Cabgolin (cabergoline) is a potent dopamine receptor agonist specifically formulated for the management of hyperprolactinemic disorders. It offers a targeted mechanism of action that directly inhibits prolactin secretion from the pituitary gland, providing a non-invasive pharmacological alternative to surgical intervention. With its high receptor affinity and extended half-life, Cabgolin ensures sustained therapeutic effects, facilitating improved endocrine balance and symptom resolution in appropriately indicated patients. Its well-established efficacy profile makes it a cornerstone in endocrinological and gynecological therapeutics.

Features

• Active ingredient: Cabergoline 0.5 mg or 1.0 mg per tablet
• Mechanism: Selective dopamine D2 receptor agonist
• High bioavailability and lipophilic properties for efficient CNS penetration
• Long elimination half-life (approximately 63–69 hours) allowing for less frequent dosing
• Tablet formulation for precise oral administration
• Manufactured under strict pharmaceutical quality control standards

Benefits

• Effectively suppresses pathological prolactin secretion to within normal physiological ranges
• Restores gonadal function and fertility in patients with hyperprolactinemia-induced hypogonadism
• Reduces or eliminates galactorrhea and associated breast discomfort
• Promotes regression of prolactin-secreting pituitary microadenomas
• Minimizes risk of disease progression and complications related to untreated hyperprolactinemia
• Offers convenient twice-weekly dosing regimen enhancing long-term adherence

Common use

Cabgolin is primarily indicated for the treatment of hyperprolactinemia, including idiopathic or pituitary adenoma-induced elevations in prolactin levels. It is routinely prescribed for the management of associated manifestations such as amenorrhea, oligomenorrhea, infertility, and galactorrhea. In men, it addresses hypogonadism, decreased libido, and erectile dysfunction secondary to elevated prolactin. Off-label uses may include adjunctive management in Parkinson’s disease and restless legs syndrome, though these applications require careful specialist supervision.

Dosage and direction

Initiate treatment at 0.25 mg twice weekly, preferably with meals to minimize gastrointestinal discomfort. Titrate gradually by 0.25 mg per week at monthly intervals based on prolactin level monitoring and therapeutic response. Most patients achieve maintenance doses between 0.5 mg to 2.0 mg per week, administered in divided doses (e.g., Monday and Thursday). Maximum recommended dose is 4.5 mg per week. Always individualize dosing based on periodic serum prolactin measurements and clinical evaluation. Do not crush or split tablets; administer whole with water.

Precautions

Periodically assess cardiac function via echocardiography before initiation and during treatment, particularly at higher doses, due to risk of valvulopathy. Monitor for signs of fibrosis (pleural, pericardial, retroperitoneal). Use caution in patients with hepatic impairment; consider dose adjustment. May cause orthostatic hypotension—advise patients to rise slowly from sitting/lying positions. Dopamine agonists can precipitate impulse control disorders; monitor for new-onset gambling, hypersexuality, or compulsive behaviors. Not recommended during pregnancy unless clearly needed and benefits outweigh risks.

Contraindications

Hypersensitivity to cabergoline, ergot derivatives, or any excipients in the formulation. History of cardiac valvular disorders as evidenced by echocardiography (regurgitation, thickening, or stenosis). Uncontrolled hypertension. Pregnancy, unless in exceptional circumstances under specialist care. Concomitant use with medications that may exacerbate hypotension or cause additive dopaminergic effects. Severe hepatic impairment without appropriate dose monitoring and adjustment.

Possible side effect

• Nausea, vomiting, dyspepsia, or abdominal pain (usually transient)
• Headache, dizziness, or fatigue
• Orthostatic hypotension or syncope
• Constipation or diarrhea
• Nasal congestion
• Hot flashes or peripheral edema
• Less commonly: valvular heart disorders, pleural effusion, pulmonary fibrosis
• Rarely: psychiatric effects including hallucinations, confusion, or impulse control disorders

Drug interaction

Concomitant use with other dopamine antagonists (e.g., phenothiazines, butyrophenones, metoclopramide) may diminish efficacy. Macrolide antibiotics (e.g., erythromycin) can increase cabergoline plasma concentrations. Hypotensive agents may potentiate orthostasis. Avoid combination with serotonin agonists (triptans) due to theoretical risk of serotonin syndrome. Use caution with CYP3A4 inhibitors/inducers. Antipsychotics may counteract prolactin-lowering effects.

Missed dose

Take the missed dose as soon as remembered unless it is nearly time for the next scheduled dose. Do not double the dose to make up for a missed one. Resume the regular dosing schedule. If multiple doses are missed, consult a healthcare provider for guidance on re-titration to avoid adverse effects.

Overdose

Symptoms may include severe nausea, vomiting, hypotension, hallucinations, or psychosis. Management is supportive: gastric lavage if recent ingestion, activated charcoal, and close monitoring of vital signs. Treat hypotension with intravenous fluids and vasopressors if necessary. There is no specific antidote. Hemodialysis is unlikely to be effective due to high protein binding.

Storage

Store at room temperature (15–30°C) in a dry place, protected from light and moisture. Keep in the original container with the lid tightly closed. Do not store in bathrooms or near sinks. Keep out of reach of children and pets. Do not use after the expiration date printed on the packaging.

Disclaimer

This information is intended for medical professionals and should not replace personalized advice from a qualified healthcare provider. Dosage, indications, and monitoring must be individualized based on clinical context, patient history, and ongoing assessment. Always consult prescribing information and current clinical guidelines before initiation or adjustment of therapy.

Reviews

“Consistently effective in normalizing prolactin levels and restoring menstrual cycles in my patients with microprolactinomas. The twice-weekly dosing is well tolerated and promotes compliance.” – Endocrinologist, 12 years of experience
“Superior side effect profile compared to bromocriptine. Most patients report minimal nausea, and titration is straightforward with good patient acceptance.” – Gynecologist, specialized in infertility
“Important to monitor echocardiograms periodically, but overall a highly effective and specific agent for hyperprolactinemia management.” – Clinical Pharmacologist
“Rapid response in reducing galactorrhea and resolving associated symptoms. A mainstay in my practice for endocrine disorders.” – Internal Medicine Specialist