Formulary
Cabergoline: Indications, Dosing, Side Effects and Interactions
Cabergoline is a stimulant of dopamine receptors in the brain and it also inhibits release of prolactin by the pituitary.
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Cabergoline: Indications, Dosing, Side Effects and Interactions
Cabergoline is a stimulant of dopamine receptors in the brain and it also inhibits release of prolactin by the pituitary.
Drug action
Cabergoline is a stimulant of dopamine receptors in the brain and it also inhibits release of prolactin by the pituitary.
Indications and dose
**Prevention of lactation**
- **Adult** (By Mouth): 1 mg, to be taken as a single dose on the first day postpartum.
**Suppression of established lactation**
- **Adult** (By Mouth): 250 micrograms every 12 hours for 2 days.
**Hyperprolactinaemic disorders**
- **Adult** (By Mouth): Initially 500 micrograms once weekly, dose may be taken as a single dose or as 2 divided doses on separate days, then increased in steps of 500 micrograms every month until optimal therapeutic response reached, increase dose following monthly monitoring of serum prolactin levels; usual dose 0.25-2 mg once weekly, usually 1 mg weekly; reduce initial dose and increase more gradually if patient intolerant, doses over 1 mg weekly to be given as divided dose; maximum 4.5 mg per week.
**Alone or as adjunct to co-beneldopa or co-careldopa in Parkinson's disease where dopamine-receptor agonists other than ergot derivative not appropriate**
- **Adult** (By Mouth): Initially 1 mg daily, then increased in steps of 0.5-1 mg every 7-14 days, concurrent dose of levodopa may be decreased gradually while dose of cabergoline is increased; maximum 3 mg per day.
Cautions
Cardiovascular disease; history of peptic ulcer; history of serious mental disorders (especially psychotic disorders); Raynaud's syndrome Cautions, further information Hyperprolactinemic patients In hyperprolactinaemic patients, the source of the hyperprolactinaemia should be established (i.e. exclude pituitary tumour before treatment).
Contraindications
Cardiac valvulopathy-exclude before treatment (does not apply to suppression of lactation); eclampsia; history of pericardial fibrotic disorders; history of puerperal psychosis; history of pulmonary fibrotic disorders; history of retroperitoneal fibrotic disorders; hypertension in postpartum women; pre-eclampsia; uncontrolled hypertension Contra-indications, further information Use in prevention or suppression of lactation Hypertension, myocardial infarction, seizures or stroke (both sometimes preceded by severe headache or visual disturbances), and psychiatric disorders have been reported in postpartum women given cabergoline for lactation suppression-caution with drugs that affect blood pressure and avoid other ergot alkaloids. Discontinue immediately if hypertension, suggestive chest pain, severe progressive or unremitting headache, or signs of CNS toxicity develop. M
Side effects
Common or very common Asthenia; breast pain; cardiac valve disorders; confusion; constipation; depression; dizziness; drowsiness; dyspnoea; gastritis; gastrointestinal discomfort; hallucination; headache; hot flush; hypotension; movement disorders; nausea; oedema; pericardial effusion; pericarditis; sexual dysfunction; sleep disorder; vertigo; vomiting Uncommon Alopecia; delusions; digital vasospasm; epistaxis; erythromelalgia; fibrosis; hepatic function abnormal; leg cramps; palpitations; paraesthesia; psychotic disorder; pulmonary fibrosis; rash; respiratory disorders; syncope; vision disorders Frequency not known Aggression; angina pectoris; chest pain; hypertension; myocardial infarction; pathological gambling; psychiatric disorder; seizure; stroke; sudden onset of sleep (can occur without warning); tremor
Interactions
**Other interactions (3):**
- The concomitant use of other drugs during early puerperium, particularly of ergot alkaloids, was not associated with detectable interactions modifying the efficacy and safety of cabergoline.
- No information is available about the interaction between cabergoline and other ergot alkaloids; therefore, the concomitant use of these medications during long-term treatment with cabergoline is...
- Since cabergoline exerts its therapeutic effect by direct stimulation of dopamine receptors, it should not be concurrently administered with drugs which have dopamine-antagonist activity (such as...
Pregnancy
Discontinue if pregnancy occurs during treatment (specialist advice needed).
Breast feeding
Suppresses lactation; avoid breast-feeding if lactation prevention fails.
Hepatic impairment
Manufacturer advises caution in severe impairment (risk of increased exposure). Dose adjustments Manufacturer advises consider dose reduction in severe impairment.
Medicinal forms
Clinical governance
**Author:** MedNext Clinical Team. **Clinical reviewer:** Dr Shameer Deen, MBBS, MS, MRCS. **Sources:** BNF, Indian Pharmacopoeia, CIMS India. **Correction:** Report errors at support@mednext.academy.
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