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Dopamine Agonist (D2 Receptor) / Prolactin Inhibitor

Cabergoline

Brand names: Dostinex

Cabergoline is a long-acting dopamine agonist used for hyperprolactinaemia and prolactinoma, and also in Parkinson's disease. It suppresses prolactin secretion and shrinks prolactin-secreting tumours.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

US labelling (FDA)

Reference — US labelling, may differ from UK

DOSAGE AND ADMINISTRATION The recommended dosage of Cabergoline Tablets, USP for initiation of therapy is 0.25 mg twice a week. Dosage may be increased by 0.25 mg twice weekly up to a dosage of 1 mg twice a week according to the patient’s serum prolactin level. Before initiating treatment, cardiovascular evaluation should be performed and echocardiography should be considered to assess for valvular disease. Dosage increases should not occur more rapidly than every 4 weeks, so that the physician can assess the patient's response to each dosage level. If the patient does not respond adequately, and no additional benefit is observed with higher doses, the lowest dose that achieved maximal …

Source: US FDA prescribing information (openFDA / DailyMed), label dated 2025-12-08. Accessed 2026-06-12. US dosing and indications can differ from UK practice — use UK sources for prescribing decisions.

Clinical monograph

How it works

It is an ergot-derived dopamine D2 receptor agonist; stimulating pituitary dopamine receptors inhibits prolactin release.

Prescribing in practice

  • Cardiac valve fibrosis is a key risk, particularly with the higher doses used in Parkinson's disease, requiring echocardiographic monitoring.
  • Impulse-control disorders (e.g. pathological gambling, hypersexuality) and other fibrotic reactions (pulmonary, retroperitoneal) can occur.
  • Nausea and postural hypotension are common, especially on initiation and dose increases.

Monitoring

Monitor prolactin and clinical response; assess for cardiac, pulmonary and retroperitoneal fibrosis (including echocardiography per current prescribing references) and ask about impulse-control symptoms.

Counselling the patient

  • Tell your clinician about new urges such as gambling, excessive shopping or changes in sexual behaviour.
  • Report breathlessness, persistent cough or chest pain.
  • Rise slowly from sitting or lying to reduce dizziness.

Evidence & guidelines

Established first-line dopamine agonist for hyperprolactinaemia; fibrosis monitoring per the SPC and MHRA advice.

Reference: Endocrine Society Prolactinoma Guidelines 2011; MHRA Cabergoline Safety Update; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

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