Cabergoline
In brief
- Cabergoline is a prescription-only medicine (POM) in the UK and requires a valid prescription.
- Cabergoline is a dopamine agonist used primarily to treat hyperprolactinaemic disorders (for example prolactinomas) by stimulating D2 dopamine receptors in the pituitary to suppress prolactin secretion; it is also used as an adjunct in some cases of Parkinson’s disease.
- Typical regimens start at 0.25 mg twice weekly for hyperprolactinaemia with gradual titration (commonly to 0.5–1 mg per week; some patients require higher doses up to 1–2 mg/week or rarely more); for Parkinson’s adjunctive use dosing is individualised (for example starting 0.5 mg daily and titrating slowly).
- Administered orally as tablets (commonly 0.25 mg, 0.5 mg or 1 mg), usually taken with or without food according to the prescriber’s instructions.
- Biochemical reduction in prolactin is often seen within 48 hours, while clinical symptom improvement may take days to several weeks.
- Cabergoline has a long duration of action (long half-life, often allowing twice-weekly dosing); pharmacological effects can persist for several days to a week after a dose.
- Avoid or limit alcohol while taking cabergoline, as alcohol can increase dizziness, sedation and the risk of orthostatic hypotension.
- The most common side effect is nausea; other frequent effects include headache, dizziness, constipation, fatigue and orthostatic hypotension.
- Would you like to try cabergoline without a prescription?
Legal status and availability in the UK
Cabergoline is a prescription-only medicine (POM) in the UK.
In our online pharmacy, cabergoline is supplied on presentation of a valid prescription, with discreet delivery to the United Kingdom in 9–21 days.
Basic cabergoline information
- INN (international nonproprietary name): Cabergoline.
- Brand names available in the United Kingdom: Dostinex; generic cabergoline.
- ATC code: G02CB03.
- Forms and dosages: Tablets (commonly 0.5 mg) in blister or strip packs
- Registration status in the United Kingdom: Licensed by the MHRA; prescription-only medicine
- OTC / Rx classification: Prescription-only medicine (POM)
Indications and how UK prescribers use it
Clinical uses and NHS prescribing
What conditions is cabergoline used for and how will patients usually be started on it in the UK?
Cabergoline is primarily indicated for hyperprolactinaemic disorders such as prolactinomas and pituitary adenomas.
It is also used less commonly as an adjunct in Parkinson’s disease.
On the NHS, treatment is typically initiated in endocrinology following specialist review, with GPs taking on shared-care in some areas.
Cabergoline is prescription-only in the UK; prescribers should follow local formularies for initiation and follow-up.
| Indication | Typical starting dose | Typical maintenance dose |
|---|---|---|
| Hyperprolactinaemia | 0.25 mg twice weekly | Titrated by 0.25 mg twice weekly every 4 weeks to normalise prolactin or tolerability |
| Parkinson’s Disease (Adjunct) | 0.5 mg daily | Individualised, titrated slowly |
Prescribers monitor prolactin and clinical response and may continue therapy long term if needed.
Initiation usually follows endocrine assessment, imaging where indicated, and baseline blood tests.
Mechanism of action — practical explanation for patients
What it does and why it matters clinically
How does cabergoline lower prolactin and what do patients gain from that effect?
Cabergoline is a dopamine D2 receptor agonist that suppresses pituitary prolactin secretion.
Lowering prolactin reduces galactorrhoea and can restore normal menstrual cycles and ovulation in women.
Restoration of normal prolactin levels can also improve libido and sexual function in men and women.
In patients with prolactin-secreting tumours, cabergoline can reduce tumour size and related symptoms.
For Parkinson’s disease, cabergoline’s dopamine stimulation supports motor pathways, but this is a less common indication.
Dosage regimens, titration and practical dosing tips
Usual regimens and safety-first titration
What dosing patterns do clinicians use and how should patients take cabergoline safely?
For hyperprolactinaemia the usual starting regimen is 0.25 mg twice weekly, increasing by 0.25 mg twice weekly every four weeks as needed.
Maintenance doses are frequently low and tailored to prolactin levels and symptoms.
Parkinson’s regimens begin with low daily dosing such as 0.5 mg daily and are titrated cautiously.
Maximum weekly doses can be up to 1–2 mg per week in most cases, with rare situations reported up to 4.5 mg per week.
| Scenario | Usual starting dose | Titration guidance |
|---|---|---|
| Hyperprolactinaemia | 0.25 mg twice weekly | Increase by 0.25 mg twice weekly every 4 weeks until target achieved |
| Parkinson’s Adjunct | 0.5 mg daily | Titrate slowly per neurologist guidance |
Checklist for patients: do not double doses, take with food if nausea occurs, and if a dose is missed take it when remembered unless close to the next dose.
Elderly patients should start at lower doses and titrate slower to reduce risk of orthostatic hypotension and psychiatric side effects.
Children are not recommended to use cabergoline due to lack of established safety data.
Contraindications and high‑risk groups
Absolute and relative contraindications
Who must not take cabergoline and who needs extra monitoring?
Absolute contraindications include uncontrolled hypertension, known hypersensitivity to cabergoline or ergot derivatives, and a history of fibrotic disorders such as pulmonary or cardiac valvular fibrosis.
Pregnancy is an absolute contraindication unless benefits clearly outweigh risks and a specialist advises continuation.
Relative cautions include existing cardiac or valvular disease, severe hepatic impairment and severe renal impairment requiring close review.
Patients with a history of psychiatric disorders require careful assessment and monitoring for behavioural changes.
- Tell your prescriber about known heart valve disease or breathlessness.
- Baseline echocardiography is advised if prolonged therapy is planned or if there are cardiac concerns.
- Women of childbearing potential should discuss pregnancy intentions before starting treatment.
Side effects, monitoring and patient counselling
Counselling points
What should patients be warned about and what monitoring is needed?
Common side effects include nausea, headache, constipation, dizziness, fatigue and abdominal discomfort.
More significant issues reported include orthostatic hypotension, sleep disturbances, peripheral oedema and depressive symptoms.
Report mood changes, hallucinations or any new impulse-control behaviours promptly.
| Frequency | Adverse reactions |
|---|---|
| Mild | Nausea, headache, constipation, fatigue, dizziness |
| Moderate | Orthostatic hypotension, sleep disturbance, peripheral oedema, depression |
Baseline blood tests such as prolactin and renal/hepatic profile, and periodic prolactin checks during therapy, are recommended.
Consider baseline and periodic echocardiography for patients on prolonged high-dose therapy to screen for valvular changes.
Take with food if you feel sick, avoid driving until you know how cabergoline affects you, and rise slowly from sitting to reduce dizziness.
Seek immediate medical contact for urgent symptoms such as breathlessness, chest pain, sudden swelling or new psychiatric symptoms.
Drug interactions and medicines to avoid
Interaction checks
Which medicines reduce effect or increase risk when given with cabergoline?
Dopamine antagonists such as many antipsychotics and metoclopramide can reduce cabergoline’s efficacy and should be reviewed before starting treatment.
Concurrent antihypertensive therapy may increase the risk of orthostatic hypotension when cabergoline is initiated or doses are increased.
Ergot derivatives may add to adverse effect burden and should be avoided where possible.
Check for medicines that heavily affect hepatic metabolism and agents known to prolong QT as part of routine BNF/MHRA screening.
Clinical comparison: cabergoline versus bromocriptine
Choice drivers for clinicians and patients
How do clinicians decide between cabergoline and bromocriptine?
Cabergoline is often preferred because it has a longer half-life allowing less frequent dosing and generally better gastrointestinal tolerability compared with bromocriptine.
Bromocriptine may still be chosen in pregnancy planning due to a longer history of use in that setting.
| Agent | Dosing frequency | Tolerability | Notes |
|---|---|---|---|
| Cabergoline | Twice weekly or low weekly dose | Better GI tolerability | Often preferred |
| Bromocriptine | Multiple daily doses | More GI side effects | Historical safety data in pregnancy |
Storage
Storage instructions
Store below 25°C in original packaging to protect from moisture and light.
Avoid freezing and avoid exposing packs to direct sunlight or high humidity.
FAQs
Common questions and emergency advice
- Can I buy cabergoline without a prescription? No. Cabergoline is a prescription-only medicine and requires a valid prescription for supply.
- What if I miss a dose? Take the dose when you remember unless it is close to the next scheduled dose. Do not double up doses.
- What to do in case of overdose? Seek urgent medical attention. Symptoms may include nausea, vomiting, hallucinations and low blood pressure.
In an emergency, or if severe adverse effects occur, contact emergency services or the prescriber immediately.
Delivery across the United Kingdom
| City | Region | Delivery time |
|---|---|---|
| London | England | 9–21 days |
| Birmingham | England | 9–21 days |
| Manchester | England | 9–21 days |
| Glasgow | Scotland | 9–21 days |
| Leeds | England | 9–21 days |
| Liverpool | England | 9–21 days |
| Edinburgh | Scotland | 9–21 days |
| Bristol | England | 9–21 days |
| Sheffield | England | 9–21 days |
| Newcastle Upon Tyne | England | 9–21 days |
| Cardiff | Wales | 9–21 days |
| Belfast | Northern Ireland | 9–21 days |
| Norwich | England | 9–21 days |
| Plymouth | England | 9–21 days |
| Leicester | England | 9–21 days |
