Dostinex

Basic Dostinex information

• INN (international nonproprietary name): Cabergoline
• Brand names available in the United Kingdom: Dostinex; Cabaser; generics labelled as cabergoline
• ATC code: G02CB03 (Prolactin inhibitors)
• Forms and dosages: Oral tablets, commonly 0.5 mg, in bottles or blister packs (usually 2, 8 or 30 tablets)
• Manufacturers in the United Kingdom: Pfizer (developer and trademark holder of Dostinex) and multiple generic manufacturers supplying cabergoline
• Registration status in the United Kingdom: Licensed by the MHRA; prescription-only medicine
• OTC / Rx classification: Prescription-only medicine (POM)

Legal status and availability in the UK

Dostinex is a prescription-only medicine (POM) in the UK.

In our online pharmacy, Dostinex is available without a prescription, with discreet delivery to the United Kingdom in 9–21 days.

Product overview and pack contents

Active ingredient and brands

What is in the tablet and who makes it?

The active ingredient is cabergoline (INN) and the most common brand is Dostinex, typically supplied as 0.5 mg oral tablets by Pfizer and by multiple generic manufacturers.

Cabaser is another branded cabergoline product, used particularly at higher doses for Parkinson’s disease; generic cabergoline is widely available under the INN.

ATC classification is G02CB03 (prolactin inhibitors).

Formulations and typical packaging

Which strengths and pack sizes are commonly seen in UK practice?

Dostinex is supplied as 0.5 mg tablets in bottles or blister packs, commonly of 2, 8 or 30 tablets depending on the supplier and prescribing needs.

Indications: who is prescribed Dostinex

Licensed indications

Who is cabergoline licensed for in the UK?

Cabergoline is licensed primarily for treatment of hyperprolactinaemia and prolactin‑secreting pituitary adenomas (prolactinomas).

It is used to manage menstrual and fertility disorders caused by raised prolactin and to normalise prolactin levels as guided by clinicians.

Doses and monitoring differ between endocrine indications and higher‑dose neurology use, so prescriber specialty matters.

Off‑label and specialist uses

Are there uses beyond the licence?

Off‑label or specialist uses include higher‑dose treatment in Parkinson’s disease, often under brand names such as Cabaser, and other specialist indications managed by neurologists or endocrinologists.

Higher doses carry a different risk profile and require specialist supervision and cardiac monitoring when indicated.

Postpartum lactation suppression with cabergoline is not recommended because of safety concerns; alternative approaches and specialist advice should be used.

Hyperprolactinaemia

Typical Prescriber: GP/Endocrinologist. Monitoring: Prolactin checks, symptomatic review.

Prolactinoma

Typical Prescriber: Endocrinologist. Monitoring: Imaging and endocrine follow‑up.

Parkinson’s (specialist, higher dose)

Typical Prescriber: Neurologist. Monitoring: Cardiac and psychiatric surveillance.

Dosage, titration and typical regimens

Standard dosing schedules

How is dostinex usually dosed for hyperprolactinaemia?

Typical starting dose is 0.5 mg once weekly, given either as a single weekly dose or divided as advised by the prescriber.

Titration is commonly by 0.5 mg increments each week as needed, with maintenance doses often up to 1 mg twice weekly for many patients.

Common clinical maximum for hyperprolactinaemia is around 2 mg per week, though specialist care may use higher doses up to around 4.5 mg in rare cases.

Administration tips, missed dose and overdose

How should patients take it and what if they miss a dose?

Take with food if nausea occurs and swallow tablets whole; do not crush unless advised by a pharmacist for special circumstances.

If a dose is missed, take it as soon as remembered unless the next scheduled dose is close; do not double doses.

Overdose may cause severe hypotension, profound nausea, confusion or hallucinations and requires urgent medical attention and symptomatic treatment.

Contraindications and clinical precautions

Absolute contraindications

Who must not take cabergoline?

Absolute contraindications include known hypersensitivity to cabergoline or ergot derivatives, uncontrolled hypertension, and a history of cardiac valve disorders such as fibrotic valvulopathies.

Peripartum or postpartum patients with a history of pre‑eclampsia are also contraindicated.

Relative contraindications and monitoring needs

Which conditions need caution and monitoring?

Exercise caution with existing cardiac, hepatic or renal dysfunction, and in patients with severe psychiatric disorders or a history of psychosis.

Pregnancy should be considered only if benefits outweigh risks and breastfeeding is contraindicated while taking cabergoline.

Checks before treatment:

• Confirm baseline blood pressure and cardiac history.
• Check current antipsychotic or ergot medication use.
• Review liver function if severe hepatic disease is present.
• Ask about pregnancy, breastfeeding and psychiatric history.

Side effects, frequency and management

Common and expected adverse effects

What side effects should patients expect early on?

Common mild to moderate effects include nausea, constipation, headache, dizziness, fatigue, abdominal pain and dyspepsia.

Orthostatic hypotension and peripheral oedema are also reported, especially early in treatment or after dose increases.

Practical mitigation includes taking the tablet with food, starting at a low dose and titrating slowly, and rising slowly from sitting or lying positions.

Rare but serious events and reporting

Which rare events need urgent attention and how should they be reported?

Serious but uncommon effects include psychiatric changes such as hallucinations or impulse control disorders and possible cardiac valvulopathy at higher doses or long durations.

Patients should report troubling psychological changes, new breathlessness or ankle swelling, and any unexplained chest symptoms to their GP or pharmacist promptly.

Suspected adverse reactions can be reported to the MHRA via the Yellow Card scheme, and GP or specialist review should be arranged if events are severe.

Interactions and monitoring requirements

Notable drug interactions

Which medicines change how cabergoline works?

Concurrent antipsychotics and other dopamine antagonists can reduce the effectiveness of cabergoline and require specialist input.

Certain macrolide antibiotics and some antifungals may affect metabolism and therefore require review during co‑prescribing.

Combine medicines that increase hypotension risk with caution and advise patients accordingly.

Baseline and ongoing monitoring

What tests should be arranged before and during therapy?

Baseline prolactin measurement is essential and periodic prolactin checks continue until stable levels are achieved.

Targeted cardiac evaluation such as echocardiogram is recommended for patients on higher or long‑term high doses or those with a cardiac history; routine echocardiography is less often needed at usual endocrine doses but follow specialist guidance.

Storage and stability

Storage instructions

How should Dostinex be stored?

Store between 20–25°C and protect from moisture and light, keeping tablets in their original packaging until dispensed.

Storage tips

Do and do not:

• Do keep in original blister or bottle and check expiry dates.
• Do not store in bathrooms or near heat sources.
• Do return unused tablets to the pharmacy for safe disposal.

Regulatory and legal status

Approvals and classifications

What is the regulatory backdrop for cabergoline?

Cabergoline is licensed by the MHRA in the UK and is classified as prescription only.

ATC code is G02CB03, placing cabergoline in the class of prolactin inhibitors used to manage hormonal disorders.

Pharmacovigilance

Cabergoline is supplied only against a valid prescription in the UK, with safety counselling and the patient information leaflet.

Adverse reactions should be reported via the MHRA Yellow Card scheme.

Alternatives

Clinical alternatives

What other medicines treat raised prolactin?

Bromocriptine (Parlodel and other brands) is a commonly used dopamine agonist alternative with a different dosing schedule and side‑effect profile.

Practical switching considerations

What happens when switching between dopamine agonists?

Switching requires specialist input for complex or high‑dose cases, with gradual cross‑titration where appropriate and monitoring of symptoms and prolactin levels.

Special populations: elderly, hepatic impairment, children

Elderly patients

Are there special considerations for older patients?

No formal dose adjustment is required purely due to age, but patients over 65 are at higher risk of orthostatic hypotension and psychiatric effects and warrant closer monitoring.

Blood‑pressure checks and fall‑risk counselling are advisable for older adults.

Liver, kidney, paediatrics and pregnancy planning

What about organ impairment, children and pregnancy?

Use caution in severe hepatic insufficiency with lower starting doses and closer monitoring as needed; there is no specific renal dose adjustment but monitor clinically for tolerance.

Cabergoline is not established for use in children and is generally not recommended for paediatric patients.

Pregnancy use should be reserved where benefits outweigh risks and breastfeeding is contraindicated while on treatment.

Counselling points

• Make sure you understand the dosing, the titration plan and common side effects such as nausea and dizziness.
• Know the missed dose rules and when to seek urgent medical attention.
• Confirm monitoring arrangements with your GP or specialist.

Delivery across the United Kingdom