First-lineDostinex
Cabergoline
Dopamine D2 agonist
Suppress lactation; treat prolactinoma.
Oral
First-line for
- Lactation suppression (stillbirth, neonatal death, HIV)
- Hyperprolactinaemia / prolactinoma
Mechanism
D2 agonism → ↓ prolactin secretion.
Cabergoline
- 1 mg PO single dose for lactation suppression
Dosing
- Lactation suppression
- 1 mg PO single dose within 24 h of delivery
- Prolactinoma
- 0.25–0.5 mg twice weekly
Contraindications
- AbsoluteUncontrolled hypertension, pre-eclampsia, valvular heart disease
Side effects
- Postural hypotension, nausea
- Fibrosis (cardiac, retro-peritoneal) at high dose
Fetal & maternal notes
- • Stop once pregnancy confirmed in prolactinoma (specialist).
Key interactions
Antihypertensives
Caution↑ hypotension
Antipsychotics
CautionMutual antagonism
Clinical pearls
- 💡 Preferred over bromocriptine (less SE, weekly dosing).
- 💡 Echo before long-term high-dose.
Content last reviewed: REPLACE_ME (e.g. 2026-07)
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