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What is this medication?

Cabergoline, Dostinex
Ergot Derivative

Cabergoline/Dostinex is officially indicated for use in hyperprolactinemia, but it is also prescribed off-label for use in lactation Inhibition, acromegaly, Cushing syndrome, restless leg syndrome, and anorgasmia.

How does this medication work? 

Cabergoline/Dostinex is a long acting dopamine D2 receptor agonist that inhibits prolactin secretion by the anterior pituitary.  Prolactin is best known for stimulating lactorrhea but also have been found to be linked to sexual libido and penile erection.  Studies have shown that the neuroendocrine response to sexual activity is characterized by a pronounced orgasm-dependent increase in prolactin levels.  Men who have higher prolactin levels are likely to experience lower sexual drive and erectile dysfunction.  Cabergoline/Dostinex has been shown to have a positive impact in the treatment of sexual disorders as well as help improve overall sexual performance by reducing the duration of refractory period, improve sexual libido and arousal and improving overall penile erectile function.

How should I take this medication? 

Hyperprolactinemic Disorders: Take 0.25mg twice weekly; dose can be increased by 0.25mg weekly up to a maximum of 1mg twice weekly according to serum prolactin levels.

Lactation Inhibition: Take 1mg dose on first day postpartum.

Acromegaly (Off-Label): Take 0.25mg to 0.5mg twice weekly; titrate the dose according to insulin-like growth factor 1 (IGF-1) and growth hormone (GH) levels every 4 to 6 weeks.

Cushing Syndrome (Off-Label): Take 0.5mg to 1mg weekly; dose can be increased by 0.5mg to 1mg weekly at 1- or 2-month intervals until therapeutic urinary free cortisol levels are reached.

Restless Leg Syndrome (Off-Label): Take 0.5mg three hours before bedtime; dose can be increased by 0.5mg every 3 to 7 days.  Maximum recommended dose is 2mg.

Sexual Dysfunction/Performance: Take 0.25mg twice weekly.

How to Take Cabergoline, Dostinex: Take with food as this medication can cause stomach upset. 

What should I watch for while using this medication?

Do not use in patients with cardiac valvulopathy.  Cardiovascular evaluation is required prior to initiating treatment; do not start therapy if a valvular condition is detected.

Use with caution in patients with cardiovascular disease.

Use with caution in patients that may be required to operate machinery or drive due to CNS depression.

Do not use in patients with pleural/retroperitoneal fibrosis.

Use with caution in hepatic impairment, peptic ulcer disease and Raynaud syndrome.

You Need to Cabergoline, Dostinex: If you have hypersensitivity to Cabergoline/Dostinex or any component in its formulation; uncontrolled hypertension; history of cardiac valvular disorders; history of pulmonary, pericardial, or retroperitoneal fibrotic disorders.

Contact Your Doctor if You Ever Experience: Stop taking this medication and contact your doctor if you experience a rash (particularly in combination with facial swelling, breathing difficulties or flu-like symptoms); severe agitation, anxiety or excitation, major sleep disturbance or unusual change mood, muscle twitching or convulsions.

What if I miss a dose?

If you miss a dose of medication, try to take it as soon as possible. However, if it is almost time for your next dose, take only that scheduled dose. Do not take double or extra doses.

How should I store this medication?

Keep out of the reach of children at all times. Store at room temperature, 59 to 86° F (15 to 30° C). Protect from light. Keep the container tightly closed.  Properly dispose of any unused medication after the expiration date.

What are the possible side effects of using this medication? 

> 10%

Gastrointestinal: Nausea (27% to 29%)

Nervous System: Headache (26%), dizziness (15% to 17%)

Note this is not a complete list of side effects, only common ones