Pharm

Cabergoline

search

Cabergoline, Dostinex

  • Contraindications
  1. Cardiovascular Disease
  • Dosing
  • Adult
  1. Hyperprolactinemia
    1. Start: 0.25 orally twice weekly
    2. Titrate: Increase by 0.25 mg every month up to 1 mg twice weekly
    3. Follow Serum Prolactin levels
      1. May stop Cabergoline after Serum Prolactin normal for 6 months
  2. Acromegaly (not FDA approved)
    1. Start 0.5 mg orally twice weekly
    2. Base titration on plasma IGF1 Levels
      1. May increase up to 3.5 mg/dose each week as needed
  • Pharmacokinetics
  1. Hepatic metabolism
  • Adverse Effects
  1. Fewer adverse effects than Bromocriptine (but less observational data in pregnancy)
  2. Safety
    1. Pregnancy Category B
    2. Avoid in Lactation
  3. Nausea or Vomiting
  4. Postural Hypotension
  5. Dizziness
  6. Headache
  7. Sedation
  8. Hypersexuality and Compulsive Gambling (risk with most Dopamine Agonists)
  9. Valvular disorders
    1. Reported with high dose Cabergoline (>4 mg daily)
    2. Follow Echocardiogram every 6 to 12 months
  10. Fibrosis
    1. Pleural fibrosis
    2. Retroperitoneal fibrosis
    3. Cardiac fibrosis
  • References
  1. Hamilton (2020) Tarascon Pocket Pharmacopoeia
  2. Huang (2012) Am Fam Physician 85(11): 1073-80 [PubMed]