- Prolactin producing pituitary adenomas (first-line).
- GH- and TSH- producing pituitary adenomas (as an adjunct).
Typical cabergoline dose is 0.5 to 2.0 mg per week, in 2-4 divided doses. E.g., 0.5 mg twice weekly.
Some aggressive/resistant prolactinomas (~ 10-15%) require higher doses.
Cabergoline may be tapered and stopped, with careful monitoring, in patients with the following criteria:
- Received 2 years of treatment with a dopamine-agonist
- Normal serum prolactin.
- No visible tumour on MRI.
Once pregnancy is confirmed, discontinue cabergoline therapy. However, you may chose to continue therapy in women with large tumours abutting the optic chiasm.
Women taking cabergoline prior to and up to 5 weeks of gestation did not have an increased risk of miscarriage or teratogenicity.
Melmed S, Casanueva FF, Hoffman AR, Kleinberg DL, Montori VM, Schlechte JA, Wass JA; Endocrine Society. Diagnosis and treatment of hyperprolactinemia: an Endocrine Society clinical practice guideline. JCEM. 2011 Feb;96(2):273-88.
Sandret L, Maison P, Chanson P. Place of cabergoline in acromegaly: a meta-analysis. JCEM. 2011 May;96(5):1327-35.