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Cabgolin

✅ Prolactin level normalization
✅ Menstrual cycle regulation
✅ Enhanced fertility support
✅ Breast milk reduction

Cabgolin contains Cabergoline

Medically reviewed by Morgan Ellis — Pharmacy Researcher · 8 years experience  · Last reviewed: May 2026

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⚡ Quick Answer — What is Cabgolin?

Cabgolin is an oral cabergoline tablet in 0.25 mg and 0.5 mg strengths — a long-acting dopamine D₂ receptor agonist used to treat hyperprolactinaemia, prolactin-secreting pituitary adenomas (prolactinomas), and for suppression of lactation. Typical dosing is 0.25–1 mg twice weekly. Cabergoline is not hormone-replacement therapy — it reduces prolactin levels and restores normal gonadal axis function. Clinically equivalent to Pfizer’s Dostinex®.

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Cabgolin is Sun Pharma’s cabergoline tablet — a long-acting selective dopamine D₂ receptor agonist derived from ergot alkaloids. Cabergoline has been available since 1993 and is now the first-line treatment for hyperprolactinaemia and prolactinomas (the most common type of functioning pituitary tumour).

Cabgolin contains the same active ingredient at the same strengths as Pfizer’s branded Dostinex®. Its long plasma half-life (~65 hours) allows for twice-weekly dosing, which is much more convenient than the older alternative bromocriptine (taken daily or twice daily).

What Is Cabgolin?

Cabgolin is a prescription dopamine D₂ agonist indicated for:

  • Idiopathic hyperprolactinaemia — elevated prolactin without an identified cause
  • Microprolactinoma — pituitary adenomas <10 mm secreting prolactin
  • Macroprolactinoma — pituitary adenomas ≥10 mm secreting prolactin (cabergoline often shrinks these, avoiding surgery)
  • Lactation suppression — when required immediately postpartum or for established lactation (single 1 mg dose postpartum; 0.25 mg twice daily for 2 days if established)
  • Parkinson’s disease — off-label or historic use; newer non-ergot dopamine agonists are preferred
  • Prolactin-related female infertility — restores ovulatory cycles
  • Male hypogonadism / erectile dysfunction due to hyperprolactinaemia

How Does Cabgolin Work?

Prolactin is released from the anterior pituitary and is normally kept in check by dopamine (also called prolactin-inhibiting factor) travelling from the hypothalamus:

  • Cabergoline binds dopamine D₂ receptors on the pituitary lactotroph cells
  • This suppresses prolactin synthesis and release, and in prolactinoma it also shrinks the tumour cells
  • Normal prolactin levels are typically restored within 2–4 weeks
  • Once prolactin normalises, downstream effects resolve: return of menses in women, resumption of ovulation and fertility, restoration of libido and testosterone in men, and cessation of galactorrhoea
  • Cabergoline’s very long half-life (~65 hours) allows twice-weekly dosing — a major practical advantage over bromocriptine

In lactation suppression, cabergoline rapidly blocks post-delivery prolactin surge so breast engorgement and milk production are minimised.

Cabgolin Dosage and Administration

IndicationDoseSchedule
Hyperprolactinaemia (starter)0.25 mg twice weeklye.g. Monday and Thursday, at bedtime with food
Hyperprolactinaemia (target)0.5–1 mg twice weeklyTitrate up at monthly intervals based on prolactin level
Macroprolactinoma (large tumour)1–3 mg twice weeklyHigher-dose protocol; endocrinologist supervision
Lactation prevention (postpartum)1 mg (four 0.25 mg tablets)Single dose within 24 hours of delivery
Suppression of established lactation0.25 mg twice dailyFor 2 days (total 1 mg)
Parkinson’s disease (historic)2–6 mg once dailyNewer non-ergot dopamine agonists now preferred
ElderlyStart at 0.25 mg once weeklySlower titration
Hepatic impairmentReduce dose; monitor closelyCabergoline is hepatically cleared
Maximum weekly dose3 mgHigher doses carry valvular heart disease risk

How to Take Cabgolin Properly

  • Swallow tablet whole with water; take with food and at bedtime to minimise nausea and dizziness
  • Choose two fixed days of the week and stick to them (e.g. Monday and Thursday)
  • Monitor prolactin levels at 4–6 weeks after starting and after every dose change
  • Once prolactin is normal and stable, continue for at least 2 years before attempting gradual dose reduction under endocrinology supervision
  • Monitor for impulse-control disorders (gambling, hypersexuality, compulsive shopping, binge eating) — report any behavioural change
  • Echocardiography is recommended at baseline and periodically in patients on high-dose long-term therapy (>2 mg weekly for prolactinoma, or any dose for Parkinson’s)
  • Do not stop abruptly in prolactinoma — tumour regrowth can occur

Side Effects of Cabgolin

SeveritySide Effect
Common (≥1 in 10)Nausea, headache, dizziness, fatigue, constipation (usually settles in 2–4 weeks)
Common (≥1 in 100)Orthostatic hypotension (especially first dose), abdominal pain, mood changes, hot flushes, breast pain, depression
UncommonPalpitations, skin rash, paraesthesia, insomnia, peripheral oedema
Rare but seriousImpulse-control disorders (pathological gambling, hypersexuality, compulsive shopping), valvular heart disease (fibrotic changes — dose-related, rare at <3 mg/week), pulmonary or retroperitoneal fibrosis (historic concern from Parkinson’s doses), hepatic dysfunction

Impulse-control behaviour is a dopamine-agonist class effect. It can develop subtly — partners and family often notice before the patient does. Always report any new compulsive or unusual behaviour to your doctor. The effect reverses on dose reduction or discontinuation.

Warnings and Precautions

  • Valvular heart disease. Long-term high-dose cabergoline (historically for Parkinson’s at 3–6 mg/day) caused fibrotic cardiac valve changes. At the much lower prolactinoma doses (<3 mg/week) this risk is very low but screening echocardiography is still recommended at baseline and every 1–2 years in chronic use
  • Impulse-control disorders. Patients, partners, and families should be informed; monitoring is essential
  • First-dose hypotension. Take the first dose at home, at bedtime, with food. Avoid alcohol around first dose
  • Pregnancy. Stop once pregnancy is confirmed — fetal safety data is limited but the drug itself is not clearly teratogenic. Restart if tumour regrowth becomes an issue under specialist guidance
  • Breastfeeding. Contraindicated while breastfeeding — cabergoline suppresses lactation and passes into breast milk
  • Psychiatric history. Use cautiously in patients with severe depression or psychosis — rarely precipitates mood episodes
  • Alcohol. Amplifies first-dose orthostatic hypotension; limit in early weeks of treatment
  • Renal / hepatic dysfunction. Reduce dose and monitor in significant impairment

Contraindications — Who Should NOT Take Cabgolin

  • Known hypersensitivity to cabergoline, ergot alkaloids, or any excipient
  • Uncontrolled hypertension (>170/100 mmHg)
  • Pre-existing valvular heart disease
  • History of fibrotic disorders (pulmonary, retroperitoneal, pericardial)
  • Postpartum hypertension or pre-eclampsia
  • Severe hepatic impairment
  • Breastfeeding (unless lactation suppression is the goal)

Drug Interactions

Drug / ClassInteraction
Dopamine antagonists (antipsychotics, metoclopramide, prochlorperazine)Directly antagonise cabergoline — reduce efficacy; choose alternative anti-emetic
Macrolide antibiotics (erythromycin, clarithromycin)May raise cabergoline plasma levels — use cautiously
AntihypertensivesAdditive hypotension — monitor BP
Other ergot derivativesDo not combine
AlcoholAmplifies dizziness and hypotension

Storage Instructions

  • Store below 25 °C in a dry place, away from direct sunlight and moisture
  • Keep in the original blister packaging
  • Keep out of reach of children
  • Do not use after the expiry date

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Frequently Asked Questions

What is Cabgolin used for?

Cabgolin (cabergoline) is used to treat hyperprolactinaemia, prolactinomas (prolactin-secreting pituitary tumours), and for suppression of breast-milk production. It restores normal menstrual cycles in women, fertility and testosterone in men with prolactin-related hypogonadism, and can shrink large prolactin-secreting pituitary tumours.

How fast does Cabgolin work?

Prolactin levels typically fall into the normal range within 2–4 weeks. Menstrual cycles usually return within 6–12 weeks and fertility within a similar window. Tumour shrinkage (in macroprolactinomas) is seen on MRI by 3–6 months.

Is Cabgolin the same as Dostinex?

Yes — both contain cabergoline at the same strengths. Cabgolin is the Sun Pharma brand; Dostinex is Pfizer’s brand. Clinically equivalent.

Why is Cabgolin dosed only twice a week?

Cabergoline has a very long plasma half-life (~65 hours), so twice-weekly dosing maintains adequate levels. This is one of its major advantages over bromocriptine, which must be taken daily or twice daily.

Does Cabgolin cure prolactinoma?

Cabergoline is usually a suppressive treatment — it normalises prolactin and shrinks the tumour while being taken. After 2 or more years of well-controlled prolactin on a stable dose, a gradual taper under specialist supervision can sometimes lead to durable remission, particularly for smaller tumours.

Can Cabgolin help me get pregnant?

Yes — if your infertility is caused by hyperprolactinaemia, cabergoline typically restores ovulatory cycles. Many women conceive within months of starting. Once pregnancy is confirmed, stop cabergoline unless your endocrinologist advises otherwise.

Can I take Cabgolin while breastfeeding?

No — cabergoline suppresses lactation. It is specifically used for lactation suppression and is contraindicated while breastfeeding.

Will Cabgolin affect my behaviour?

A small but important proportion of patients on dopamine agonists develop impulse-control disorders — pathological gambling, hypersexuality, compulsive shopping, or binge eating. Report any new compulsive behaviour to your doctor. The effect reverses with dose reduction or discontinuation.

Do I need echocardiography on Cabgolin?

Yes — a baseline echocardiogram before starting and periodic follow-up (every 1–2 years) is recommended for anyone on long-term cabergoline, to screen for rare valvular fibrotic changes. Risk is low at typical prolactinoma doses (<3 mg/week) but monitoring remains standard practice.

How should I take Cabgolin if I miss a dose?

If the missed dose is within a day, take it as soon as you remember. If close to the next scheduled dose, skip the missed one — do not double up. Missing an occasional dose does not significantly affect prolactin control given the long half-life.

Can I drink alcohol on Cabgolin?

Moderate alcohol is usually tolerated after the first few weeks. Early in treatment, alcohol compounds first-dose dizziness and orthostatic hypotension — minimise until you know how you tolerate the drug.

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Strength

0.25 mg, 0.5 mg

Quantity

12 Tablet/s, 24 Tablet/s, 36 Tablet/s

Pharma Form

Tablet/s

Manufacturer

Sun Pharma

Treatment

Increased prolactin levels, Acromegaly

Generic Brand

Cabergoline

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