Cabergoline

FDA label

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Titration No less than 4 weeks between dose increases

Renal Undefined

Hepatic Mild (Child-Pugh A): no adjustment; moderate (B): increase adverse-reaction monitoring; severe (C): not recommended

Instructions

• Before initiating, evaluate for valvular heart disease including echocardiogram; do not use if valvular disease detected
• May take with or without food
• If discontinued, monitor serum prolactin periodically

Contraindications

• Uncontrolled hypertension
• Known hypersensitivity to ergot derivatives
• History of cardiac valvular disorders or pericardial fibrosis
• History of pleural, pulmonary, or retroperitoneal fibrotic disorders

Cautions

• Cardiac valvulopathy and pericardial fibrosis — echocardiogram at baseline and every 6–12 months
• Pleural, pulmonary, and retroperitoneal fibrosis
• Orthostatic hypotension
• Avoid use for inhibition/suppression of physiologic lactation
• Impulse control disorders and compulsive behaviors

Adverse reactions

• Nausea
• Headache
• Dizziness
• Constipation
• Fatigue
• Postural hypotension

Pregnancy If conception occurs, discontinue if maternal/fetal risks outweigh benefits; generally avoid dopamine agonists in pregnancy/postpartum

Lactation Not recommended while breastfeeding; avoid for lactation suppression