Cabergoline: a long-acting alternative to bromocriptine

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IN BRIEFCabergoline is an ergot derivative with dopamine D2 agonist effects. Compared with bromocriptine, it is much longer acting, and so may be administered once or twice weekly as opposed to twice daily.Cabergoline was at least as effective as bromocriptine in restoring ovulatory menses in women with hyperprolactinaemia. A single dose of cabergoline prevented postpartum lactation in a similar proportion of women as a 14-day bromocriptine regimen.Dopaminergic adverse effects such as nausea, headache and dizziness occur with cabergoline therapy and are most frequent on initiation of therapy. Fewer patients experienced nausea with cabergoline than bromocriptine.The safety of cabergoline in pregnancy has not been extensively investigated. Thus, at present, cabergoline should not replace bromocriptine as first-line treatment of infertility associated with hyperprolactinaemia. It is likely to prove a useful alternative to bromocriptine in patients who do not tolerate this agent.If drug treatment is required to inhibit postpartum lactation, cabergoline has advantages over bromocriptine in terms of simplicity of dosage regimen and tolerability. Cabergoline has not been associated with thromboembolic events in postpartum patients.

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