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cabergoline (Rx)Brand and Other Names:Dostinex

 
 
 

Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

tablet

  • 0.5mg
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Hyperprolactinemic Disorders of Either Idiopathic or Pituitary Adenoma Origin

Initital:0.25 mg 2 times per week PO

May increase by 0.25 mg q4Weeks (or longer) up to 1 mg 2 times per week

Safety & efficacy not established

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Interactions

Interaction Checker

cabergoline and

No Results

     
     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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            Adverse Effects

            >10%

            Nausea (27%)

            Headache (26%)

            Dizziness (15%)

            Constipation (10%)

            1-10%

            Asthenia (9%)

            Fatigue (7%)

            Abdominal pain (5%)

            Somnolence (5%)

            Postural hypotension (4%)

            Depression (3%)

            Dyspepsia (2%)

            Nervousness (2%)

            Abnormal vision (1%)

            Breast pain (1%)

            Dysmenorrhea (1%)

            Hot flashes (1%)

            Paresthesia (1%)

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            Warnings

            Contraindications

            Uncontrolled hypertension

            Hypersensitivity to ergot derivatives

            Severe hepatic dz

            Severe pre-eclampsia

            Concurrency with D2 antagonists

            Women planning to nurse

            Not indicated for suppression of established lactation even in Canada

            History of cardiac valvular disorders as suggested by anatomical evidence of valvulopathy of any valve, determined by pretreatment evaluation including echocardiographic demonstration of valve leaflet thickening, valve restriction, or mixed valve restriction-stenosis

            Cautions

            Initial doses >1 mg may produce orthostatic hypotension

            Concomitant antihypertensives

            Reportedly can cause cardiac damage

            Hepatic impairment

            Inhibits lactation

            Valvular disease

            • All patients should undergo a cardiovascular evaluation, including echocardiogram to assess the potential presence of valvular disease; if valvular disease is detected, the patient should not be treated with cabergoline
            • Following treatment initiation, clinical and diagnostic monitoring (for example, chest x-ray, CT scan and cardiac echocardiogram) should be conducted to assess the risk of cardiac valvulopathy
            • Discontinue if an echocardiogram reveals new valvular regurgitation, valvular restriction or valve leaflet thickening
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            Pregnancy & Lactation

            Pregnancy Category: B

            Lactation: excretion in milk unknown; use with caution

            Pregnancy Categories

            A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA:Information not available.

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            Pharmacology

            Half-life:63-69 hr

            Distribution

            High levels in pituitary (100x of plasma)

            Peak Plasma: 30-70 pg/mL following single oral doses of 0.5-1.5 mg

            Excretion

            Urine: 22%

            Feces: 60%

            Other Information

            Protein Bound: 40-42%

            Metabolism: extensively hydrolyzed

            Renal Clearance: 0.08 L/min

            Mechanism of Action

            Dopamine receptor agonist with high affinity for D2 receptors, thereby inhibiting prolactin release

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            Formulary

            FormularyPatient Discounts

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            The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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