Cabgolin: Effective Prolactin Regulation for Endocrine Health
Cabgolin
| Product dosage: 0.5mg | |||
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Cabgolin (cabergoline) is a potent dopamine receptor agonist specifically formulated for the management of hyperprolactinemic disorders. It offers a targeted mechanism of action, directly inhibiting prolactin secretion from the anterior pituitary gland. This results in rapid normalization of elevated prolactin levels and resolution of associated clinical manifestations. Its extended half-life and favorable tolerability profile make it a cornerstone of long-term endocrine therapy, providing clinicians with a reliable option for restoring hormonal balance and improving patient quality of life.
Features
- Active ingredient: Cabergoline 0.5 mg per tablet
- Pharmacological class: Dopamine D2 receptor agonist
- High selectivity for pituitary lactotroph receptors
- Extended elimination half-life (approximately 63–69 hours)
- Oral administration with once or twice weekly dosing
- High bioavailability when taken with food
- Excreted primarily via feces with minimal renal clearance
- Manufactured under strict pharmaceutical quality standards
Benefits
- Rapid and sustained reduction of elevated serum prolactin levels
- Restoration of gonadal function and fertility in both sexes
- Resolution of galactorrhea and normalization of menstrual cycles
- Shrinkage of prolactin-secreting pituitary adenomas
- Improved bone mineral density through estrogen repletion
- Enhanced quality of life through symptom control and psychological well-being
Common use
Cabgolin is primarily indicated for the treatment of hyperprolactinemia, whether idiopathic or associated with pituitary microadenomas and macroadenomas. It is routinely prescribed for managing galactorrhea, amenorrhea, infertility, and hypogonadism resulting from elevated prolactin levels. Additionally, it finds application in suppressing physiological lactation when medically necessary and serves as adjunctive therapy in Parkinson’s disease management at higher doses. Its use extends to cases where other dopamine agonists prove intolerable or ineffective.
Dosage and direction
Initiate treatment at 0.25 mg twice weekly, preferably with meals to enhance gastrointestinal tolerance. Titrate gradually by 0.25 mg increments at weekly or biweekly intervals based on prolactin level monitoring and clinical response. Most patients achieve normalization with 0.5–1 mg weekly, though macroadroadenomas may require up to 4.5 mg weekly. Administer tablets whole with water; do not crush or chew. Regular follow-up with prolactin assays and clinical assessment is mandatory during dose adjustment phases. Maintenance dosing should utilize the lowest effective dose to minimize potential adverse effects.
Precautions
Monitor for signs of fibrotic reactions (respiratory, cardiac, or retroperitoneal) through periodic imaging and clinical evaluation. Assess cardiac valve function via echocardiography before initiation and periodically during long-term therapy. Exercise caution in patients with hepatic impairment due to extensive hepatic metabolism. Orthostatic hypotension may occur, particularly during dose escalation. Psychiatric monitoring is advised, especially in patients with history of psychotic disorders. Pregnancy testing is recommended before initiation in women of childbearing potential.
Contraindications
Hypersensitivity to ergot derivatives or any component of the formulation. Uncontrolled hypertension. History of cardiac valvular disorders as evidenced by echocardiography. Pulmonary, pericardial, or retroperitoneal fibrotic disorders. Concurrent use of medications with significant QT-prolonging potential. Severe hepatic impairment (Child-Pugh class C). History of psychotic disorders poorly controlled by antipsychotic therapy.
Possible side effect
- Nausea and vomiting (dose-dependent, usually transient)
- Headache and dizziness (often resolves with continued therapy)
- Orthostatic hypotension (particularly during dose titration)
- Constipation or dyspepsia
- Fatigue and asthenia
- Nasal congestion
- Hot flashes
- Peripheral edema
- Rare but serious: cardiac valvulopathy, pleural fibrosis, psychotic symptoms
Drug interaction
Strong CYP3A4 inhibitors (ketoconazole, ritonavir) significantly increase cabergoline exposure—avoid concomitant use. Macrolide antibiotics and protease inhibitors may elevate plasma concentrations. Antihypertensive agents may potentiate hypotensive effects. Antipsychotics (especially D2 antagonists) may diminish therapeutic efficacy. Metoclopramide and other dopamine antagonists should be avoided. Serotonergic drugs may increase risk of serotonin syndrome. Monitor closely when administering with QT-prolonging agents.
Missed dose
Take the missed dose as soon as remembered if within 12 hours of scheduled time. If beyond 12 hours, skip the missed dose and resume regular dosing schedule. Do not double the dose to compensate for missed administration. Contact healthcare provider if multiple doses are missed or if uncertainty exists regarding dosing schedule.
Overdose
Symptoms may include severe nausea, vomiting, hypotension, hallucinations, and psychosis. Management involves immediate gastric lavage if ingestion occurred within 2 hours, followed by activated charcoal administration. Provide supportive care including IV fluids for hypotension and antiemetics for nausea. Hemodialysis is not effective due to high protein binding. Monitor cardiac function and provide symptomatic treatment. Contact poison control center for specific guidance.
Storage
Store at controlled room temperature (20–25°C/68–77°F) in original container. Protect from light and moisture. Keep tightly closed and out of reach of children. Do not use if tablets show signs of discoloration or deterioration. Discard unused medication properly through drug take-back programs.
Disclaimer
This information does not replace professional medical advice. Consult a qualified healthcare provider for diagnosis and treatment recommendations. Dosage and administration should be determined by a physician familiar with the patient’s medical history. Individual response to therapy may vary. Report any adverse effects to your healthcare provider promptly.
Reviews
“Cabgolin has transformed our management of hyperprolactinemia. The extended half-life allows for convenient twice-weekly dosing, significantly improving patient compliance compared to daily alternatives. We observe consistent prolactin normalization within 4 weeks in most cases, with excellent tolerability profile.” - Endocrinologist, 15 years experience
“Our fertility clinic considers cabergoline first-line for hyperprolactinemia-related infertility. The rapid restoration of ovulatory cycles and impressive safety profile during early pregnancy make it indispensable. We maintain careful monitoring but find side effects generally manageable with proper dose titration.” - Reproductive Endocrinologist
“While highly effective, we maintain vigilance for cardiac monitoring requirements. The convenience of administration must be balanced with appropriate echocardiographic surveillance, particularly in patients requiring higher doses or long-term therapy. Overall, it remains our preferred dopamine agonist for most patients.” - Neuroendocrinologist