not been established.

    Children

    Safety and efficacy have not been established.

    Infants

    Safety and efficacy have not been established.

    Cabergoline

    tablet

    • 0.5mg