cabergoline

Contraindicated in:

Hypersensitivity to cabergoline or ergot alkaloids;
Uncontrolled hypertension;
History of pulmonary, pericardial, or retroperitoneal fibrotic disorders;
History of cardiac valvular disease;
Lactation: Has been associated with hypertension, stroke, and seizures. Not to be used for suppression of physiologic lactation.

Use Cautiously in:

Hepatic impairment;
Patients who have received medications associated with valvular disorders;
OB: Use only if clearly needed;
Pedi: Safety not established.

Adv. Reactions/Side Effects ⬆ ⬇

CV: hot flashes, PERICARDIAL FIBROSIS, postural hypotension, VALVULAR DISORDERS

EENT: abnormal vision

Endo: breast pain

GI: constipation, nausea, abdominal pain, dyspepsia, RETROPERITONEAL FIBROSIS, vomiting

GU: dysmenorrhea

Neuro: dizziness, headache, depression, drowsiness, fatigue, impulse control disorders (gambling, sexual), nervousness, paresthesia, vertigo, weakness

Resp: pleural effusion, PULMONARY FIBROSIS

Interactions ⬆ ⬇

Drug-drug:

↑risk of hypotension with antihypertensives.
May ↑ the effects of SSRIs and other serotonin agonists (induces serotonin syndrome).
Effectiveness may be ↓ by phenothiazines, butyrophenones (haloperidol), thioxanthenes, or metoclopramide (avoid concurrent use).

Availability ⬆ ⬇

(Generic available)

Tablets: 0.5 mg

Route/Dosage ⬆ ⬇

PO (Adults ): 0.25 mg twice weekly; may be ↑ at 4-wk intervals up to 1 mg twice weekly.

US Brand Names ⬆ ⬇

Action ⬆ ⬇

Inhibits secretion of prolactin by acting as a dopamine agonist.

Therapeutic effects:

Decreased secretion of prolactin in hyperprolactinemia.

Classifications ⬆ ⬇

Therapeutic Classification: antihyperprolactinemic

Pharmacologic Classification: dopamine agonists

Pharmacokinetics ⬆ ⬇

Absorption: Well absorbed but undergoes extensive first-pass hepatic metabolism.

Distribution: Widely distributed; concentrates in pituitary.

Metabolism/Excretion: Extensively metabolized by the liver; <4% excreted unchanged in urine.

Protein Binding: 40–42%.

Half-Life: 63–69 hr.

Time/Action Profile ⬆ ⬇

(effect on serum prolactin levels)

ROUTE	ONSET	PEAK	DURATION
PO	unknown	2–3 hr	unknown

Patient/Family Teaching ⬆ ⬇

Instruct patient to take medication as directed. Take missed doses as soon as possible within 1 or 2 days. If not remembered until time of next dose, double dose. If nausea occurs, discuss with health care professional.
May cause drowsiness and dizziness. Caution patient to avoid driving and other activities requiring alertness until response to medication is known.
Advise patient to change positions slowly to minimize orthostatic hypotension.
Caution patient to avoid concurrent use of alcohol during therapy.
Instruct patients taking cabergoline for pituitary tumors to inform health care professional immediately if signs of tumor enlargement occur (blurred vision, sudden headache, severe nausea, and vomiting).
Advise patient to notify health care professional if signs of valvular disorders (shortness of breath, swelling in extremities) occurs.
Advise patient to notify health care professional if new or increased gambling, sexual, or other impulse control disorders occur.
Advise women to consult with health care professional regarding a nonhormonal method of birth control. Women should contact health care professional promptly if pregnancy is planned or suspected.
Emphasize the importance of regular follow-up exams to determine effectiveness and monitor side effects.

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Indications ⬇

Contraind./Precautions ⬆ ⬇