Cabergoline, Dostinex
Description: Ergot Derivative
CSA NA – FDA Approved – REMS (N) – Can Ship
How Does It 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.
Indications For Use
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.
Precautions
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.
Usual Dosing
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.
Points To Consider
Pros
Improve male sexual endurance by reducing refractory time between ejaculations
Generally works better than bromocriptine
Easy to take because of long-half life; most cases twice weekly
Pharmacist Tips On Using
How to Take Cabergoline, Dostinex: Take with food as this medication can cause stomach upset.
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.
Side Effects
> 10%
Gastrointestinal: Nausea (27% to 29%)
Nervous System: Headache (26%), dizziness (15% to 17%)