cabergoline (Rx)

Brand and Other Names:Dostinex
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Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

tablet

  • 0.5mg
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Hyperprolactinemia

Indicated for hyperprolactinemic disorders of either idiopathic or pituitary adenoma origin

Initital: 0.25 mg PO 2x/week

May increase by 0.25 mg q4Weeks (or longer) up to 1 mg 2x/week

Safety & efficacy not established

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Interactions

Interaction Checker

and cabergoline

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%)

            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%)

            Constipation (10%)

            <1%

            Aggression

            Fibrosis

            Gastric ulcer

            Valvulopathy

            Gastric ulcer

            Pleural effusion

            Psychosis

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            Warnings

            Contraindications

            Uncontrolled hypertension

            Hypersensitivity to ergot derivatives

            Severe hepatic disease

            Concurrent use with D2 antagonists

            History of pulmonary, pericardial, or retroperitoneal fibroti disorders

            Women planning to nurse

            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

            May cause somnolence; avoid performing tasks that require mental alertness

            Reportedly can cause cardiac damage

            May cause orthostatic hypotension; avoid concurrent use with antihypertensives

            Rare cases of retroperitoneal fibrosis reported

            Pathological gambling and increased libido reported

            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; not recommended

            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

            Mechanism of Action

            Long acting dopamine receptor agonist with high affinity for D2 receptors, thereby inhibiting prolactin release

            Pharmacokinetics

            Half-life:63-69 hr

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

            Excretion: Urine (22%); feces (60%)

            Protein Bound: 40-42%

            Peak plasma time: 2-3 hr

            Metabolism: Extensively hydrolyzed in the liver

            Renal Clearance: 0.08 L/min

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            Images

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            Formulary

            FormularyPatient Discounts

            Adding plans allows you to compare formulary status to other drugs in the same class.

            To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

            Adding plans allows you to:

            • View the formulary and any restrictions for each plan.
            • Manage and view all your plans together – even plans in different states.
            • Compare formulary status to other drugs in the same class.
            • Access your plan list on any device – mobile or desktop.

            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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            Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.