C₂₆H₃₇N₅O₂

Cabergoline, a derivative of ergot, is a dopamine D2 agonist with actions and uses similar to those of bromocriptine. It potently inhibits prolactin secretion.  It is used in the treatment of disorders associated with hyperprolactinemia, in the treatment of Parkinson's disease and to suppress puerperal lactation. To inhibit lactogenesis II (milk let-down) a single dose (0.5 - 1 mg) on the first day after delivery is sufficient. To suppress breastfeeding already established, 2 daily doses are required for 2 days. In hyperprolactinemia a weekly dose is administered and in Parkinson's disease a daily dose. Oral administration. 

At the time of the last update, we found no published data on its excretion in breast milk.

No adverse effects have been reported in newborns whose mothers resume breastfeeding after a single dose to inhibit lactation (by mistake or subsequent reconsideration by the mother). If cabergoline was administered promptly to suppress lactation and it is desired to resume breastfeeding, the mother can do so immediately, attempting frequent breastfeeding to minimize the effect of the drug on milk production.

A mother who received ibuprofen and low doses of cabergoline on the 5th postpartum day for two days to treat severe breast engorgement with bleeding cracks was able to resume breastfeeding two days later with mechanical expression and direct breastfeeding. ^{(Coban 2021)}

No short- or long-term problems were observed in an infant breast-fed by a hyperprolactinemic mother taking cabergoline weekly. ^{(Popescu 2022)}

Expert authors advise treating nursing mothers with excess milk production (hyperlactation) with cabergoline at low doses (0.25 to 0.5 mg) every 3 to 5 days. ^{(ABM protocol 32, 2020)}

Cabergoline decreases prolactin production, inhibits postpartum lactation and has few and self-limited adverse effects ^{(Humphrey 2022, Yang 2020, Bravo 2004, Bracco 1997, Giorda 1991, Caballero 1991, Melis1988 & 1987)}, such as headache, dizziness, nausea and vomiting. ^{(Harris 2020, Bracco 1997, Giorda 1991)}

With cabergoline there is less breastfeeding rebound effect than with bromocriptine and with fewer side effects. ^{(European MSG 1991, Giorda 1991)}

Cabergoline is the drug of choice for the treatment of hyperprolactinemia. ^{(Bruehlman 2022)}

There is no evidence that pharmacological treatments are more effective than no treatment in suppressing lactation in the first week postpartum. Expert authors and professional consensus contraindicate pharmacological treatment to suppress lactation.^{(Marcellin 2015, Sénat 2015, Prescrire 2013, Oladapo 2012)}