Home Drug Guide Cabergoline

Drug Guide

Generic Name

Cabergoline

Brand Names Dostinex

Classification

Therapeutic: Prolactin inhibitor, Dopamine agonist

Pharmacological: Dopamine receptor agonist

FDA Approved Indications

Hyperprolactinemia
Parkinson's disease (off-label)

Mechanism of Action

Cabergoline is a dopamine D2 receptor agonist that inhibits prolactin secretion from the anterior pituitary gland.

Dosage and Administration

Adult: Initially, 0.5 mg twice weekly; may be increased gradually based on response, up to a maximum of 3 mg twice weekly.

Pediatric: Not approved for pediatric use.

Geriatric: Use cautiously; no specific dosage adjustments provided.

Renal Impairment: Use with caution; no specific adjustments, monitor renal function.

Hepatic Impairment: Use with caution; no specific adjustments, monitor hepatic function.

Pharmacokinetics

Absorption: Well absorbed orally with high bioavailability.

Distribution: Widely distributed; crosses the blood-brain barrier.

Metabolism: Metabolized in the liver, mainly by CYP3A4.

Excretion: Excreted primarily in the urine.

Half Life: Approximately 65 hours.

Contraindications

Hypersensitivity to cabergoline or other ergot derivatives.
Uncontrolled hypertension.

Precautions

Assess cardiovascular status prior to therapy.
Use with caution in patients with psychiatric disorders, history of cerebrovascular disease, or valvular heart disease.

Adverse Reactions - Common

Nausea (Common)
Dizziness (Common)
Fatigue (Common)
Constipation (Common)

Adverse Reactions - Serious

Valvular heart disease (Rare)
Psychosis or hallucinations (Rare)
Orthostatic hypotension (Rare)

Drug-Drug Interactions

Ergot alkaloids (e.g., bromocriptine, pergolide) - increased risk of valvular fibrosis.
Antihypertensives - additive hypotensive effect.

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor blood pressure, cardiac function (including echocardiography if indicated), and serum prolactin levels.

Diagnoses:

Risk for cardiovascular events
Ineffective health maintenance

Implementation: Administer as prescribed; monitor for adverse effects; counsel patient about symptoms of cardivascular issues.

Evaluation: Assess reduction in prolactin levels and resolution of symptoms.

Patient/Family Teaching

Take medication exactly as prescribed.
Report symptoms of dizziness, shortness of breath, or heart palpitations.
Regular follow-up appointments for cardiac monitoring.

Special Considerations

Black Box Warnings:

Potential for valvular heart disease and fibrosis. Patients should undergo baseline and periodic echocardiograms.
Avoid use in pregnancy as safety is not established.
Drug-induced fibrosis may be irreversible.

Genetic Factors: No specific genetic testing required.

Lab Test Interference: May cause false-positive urinary protein tests.

Overdose Management

Signs/Symptoms: Nausea, vomiting, hypotension, hallucinations, psychosis.

Treatment: Discontinue medication; supportive care; manage symptoms accordingly.

Storage and Handling

Storage: Store at room temperature away from moisture and heat.

Stability: Stable for shelf life as per manufacturer.