Last update Oct. 23, 2023

卡麦角林

High Risk

Poorly safe. Evaluate carefully. Use safer alternative or interrupt breastfeeding 3 to 7 T ½ (elimination half-lives). Read the Comment.

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)

Alternatives

We do not have alternatives for 卡麦角林.

Suggestions made at e-lactancia are done by APILAM team of health professionals, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it. The pharmaceutical industry contraindicates breastfeeding, mistakenly and without scientific reasons, in most of the drug data sheets.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

Your contribution is essential for this service to continue to exist. We need the generosity of people like you who believe in the benefits of breastfeeding.

Thank you for helping to protect and promote breastfeeding.

José María Paricio, founder of e-lactancia.

Pharmacokinetics

Variable Value Unit
Oral Bioavail. 100 %
Molecular weight 452 daltons
Protein Binding 41 %
pKa 15.25 -
Tmax 2 - 3 hours
63 - 69 hours

References

  1. Humphrey S, Baechler M, Schiff M, Hitti J. Cabergoline for postpartum lactation suppression: Effect on blood pressure and pulse. Int J Gynaecol Obstet. 2022 Dec;159(3):776-782. Abstract
  2. Popescu AD, Carsote M, Valea A, Nicola AG, Dascălu IT, Tircă T, Abdul-Razzak J, Țuculină MJ. Approach of Acromegaly during Pregnancy. Diagnostics (Basel). 2022 Nov 2;12(11). pii: 2669. Abstract Full text (link to original source)
  3. Bruehlman RD, Winters S, McKittrick C. Galactorrhea: Rapid Evidence Review. Am Fam Physician. 2022 Dec;106(6):695-700. Abstract
  4. Coban A, Bayraktar S, Yıldız N, Tunçel D, Gökçay G, Ince Z. A Case Study of Early Postpartum Excessive Breast Engorgement: Is it Related to Feedback Inhibition of Lactation? J Hum Lact. 2021 May;37(2):414-418. Abstract
  5. Yang Y, Boucoiran I, Tulloch KJ, Poliquin V. Is Cabergoline Safe and Effective for Postpartum Lactation Inhibition? A Systematic Review. Int J Womens Health. 2020 Mar 9;12:159-170. Abstract Full text (link to original source)
  6. Harris K, Murphy KE, Horn D, MacGilivray J, Yudin MH. Safety of Cabergoline for Postpartum Lactation Inhibition or Suppression: A Systematic Review. J Obstet Gynaecol Can. 2020 Mar;42(3):308-315.e20. Abstract
  7. (ABM) Johnson HM, Eglash A, Mitchell KB, Leeper K, Smillie CM, Moore-Ostby L, Manson N, Simon L; Academy of Breastfeeding Medicine.. ABM Clinical Protocol #32: Management of Hyperlactation. Breastfeed Med. 2020 Mar;15(3):129-134. Abstract Full text (link to original source)
  8. Trimeloni L, Spencer J. Diagnosis and Management of Breast Milk Oversupply. J Am Board Fam Med. 2016 Abstract Full text (link to original source) Full text (in our servers)
  9. Sénat MV, Sentilhes L, Battut A, Benhamou D, Bydlowski S, Chantry A, Deffieux X, Diers F, Doret M, Ducroux-Schouwey C, Fuchs F, Gascoin G, Lebot C, Marcellin L, Plu-Bureau G, Raccah-Tebeka B, Simon E, Bréart G, Marpeau L. [Post-partum: Guidelines for clinical practice--Short text]. J Gynecol Obstet Biol Reprod (Paris). 2015 Dec;44(10):1157-66. Abstract
  10. Eglash A. Treatment of maternal hypergalactia. Breastfeed Med. 2014 Abstract Full text (link to original source) Full text (in our servers)
  11. PDR.net Cabergolina Drug Summary 2014 Full text (in our servers)
  12. [No authors listed] Do not use drugs to prevent onset of lactation. Relieve the discomfort and wait. Prescrire Int. 2013 Abstract
  13. Auriemma RS, Perone Y, Di Sarno A, Grasso LF, Guerra E, Gasperi M, Pivonello R, Colao A. Results of a single-center observational 10-year survey study on recurrence of hyperprolactinemia after pregnancy and lactation. J Clin Endocrinol Metab. 2013 Abstract Full text (link to original source) Full text (in our servers)
  14. Oladapo OT, Fawole B. Treatments for suppression of lactation. Cochrane Database Syst Rev. 2012 Sep 12;2012(9):CD005937. doi: 10.1002/14651858.CD005937.pub3. Full text (link to original source)
  15. Shahzad H, Sheikh A, Sheikh L. Cabergoline therapy for macroprolactinoma during pregnancy: a case report. BMC Res Notes. 2012 Abstract Full text (link to original source) Full text (in our servers)
  16. AEMPS Cabergolina Ficha Técnica 2011 Full text (link to original source) Full text (in our servers)
  17. Bravo-Topete EG, Mendoza-Hernández F, Cejudo-Alvarez J, Briones-Garduño C. [Cabergoline for inhibition of lactation]. Cir Cir. 2004 Jan-Feb;72(1):5-9. Spanish. Abstract
  18. Bracco PL, Armentano G, Pellegrini A, Sugliano GC, Tornatore GP. [Cabergoline in the inhibition of lactogenesis and suppression of lactopoiesis]. Minerva Ginecol. 1997 Oct;49(10):469-73. Italian. Abstract
  19. Giorda G, de Vincentiis S, Motta T, Casazza S, Fadin M, D'Alberton A. Cabergoline versus bromocriptine in suppression of lactation after cesarean delivery. Gynecol Obstet Invest. 1991;31(2):93-6. Abstract
  20. [No authors listed] Single dose cabergoline versus bromocriptine in inhibition of puerperal lactation: randomised, double blind, multicentre study. European Multicentre Study Group for Cabergoline in Lactation Inhibition. BMJ. 1991 Abstract Full text (link to original source) Full text (in our servers)
  21. Caballero-Gordo A, Lopez-Nazareno N, Calderay M, Caballero JL, Mancheño E, Sghedoni D. Oral cabergoline. Single-dose inhibition of puerperal lactation. J Reprod Med. 1991 Abstract
  22. Melis GB, Mais V, Paoletti AM, Beneventi F, Gambacciani M, Fioretti P. Prevention of puerperal lactation by a single oral administration of the new prolactin-inhibiting drug, cabergoline. Obstet Gynecol. 1988 Abstract
  23. Melis GB, Gambacciani M, Paoletti AM, Beneventi F, Mais V, Baroldi P, Fioretti P. Dose-related prolactin inhibitory effect of the new long-acting dopamine receptor agonist cabergoline in normal cycling, puerperal, and hyperprolactinemic women. J Clin Endocrinol Metab. 1987 Sep;65(3):541-5. Abstract

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