From the Guidelines
Cabergoline is primarily used to treat conditions related to high prolactin levels, including prolactin-secreting tumors of the pituitary gland, and is the dopamine agonist of choice for both adults and children with prolactinoma 1. The medication works by mimicking the action of dopamine in the brain, which inhibits prolactin secretion from the pituitary gland. Some key uses of cabergoline include:
- Treating prolactinomas, which are tumors of the pituitary gland that secrete excess prolactin
- Normalizing prolactin levels, which can help alleviate symptoms such as irregular menstruation, infertility, and unwanted breast milk production (galactorrhea)
- Resolving visual field defects and improving sexual function in patients with prolactinomas
- Managing symptoms caused by high prolactin levels, such as decreased sexual function and galactorrhea. The typical starting dose of cabergoline is 0.25 mg twice weekly, with gradual increases as needed based on prolactin levels and symptom response, up to 1 mg twice weekly 1. However, for patients resistant to standard doses, graduated dose increments of up to 3.5 mg per week or up to 7 mg per week in exceptional cases may be offered 1. Common side effects of cabergoline include nausea, headache, dizziness, and fatigue, which often improve with continued use. Patients should take cabergoline with food to minimize stomach upset and should be monitored regularly with blood tests to check prolactin levels and adjust dosing as needed. Those with heart valve problems should use caution, as cabergoline has been associated with heart valve abnormalities at higher doses used for Parkinson's disease.
From the FDA Drug Label
Cabergoline tablets are indicated for the treatment of hyperprolactinemic disorders, either idiopathic or due to pituitary adenomas. The main use of cabergoline is for the treatment of hyperprolactinemic disorders.
- Key indications include:
- Idiopathic hyperprolactinemic disorders
- Hyperprolactinemic disorders due to pituitary adenomas 2
From the Research
Uses of Cabergoline
- Cabergoline is used in the treatment of hyperprolactinaemia, a condition characterized by elevated levels of prolactin in the blood 3, 4, 5, 6, 7.
- It is effective in normalizing prolactin levels, restoring ovulatory cycles, and shrinking tumors in patients with hyperprolactinaemic disorders 3, 4, 5, 7.
- Cabergoline is also used to prevent or suppress puerperal lactation, and it has been shown to be more effective and better tolerated than bromocriptine in this indication 3.
- In addition, cabergoline has been used to treat infertility in women with hyperprolactinemic hypogonadism, and it has been shown to achieve a high pregnancy rate with uneventful outcomes in these patients 7.
- The drug has a favorable safety profile, with a lower incidence of adverse events compared to other dopamine agonists such as bromocriptine 3, 4, 5, 6.
Specific Patient Populations
- Cabergoline is effective in patients with microprolactinomas and macroprolactinomas, as well as in those with idiopathic hyperprolactinaemia 4, 5, 7.
- It is also effective in patients who are intolerant or resistant to bromocriptine, with a high rate of normalization of prolactin levels and restoration of ovulatory cycles 4, 7.
- Cabergoline has been used in pregnant women, and it has been shown to be safe and effective in this population, although the limited experience with the drug in pregnancy means that it cannot be considered as a first-line therapy for the treatment of infertility associated with hyperprolactinaemia 3, 7.