Cabergoline

Used to regulate prolactin production in the body, Cabergoline is prescribed to treat various different types of conditions.

Overview

Normally produced in the pituitary gland, prolactin is a hormone which affects numerous functions in the body. As well as affecting milk production, prolactin is believed to affect the immune system, the reproductive system, the metabolic system and the regulation of fluids.

As prolactin has an effect on so many bodily functions, there are various illnesses which can occur if prolactin production is disrupted. When too much prolactin is produced, individuals can suffer from thyroid problems, excess lactation, menstrual disruptions, low testosterone and even pituitary tumors.

By stopping the pituitary gland from making and releasing prolactin, Cabergoline effectively treats hyperprolactinemia and its associated conditions. Once the medication has been prescribed, patients will usually take Cabergoline for a significant period of time. This allows the medication to reduce prolactin production or stop it completely and ensures that the patient’s prolactin levels return to normal.

With so many conditions associated with hyperprolactinemia or excess prolactin, Cabergoline is a treatment which is routinely used. Although milk production is normally associated with female patients, males can suffer from hyperprolactinemia as well. Due to this, Cabergoline is regularly prescribed to both male and female patients, once the excessive production of prolactin has been confirmed.

Conditions Treated:

  • Hyperprolactinaemia (Excessive levels of prolactin)

Type of Medicine:

  • Dopamine Receptor Agonist

Side Effects:

When taking any medication, there is always the possibility that side-effects can occur. Whilst many of these side-effects are relatively mild and unproblematic, some side-effects may indicate an issue with treatment. Severe side-effects may mean that the dose of the medication needs to be altered, for example, or that an alternative treatment should be sought.

If patients experience the following side-effects when taking Cabergoline, they should seek medical advice from their doctor. Whilst they may not be indicative of a problem, the patient’s doctor will be able to rule out any adverse physiological effects and provide further advice regarding treatment. Side-effects which warrant medical attention include:

  • Chest pain or tightness
  • Continuing loss of appetite
  • Vomiting
  • Continuing or severe nausea and vomiting
  • Cough
  • Burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
  • Fever
  • Cold sweats
  • Lower abdominal or stomach pain
  • Rapid weight gain
  • Swelling around the eyes
  • Shortness of breath
  • Trouble with breathing
  • Continuing or severe abdominal or stomach pain
  • Weakness
  • Bloating or swelling of the face, arms, hands, lower legs, or feet
  • Decreased ability to exercise
  • Chills
  • Increased frequency of urination
  • Confusion
  • Unusual tiredness or weakness
  • Fast, irregular, pounding, or racing heartbeat or pulse
  • General feeling of discomfort or illness
  • Lower back pain
  • Nausea
  • Tingling of the hands or feet
  • Dizziness, faintness, or lightheadedness when getting up from lying or sitting position
  • Unusual weight gain or loss

Although the above side-effects due require medical attention, there are additional side-effects which may not warrant urgent medical assessment. In many instances, these side-effects will subside as the patient becomes accustomed to the medication. These include:

  • Difficulty having a bowel movement (stool)
  • Abdominal or stomach pain
  • Excess air or gas in the stomach or intestines
  • Headache
  • Belching
  • Lack or loss of strength
  • Passing gas
  • Dizziness
  • Acid or sour stomach
  • Anxiety
  • Full feeling
  • Changes in vision
  • Breast pain
  • Burning, itching, or stinging of the skin
  • Blemishes on the skin
  • Joint pain
  • Gas
  • Diarrhea
  • Difficulty with moving
  • Itching
  • Feeling of constant movement of self or surroundings
  • Feeling of warmth
  • Depression
  • Heartburn
  • Heavy bleeding
  • Runny nose
  • Dry mouth or toothache
  • Cramps
  • Muscle aches and pains
  • Muscle stiffness
  • Shivering
  • Difficulty in concentrating
  • Redness of the face, neck, arms, and occasionally, upper chest
  • Indigestion
  • Sensation of spinning
  • Pimples
  • Sore throat
  • Sudden sweating
  • Sneezing
  • Stomach discomfort or upset
  • Unable to sleep
  • Weight loss
  • Bloody nose
  • Increased in sexual ability, desire, drive, or performance

Although these side-effects can be unpleasant, they do not necessarily mean that treatment with Cabergoline is ineffective. In addition to this, if patients experience side-effects when they begin taking Cabergoline, it doesn’t necessarily mean that these side-effects will be present for as long as they take the medication.

If the patient finds that the side-effects are becoming intolerable or if they have questions about the presence of side-effects, they should seek medical advice from a doctor or pharmacist.

When taking Cabergoline, some patients may experience emotional or psychological side-effects. Although fairly rare, patients may notice behavioral changes occurring when they’re taking the medication. In addition to this, patients may feel that they are being watched or controlled by another person or they may feel that other people can hear their thoughts. As well as this, patients may exhibit unusual behavior, undergo mood changes or display excessive and unregulated behavior.

Although these types of side-effects are not common, patients should seek medical help if they notice psychological changes when taking Cabergoline. In many cases, doctors will be able to help minimize the side-effects with further treatment or provide an alternative treatment for prolactin reduction.

The Food and Drug Administration invites patients to report side-effects to them, if they experience any when they’re taking medication. This enables them to collate information and hone the use of the drug in the future. If they wish to do so, patients can contact the FDA on 1-800-FDA-1088 to report symptoms.

Dosage:

When patients are prescribed Cabergoline, they will be told how much medication to take by their physician. The patient’s medical history, weight, age and prolactin levels will all have an impact on the dosing strategy so it’s important that patients follow their doctor’s instructions.

As well as being told the appropriate dose to take, patients should find that their specific dosage instructions are printed and placed on the box of the medication. This ensures that patients can refer back to these instructions and confirm that they are taking the appropriate dose of Cabergoline.

Although every patient will be given an individual treatment plan, there are standard starting doses of Cabergoline. When adults are prescribed Cabergoline for high prolactin levels or pituitary tumors, they are often started on a dose of 0.25mg twice weekly. After monitoring the patient’s response to the drug, doctors may increase the dose so that the medication is more effective. Although the dose can be increased, physicians will not normally prescribe more than 1mg of Cabergoline twice weekly.

Whilst this is an example of a standard Cabergoline dosing procedure, every patient is different and should follow the instructions given to them by their physician.

If the patient misses a dose of Cabergoline, they should take the missed dose as soon as they remember to do so. If it is almost time for the next dose to be administered, patients should seek medical advice from their doctor. In some instances, physicians may advise the patient to take a double dose of Cabergoline, if a previous dose has been missed. Patients should not take a double dose of medication without clear advice from a medical professional, even if a dose has been skipped or missed.

Potential drug Interactions:

Using Cabergoline with Sulpiride medication is not normally recommended because of the possible interactions which can occur. If the patient is already taking Sulpiride, doctors may decide not to prescribe Cabergoline as well.

Similarly, Cabergoline may not be prescribed in conjunction with anti-psychotic medications and/or anti-nausea medications. These medications tend to have opposing effects on the body and may, therefore, cancel each other out if they are taken at the same time.

Whilst additional drug interactions may occur, they are not always as serious as the above examples. By changing the dose of medications, providing treatment for side-effects and altering the time medication should be taken, doctors may still prescribe Cabergoline alongside the following drugs, even though interactions are possible:

  • Acetaminophen
  • Clarithromycin
  • Aspirin
  • Lorcaserin
  • Amoxicillin
  • Omeprazole
  • Erythromycin
  • Sulfisoxazole
  • Propoxyphene
  • Sodium Oxybate
  • Troleandomycin
  • Aripiprazole
  • Quinapril
  • Benazepril
  • Olmesartan
  • Valsartan
  • Hydrochlorothiazide
  • Perindopril
  • Amoxapine
  • Nifedipine
  • Flibanserin
  • Promethazine
  • Hydralazine
  • Chlorothiazide
  • Rufinamide
  • Betaxolol
  • Bendroflumethiazide
  • Sotalol
  • Verapamil
  • Methyldopa
  • Reserpine
  • Doxazosin
  • Diltiazem
  • Clonidine
  • Nitroglycerin
  • Torsemide
  • Eplerenone
  • Fluoxetine
  • Eprosartan
  • Felodipine
  • Fosinopril
  • Flibanserin
  • Furosemide
  • Ziprasidone
  • Guanethidine
  • Haloperidol
  • Propranolol
  • Triamterene
  • Moexipril
  • Metolazone
  • Nitroprusside
  • Olanzapine
  • Azithromycin
  • Tizanidine
  • Ethacrynic Acid

Although Cabergoline can interact with the above prescription medications, it can also interact with over-the-counter medications, vitamins and herbal or sports supplements. If patients are taking of these substances, they should discuss usage with their physician before taking Cabergoline.

Similarly, if patients purchase over-the-counter medications, supplements or vitamins when taking Cabergoline, they should seek medical advice before taking or consuming anything.

Warnings:

If patients take too much Cabergoline, they may begin to experience the effects of an overdose. The symptoms may present as seeing, feeling or hearing things which aren’t really present, fainting and/or having a stuffy nose. If patients have taken too much Cabergoline or begin to exhibit symptoms of an overdose, emergency medical help should be sought.

If patients are suffering from any other medications, they may affect the suitability of Cabergoline as a treatment for high prolactin levels. The following conditions affect the way the medicine works and may, therefore, prevent Cabergoline from being prescribed:

  • Heart problems
  • Heart valve disease
  • Fibrotic disorders (such as scarring of the lungs, heart or stomach)
  • Heart disease
  • Hypertension
  • Lung disease
  • High blood pressure
  • Breathing problems or difficulties
  • Liver disease

Although these conditions may prevent Cabergoline from being prescribed, they will not necessarily be a barrier to treatment. If a patient has experienced heart valve problems, for example, doctors may carry out various tests, such as an EKG, to determine whether the use of Cabergoline is appropriate.

If patients have experienced any of these conditions or are receiving treatment currently, they should inform their physician before taking Cabergoline. By providing medics with information regarding their medical history, patients can ensure that they have access the most the appropriate medications.

Cabergoline is considered to be a category B drugs in terms of treating pregnant women. This means that there have not been enough studies carried out on human patients to determine whether or not treatment with Cabergoline could harm an unborn baby. Due to this, doctors may be unwilling to prescribe Cabergoline to pregnant patients, unless no alternative is available and the benefits outweigh the potential risks.

If patients become pregnant when taking Cabergoline, they should seek advice from their doctor as soon as possible.

Similarly, it is not yet known if Cabergoline can be passed to infants when they are nursed by their mother. If the drug can be passed to the infant via breastfeeding, it is likely to have an effect on the child. Due to this, mothers may want to refrain from breastfeeding while they are receiving treatment with Cabergoline. Affected patients should discuss this decision with their doctor before taking Cabergoline.

Although Cabergoline can be prescribed to older patients, it is important that their medical history and current health is examined in detail. Elderly patients may be more likely to suffer from heart, kidney and lung problems which may affect the proposed treatment. In addition to this, elderly patients may take longer to process the drug and the dose may need to be reduced to reflect this.

When taking any medication, there is the possibility of the patient suffering an allergic reaction. This is often characterized by swelling of the throat, lips and/or tongue, trouble breathing and/or skin rashes and itching. If patients develop these symptoms, it is a medical emergency and they will require immediate medical attention.

If patients are aware of any existing allergies, they should inform their physician and pharmacist so that they are not at risk of developing a reaction when taking Cabergoline.

Storage

Cabergoline is generally prescribed in tablet form and most patients are able to store the medicine at home and take it as directed. When storing medication at home, it’s essential that patients use a secure location. If pets and/or children are present in the home, the medication must be kept in a location where it cannot be accessed.

In addition to this, Cabergoline should be at room temperature and the medication should not be heated or frozen. When choosing a location to store medicines, it’s important to choose somewhere that is free from direct sunlight, moisture and heat.

If you’re advised to stop taking the medication, it should be disposed of carefully. Rather than throwing medicine out with other household waste, patients should seek advice from their pharmacist regarding the disposal of Cabergoline tablets.

Summary

When prolactin levels are excessively high, it can cause patients to develop a number of other conditions and symptoms. As prolactin affects so much of the body, patients can find that their immune systems, reproductive health, and metabolism is affected by unregulated levels of the hormone.

Treatment with Cabergoline is, therefore, highly effective. By preventing prolactin from being produced, Cabergoline ensures that prolactin levels cannot increase any further. Once the medicine has had time to take effect, patients should notice a decrease in the symptoms they were previously experiencing. When production of prolactin has ceased, levels of the hormone should return to normal and symptoms should not reoccur.

Following this, physicians may advise patients to stop taking the medicine and monitor any changes in prolactin levels. If prolactin starts to rise again once Cabergoline has been discontinued, your physician may re-start treatment in order to keep prolactin levels within a certain range.

Although the drug is associated with some side-effects, the majority of patients tolerate Cabergoline well. Due to this, the medicine is widely-used and deemed to be extremely effective in treating excess prolactin production and its associated conditions.

Resources
Last Reviewed:
December 23, 2017
Last Updated:
December 22, 2017