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[Pharmacology](https://durgical.com/en/pharmacology/) · [Dopamine agonists](https://durgical.com/en/pharmacology/classes/dopamine-agonists/)

# Cabergoline

A long-acting ergot dopamine agonist that lowers prolactin and shrinks prolactinomas. Valve disease and fibrosis are the key risks.

Updated 2026-11-01

- Class: [Dopamine agonists](https://durgical.com/en/pharmacology/classes/dopamine-agonists/)
- Receptor: Dopamine D2 receptor
- ATC code: N04BC06
- WHO Model List of Essential Medicines

◎**Dopamine D2 receptor**Cabergoline

ⓘ The figure shows bromocriptine, another ergot dopamine agonist, in the human D2 receptor; cabergoline binds the same dopamine site.

**Target in 3D:** Dopamine D2 receptor. PDB structure 7JVR (RCSB PDB, public domain). [View the structure at RCSB PDB](https://www.rcsb.org/structure/7JVR) · Drag to rotate · pinch to zoom

## Mechanism of action

Cabergoline is an ergot derivative with high affinity for D2 receptors. On pituitary lactotroph cells, D2 stimulation directly inhibits prolactin secretion; prolactin falls and prolactin-secreting adenomas shrink. It has low affinity for D1, adrenergic and some serotonin receptors.

- Cabergoline binds D2 receptors on pituitary lactotrophs
- Prolactin synthesis and release are switched off
- Prolactin falls and the adenoma shrinks
- Periods, fertility and libido can return

## Pharmacokinetics

**Metabolism**
Extensive first-pass metabolism in the liver

**Half-life**
Very long: about 63 to 69 hours, allowing doses once or twice a week

## Indications

- Hyperprolactinaemic disorders, idiopathic or due to a pituitary adenoma (prolactinoma) [Prolactinoma (hyperprolactinaemia) →](https://durgical.com/en/conditions/prolactinoma/)
- Parkinson disease: little used today because of the risk of valve disease [Parkinson disease →](https://durgical.com/en/conditions/parkinson-disease/)

## Adverse effects

### Common

- Nausea and vomiting
- Headache and dizziness
- Orthostatic hypotension
- Constipation

### Serious (rare, important)

- Cardiac valve disease and pericardial fibrosis
- Pleural, pulmonary and retroperitoneal fibrosis
- Impulse-control disorders (gambling, sexual urges, spending)

## Contraindications

- Uncontrolled hypertension
- Hypersensitivity to ergot derivatives
- History of cardiac valve disease or pericardial fibrosis
- History of pleural, pulmonary or retroperitoneal fibrosis

## Key interactions

**Dopamine antagonists (antipsychotics, metoclopramide)**
Oppose its prolactin-lowering effect

**Antihypertensives**
Additive fall in blood pressure

## What is monitored

- Echocardiogram before starting and periodically during treatment
- Serum prolactin and, for adenomas, pituitary imaging
- Blood pressure and orthostatic symptoms
- Breathlessness, chest pain, oedema or flank pain (fibrosis)

## Administration and safety

- Given by mouth, usually once or twice a week
- Not used to suppress normal postpartum lactation because of serious cardiovascular and neurological risks
- Taking it with food can reduce nausea

## Nursing care

- Confirm a baseline echocardiogram has been done
- Check blood pressure lying and standing at the start
- Ask about gambling, shopping or sexual urges
- Teach to report breathlessness, cough, chest pain or swelling

## Pregnancy and breastfeeding

Fertility can return quickly as prolactin falls; if pregnancy occurs, continuation is weighed by the specialist.

## Memory aid

«Cabergoline: Calm the prolactin, Check the valves».

## Test yourself

Think of the answer, then tap the question to see it.

## What is the first-line medical treatment of a prolactinoma?

A dopamine agonist, usually cabergoline (bromocriptine is the alternative).

## Which test is done before and during cabergoline treatment, and why?

An echocardiogram, because ergot dopamine agonists can cause cardiac valve disease.

## Why can cabergoline be given only once or twice a week?

Its elimination half-life is very long, around 63 to 69 hours.

[Add to my cards (3)](https://durgical.app/estudiar/?add=/en/pharmacology/cabergoline/)

## Related drugs

- [Bromocriptine](https://durgical.com/en/pharmacology/bromocriptine/)
- [Pramipexole](https://durgical.com/en/pharmacology/pramipexole/)

## Related conditions

- [Prolactinoma (hyperprolactinaemia)](https://durgical.com/en/conditions/prolactinoma/)
- [Parkinson disease](https://durgical.com/en/conditions/parkinson-disease/)

[← Back to the class: Dopamine agonists](https://durgical.com/en/pharmacology/classes/dopamine-agonists/)

Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.

Sources: [DailyMed - CABERGOLINE tablet](https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=e497366b-a124-4d7f-bd45-a883c392d4bb) (DailyMed (U.S. National Library of Medicine), 2026); Goodman & Gilman's The Pharmacological Basis of Therapeutics, 14th ed., ch. 46 (McGraw Hill, 2023); Goodman & Gilman's The Pharmacological Basis of Therapeutics, 14th ed., ch. 15 (McGraw Hill, 2023); [eEML - Electronic Essential Medicines List](https://list.essentialmeds.org/) (World Health Organization, 2025).

## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake

Representative model, for educational purposes only.

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Source: https://durgical.com/en/pharmacology/cabergoline/
License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/pharmacology/cabergoline/