- 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.