Cabergoline is used to suppress breast milk production shortly after childbirth, stillbirth, abortion, or miscarriage. It may also be prescribed for women who choose not to continue breastfeeding. Additionally, Cabergoline is indicated for treating conditions caused by hormonal imbalance that lead to elevated prolactin levels in the blood.

Cabergoline belongs to a class of medications known as dopamine receptor agonists. It works by lowering the release of prolactin hormone from the pituitary gland. It is commonly used to manage conditions where there is an excess level of prolactin in the bloodstream, a condition known as hyperprolactinemia.

Cabergoline acts as a dopamine receptor agonist. Prolactin secretion from the anterior pituitary gland is mainly regulated by inhibitory signals from the hypothalamus through dopamine release. Cabergoline is a long-acting agent with strong affinity for D2 receptors. Studies have shown that it directly suppresses prolactin secretion from pituitary cells. Research also indicates that Cabergoline has minimal affinity for dopamine D1, α1, α2 adrenergic, and serotonin (5HT1, 5HT2) receptors.

The recommended dosage of Cabergoline for initiation of therapy is 0.25 mg twice a week. Dosage may be increased by 0.25 mg twice weekly up to a dosage of 1 mg twice a week according to the patient’s serum prolactin level. Dosage increases should not occur more rapidly than every 4 weeks, so that the physician can assess the patient’s response to each dosage level. If the patient does not respond adequately and no additional benefit is observed with higher doses, the lowest dose that achieved maximal response should be used and other therapeutic approaches considered. After a normal serum prolactin level has been maintained for 6 months, Cabergoline may be discontinued, with periodic monitoring of the serum prolactin level to determine whether or when treatment with Cabergoline should be reinstituted.

• To prevent milk production (lactation): 1 mg Cabergoline tablet on the first day after delivery.
• To stop lactation once have started to breastfeed: 0.25 mg Cabergoline tablet every 12 hours for two days.
• To reduce prolactin levels in other conditions: Initially take one Cabergoline 0.5 mg tablet (to be taken in two doses) spread out over a week (e.g., half a tablet on Monday and the other half of the tablet on Thursday). Dose will be increased up to a maximum dose of 4.5 mg or until have responded fully to treatment.

Cabergoline may interact with antihypertensive medicines used to lower blood pressure, antipsychotic drugs such as chlorpromazine and haloperidol, and medications used for nausea and vomiting like domperidone and metoclopramide. It may also interact with drugs used for migraine, including ergot derivatives such as pergolide, bromocriptine, lisuride, ergotamine, dihydroergotamine, ergometrine, and methysergide.

Cabergoline is contraindicated in patients with a history of severe psychiatric disorders, particularly psychosis, as well as in those with liver or kidney disease. It should not be used in patients with pregnancy-induced hypertension such as toxemia or pre-eclampsia, or in individuals with a history of mental illness associated with childbirth (puerperal psychosis).

Patients who are pregnant or planning pregnancy should consult a doctor before using cabergoline. Cabergoline is categorized as pregnancy category B. If pregnancy occurs, treatment should be discontinued for at least one month, as the drug suppresses milk production. Women who intend to breastfeed should avoid using cabergoline.

Women who are pregnant or planning pregnancy should consult their physician before starting treatment. Cabergoline falls under pregnancy category B. Before initiating therapy, it should be confirmed that the patient is not pregnant. If pregnancy occurs, cabergoline should be discontinued for at least one month. Since cabergoline inhibits lactation, it should not be used by women who wish to breastfeed.

Cabergoline should be used cautiously in the following situations:

• Hypersensitivity to cabergoline or other ergot alkaloids (e.g., bromocriptine, pergolide, lisuride, ergotamine, ergometrine)
• Severe liver disease
• Hypertension during pregnancy with edema and proteinuria
• History of psychiatric illness, especially postpartum psychosis
• During pregnancy or breastfeeding
• Long-term use associated with fibrotic reactions affecting the heart

Dopamine agonists should generally be avoided in pregnancy-induced hypertension unless benefits outweigh risks. Higher initial doses may cause orthostatic hypotension. Caution is advised when used with antihypertensive drugs. Cabergoline is not recommended for routine suppression of normal lactation. Because cabergoline is extensively metabolized in the liver, caution is needed in hepatic impairment. In cases of pleural effusion, pulmonary fibrosis, or valvular heart disease, discontinuation may improve symptoms.

Overdose may lead to symptoms such as nasal congestion, fainting, or hallucinations. Supportive treatment should be provided, including measures to maintain blood pressure if necessary.

Antiparkinson drugs

Store in a cool, dry place away from light. Keep out of reach of children.