What is Cabergoline: Uses, Dosage, Side Effects and More

Cabergoline is a prescription medication that helps control high levels of a hormone called prolactin in your body. Your doctor might prescribe this medicine if you have conditions like prolactinomas (benign tumors that produce too much prolactin) or other disorders where your prolactin levels are higher than they should be.

This medication works by mimicking a natural brain chemical called dopamine, which helps regulate hormone production. Think of it as a gentle brake that slows down your body's prolactin production to bring it back to healthy levels.

What is Cabergoline?

Cabergoline belongs to a group of medicines called dopamine agonists. It's a synthetic version of a chemical your brain naturally produces to help control various hormone levels throughout your body.

The medication comes as small tablets that you take by mouth, usually just once or twice a week. Unlike daily medications, cabergoline has a long-lasting effect in your system, which is why you don't need to take it every day.

Your doctor will prescribe cabergoline when your body produces too much prolactin, a hormone that normally helps with milk production in nursing mothers. When prolactin levels get too high in non-nursing people, it can cause various uncomfortable symptoms.

What is Cabergoline Used For?

Cabergoline primarily treats disorders caused by too much prolactin in your blood, a condition called hyperprolactinemia. This happens when your pituitary gland produces more prolactin than your body needs.

The most common reason doctors prescribe cabergoline is for prolactinomas, which are non-cancerous tumors in your pituitary gland. These small growths can cause your prolactin levels to skyrocket, leading to various symptoms that affect your daily life.

Here are the main conditions cabergoline helps treat, starting with the most common reasons your doctor might recommend it:

• Prolactinomas (benign pituitary tumors)
• Unexplained high prolactin levels
• Irregular or absent menstrual periods caused by high prolactin
• Unwanted breast milk production in non-nursing women
• Fertility problems related to high prolactin
• Sexual dysfunction caused by elevated prolactin levels

In some cases, doctors may prescribe cabergoline for Parkinson's disease, though this is less common. Your healthcare provider will determine if cabergoline is right for your specific situation.

How Does Cabergoline Work?

Cabergoline works by binding to dopamine receptors in your brain, specifically in the pituitary gland where prolactin is made. When the medication attaches to these receptors, it sends a signal to reduce prolactin production.

This medication is considered moderately strong and highly effective for its intended purpose. Most people see significant improvements in their prolactin levels within a few weeks of starting treatment.

The drug stays active in your system for several days, which is why you typically only need to take it once or twice per week. This long-lasting effect makes it more convenient than medications that require daily dosing.

How Should I Take Cabergoline?

Take cabergoline exactly as your doctor prescribes, typically once or twice weekly with food. Taking it with a meal or snack helps reduce stomach upset and improves how well your body absorbs the medication.

You can take cabergoline with water, milk, or juice. Having some food in your stomach before taking the pill helps prevent nausea, which is one of the most common side effects when starting this medication.

Here's what you should know about taking cabergoline safely:

• Take it on the same day each week to maintain steady levels
• Eat a light meal or snack 30 minutes before taking the pill
• Avoid alcohol on the days you take cabergoline
• Don't crush or chew the tablets
• Keep the medication in a cool, dry place

If you feel dizzy or lightheaded after taking cabergoline, lie down for a while and avoid driving or operating machinery. These effects usually improve as your body adjusts to the medication.

How Long Should I Take Cabergoline For?

Most people need to take cabergoline for several months to years, depending on their specific condition. Your doctor will monitor your prolactin levels regularly to determine how long you need treatment.

For prolactinomas, you might need to take cabergoline for 2-3 years or longer. Some people with small tumors can eventually stop the medication once their prolactin levels normalize and stay stable.

Your healthcare provider will schedule regular blood tests to check your prolactin levels and may also order periodic heart tests. Never stop taking cabergoline suddenly without talking to your doctor first, as this can cause your prolactin levels to rise quickly again.

What Are the Side Effects of Cabergoline?

Most people tolerate cabergoline well, but like all medications, it can cause side effects. The good news is that many side effects are mild and often improve as your body adjusts to the medication.

Common side effects that affect many people include nausea, dizziness, and headaches. These usually occur during the first few weeks of treatment and often become less bothersome over time.

Here are the most frequently reported side effects, organized from most common to less common:

• Nausea and stomach upset
• Dizziness or lightheadedness
• Headaches
• Fatigue or tiredness
• Constipation
• Dry mouth
• Sleep problems or vivid dreams

Less common but more serious side effects can occur, though they affect fewer people. These require immediate medical attention if they happen to you:

• Chest pain or heart palpitations
• Shortness of breath
• Swelling in legs or feet
• Sudden onset of gambling or sexual urges
• Hallucinations or confusion
• Severe abdominal pain

Rare but serious side effects include heart valve problems, which is why your doctor may order periodic heart tests. If you experience any unusual symptoms, contact your healthcare provider right away.

Who Should Not Take Cabergoline?

Cabergoline isn't safe for everyone, and certain health conditions make it unsuitable. Your doctor will carefully review your medical history before prescribing this medication.

People with uncontrolled high blood pressure should not take cabergoline, as it can worsen this condition. The medication can also interact dangerously with certain heart medications and blood pressure drugs.

Here are the main conditions and situations where cabergoline should be avoided:

• Known allergy to cabergoline or similar medications
• Uncontrolled high blood pressure
• Heart valve disease or history of heart problems
• Severe liver disease
• Pregnancy (unless specifically prescribed by your doctor)
• Breastfeeding mothers trying to suppress milk production

Certain medications can interact with cabergoline, including some antipsychotic drugs, blood pressure medications, and anti-nausea medicines. Always tell your doctor about all medications, supplements, and herbal remedies you're taking.

Cabergoline Brand Names

Cabergoline is available under several brand names, with Dostinex being the most commonly recognized. Your pharmacy might dispense the medication under different names depending on the manufacturer.

Other brand names include Cabaser and Cabaseril, though availability varies by country. The generic version simply called "cabergoline" is also widely available and works just as effectively as the brand-name versions.

Regardless of which brand you receive, the active ingredient and effectiveness remain the same. Your pharmacist can answer any questions about the specific brand they're dispensing to you.

Cabergoline Alternatives

Several other medications can treat high prolactin levels if cabergoline isn't suitable for you. Bromocriptine is the most common alternative and works similarly to cabergoline.

Bromocriptine requires daily dosing and may cause more side effects than cabergoline, but it's often less expensive and has been used safely for many years. Some people tolerate bromocriptine better than cabergoline.

Other alternatives your doctor might consider include:

• Bromocriptine (Parlodel) - taken daily
• Quinagolide - taken daily
• Surgery for large prolactinomas
• Radiation therapy in rare cases

Your doctor will help you choose the best treatment option based on your specific condition, other health problems, and how well you tolerate different medications.

Is Cabergoline Better Than Bromocriptine?

Cabergoline is generally considered more effective and better tolerated than bromocriptine for treating high prolactin levels. Most people prefer cabergoline because it's taken less frequently and causes fewer side effects.

Studies show that cabergoline is more effective at normalizing prolactin levels and shrinking prolactinomas. About 85-90% of people achieve normal prolactin levels with cabergoline, compared to 70-75% with bromocriptine.

The main advantages of cabergoline over bromocriptine include less frequent dosing (twice weekly vs. daily), fewer gastrointestinal side effects, and better long-term results. However, cabergoline is typically more expensive than bromocriptine.

Your doctor will consider factors like your prolactin levels, tumor size, side effect tolerance, and cost when choosing between these medications. Some people do better with bromocriptine despite cabergoline's general advantages.