CONTRAINDICATIONS / PRECAUTIONS
Ergot alkaloid hypersensitivity
Cabergoline is contraindicated in patients with a known ergot derivative or ergot alkaloid hypersensitivity because of the possibility of an allergic reaction.
Valvular heart disease
Cabergoline is contraindicated in patients with a history of valvular heart disease, as suggested by anatomical evidence of valvulopathy of any valve, determined by pre-treatment evaluation including echocardiographic demonstration of valve leaflet thickening, valve restriction, or mixed valve restriction stenosis. Postmarketing cases of cardiac valvulopathy have been reported in patients receiving cabergoline. These cases have generally occurred during the use of high doses of the drug (i.e., more than 2mg/day). Cases of cardiac valvulopathy have also been reported in patients receiving lower doses of cabergoline for the treatment of hyperprolactinemic disorders. Cautious use of cabergoline is recommended in patients who have been exposed to other medications associated with valvulopathy. All patients should undergo a cardiovascular evaluation, including an echocardiogram, before cabergoline initiation to assess for valvular disease. If valvular disease is present, cabergoline treatment should not be initiated. Clinical and diagnostic monitoring (e.g., chest x-ray, CT scan, cardiac echocardiogram) should be conducted periodically in all patients receiving cabergoline to evaluate the risk of cardiac valvulopathy. Echocardiographic monitoring should be conducted every 6 to 12 months or as needed by the presence of edema, new cardiac murmur, dyspnea, congestive heart failure, or other signs and symptoms of valvulopathy. Cabergoline should be discontinued if an echocardiogram demonstrates new valvular regurgitation, valvular restriction, or valve leaflet thickening.
Constrictive pericarditis, pulmonary fibrosis, retroperitoneal fibrosis
Cabergoline is contraindicated for use by patients with a history of pulmonary, pericardial, cardiac valvular or retroperitoneal fibrotic disorders. Cabergoline should not be used in patients with a history of or current signs/clinical symptoms of respiratory, cardiac, or other disorders linked to fibrotic tissue such as pulmonary fibrosis, retroperitoneal fibrosis, or constrictive pericarditis. One case of constrictive pericarditis with subsequent pleuropulmonary inflammatory-fibrotic syndrome has occurred with cabergoline administration. Similar to other ergot derivatives, cabergoline can cause fibrotic changes, inflammatory fibrosis, pleural effusion, and valvulopathy. Therefore, patients receiving cabergoline should be monitored for the potential development of fibrotic disorders. Clinical and diagnostic monitoring (e.g., erythrocyte sedimentation rate, chest x-ray, serum creatinine) should be considered at baseline and as needed during treatment. Potential signs and symptoms of fibrotic disorders, including dyspnea, chronic cough, chest pain, renal insufficiency, ureteral/abdominal vascular obstruction, abdominal masses or tenderness, and cardiac failure, should be promptly evaluated. Discontinuation of cabergoline may result in improvement in the symptoms of pleural effusion and pulmonary fibrosis.
Hypertension
Like other ergot derivatives, cabergoline is contraindicated in patients with uncontrolled hypertension. Ergot-derived dopamine agonists have been associated with hypertension, strokes, and seizures. Patients should be advised to immediately report new or worsening hypertension, severe headaches, or other adverse CNS effects.
Hypotension, orthostatic hypotension
Cabergoline has been associated with orthostatic hypotension. Initiating treatment with dosages greater than 1 mg are most likely to produce this effect. Cabergoline should be used cautiously in those with a history of hypotension or those receiving medications known to cause hypotension.
Hepatic disease
Since cabergoline is extensively metabolized by the liver, caution should be used, and careful monitoring implemented, when administering cabergoline to patients with hepatic disease. No effects on the kinetics of cabergoline have been observed in patients with mild to moderate hepatic impairment, but patients with significant impairment had significantly increased exposure to the drug.
Impulse control symptoms
Some patients receiving dopamine agonists, including cabergoline, have reported impulse control symptoms/compulsive behaviors, including pathological gambling, increased libido, and hypersexuality. Generally, these impulse control symptoms are reversible after the dose is reduced or the drug is discontinued. Practitioners should inquire periodically about new or worsening impulsivity in patients receiving cabergoline. Likewise, patients should be instructed to report such changes while receiving cabergoline. Dose reduction or discontinuation should be considered in those who experience these effects.
Eclampsia, preeclampsia, pregnancy, pregnancy testing
Although the available data suggest a low fetal risk in early pregnancy, the risk to the developing fetus during chronic cabergoline exposure is unknown. Therefore, cabergoline should be used during pregnancy only if clearly needed. Dopamine agonists, like cabergoline, should generally not be used in patients with pregnancy-induced hypertension (e.g., preeclampsia, eclampsia, or postpartum hypertension), unless the potential benefit is judged to outweigh the possible risk. There is an association of use of these drugs with hypertension, seizures, myocardial infarction, and stroke in postpartum patients. In one review of over 200 pregnancies in cabergoline-exposed women, no increased miscarriage rates, congenital malformations, abnormal distribution of birthweights, or disturbances in postnatal development were noted in comparison to the expected population rate. The range of embryo-fetal exposure to cabergoline was between 1 and 144 days. Among 56 women receiving cabergoline for amenorrhea secondary to hyperprolactinemia, the following outcomes were reported in 17 subsequent pregnancies: 1 spontaneous abortion, 6 pending outcomes, and 10 term infants with normal physical and mental development. In a separate group of women receiving cabergoline for hyperprolactinemia, the following outcomes were reported in 61 pregnancies: 5 elective abortions (1 suspected malformation), 6 spontaneous abortions, 1 hydatidiform mole, and 49 live births (1 minor defect and 1 trisomy). In one study enrolling 47 hyperprolactinemic females, 9 became pregnant against medical advice. Treatment with cabergoline was interrupted when pregnancy was diagnosed. The pregnancy outcomes included 1 voluntary termination, 1 spontaneous termination, and 7 healthy term infants showing normal development during 8 years of continued follow-up. One case describes a patient with two separate pregnancies and the use of levodopa and cabergoline for Parkinson's disease throughout the pregnancies. There were no fetal complications; however, C-section was required in the second birth due to placental abruption. Instruct patients to notify their physician if they suspect they are pregnant, become pregnant, or intend to become pregnant during therapy. Cabergoline treatment in a patient with infertility due to hyperprolactinemia may restore fertility. Conduct pregnancy testing if there is any suspicion of pregnancy.
Breast-feeding
A decision should be made whether to discontinue breast-feeding or to discontinue the drug, taking into account the importance of the drug to the mother. Cabergoline interferes with lactation due to a central prolactin-lowering effect. Cabergoline is also not indicated for postpartum lactation inhibition because the use of other dopamine agonists (e.g., bromocriptine) for this purpose has resulted in hypertension, stroke, and seizures.
Geriatric
Clinical studies of cabergoline did not include a sufficient number of patients 65 years and older to determine whether they respond differently than younger adults. Other reported clinical experience has not identified differences in responses between geriatric and younger adult patients. However, cabergoline dosing and titration should be more cautious in geriatric patients, starting at the lower end of the dose range to account for differences in renal, hepatic, or cardiac systems as well as concomitant disease states and medications.
Children, infants
The safety and efficacy of cabergoline in pediatric patients, particularly children and infants, have not been established.
DRUG INTERACTIONS
Acebutolol: (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including beta-blockers. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure.
Aliskiren: (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including aliskiren. Cabergoline has been associated with hypotension in some instances. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure.
Aliskiren; Amlodipine: (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including aliskiren. Cabergoline has been associated with hypotension in some instances. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure. (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including amlodipine. Cabergoline has been associated with hypotension. Initial doses higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure.
Aliskiren; Amlodipine; Hydrochlorothiazide, HCTZ: (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including aliskiren. Cabergoline has been associated with hypotension in some instances. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure. (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including amlodipine. Cabergoline has been associated with hypotension. Initial doses higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure. (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including thiazide diuretics. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure.
Aliskiren; Hydrochlorothiazide, HCTZ: (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including aliskiren. Cabergoline has been associated with hypotension in some instances. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure. (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including thiazide diuretics. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure.
Aliskiren; Valsartan: (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including aliskiren. Cabergoline has been associated with hypotension in some instances. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure. (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including angiotensin II receptor antagonists. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure.
Almotriptan: (Major) When possible, avoid concomitant use of serotonin-receptor agonists (triptans) within 24 hours of cabergoline administration to minimize the risk for serious coronary ischemia. Ergot alkaloids have been reported to cause prolonged vasospastic reactions which may be additive with the effects of triptans. The risk for vasospastic adverse reactions may be less with cabergoline, a semisynthetic ergot alkaloid derivative, than with other ergot alkaloids as cabergoline is a relatively selective dopamine agonist. In select patients, the combination of cabergoline and "triptans" has been utilized in the management of some headache types, but more data are needed regarding safety and efficacy.
Alpha-blockers: (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including alpha-blockers. Cabergoline has been associated with hypotension. Initial doses higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure.
Amiloride: (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including potassium-sparing diuretics. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure.
Amiloride; Hydrochlorothiazide, HCTZ: (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including potassium-sparing diuretics. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure. (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including thiazide diuretics. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure.
Amlodipine: (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including amlodipine. Cabergoline has been associated with hypotension. Initial doses higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure.
Amlodipine; Atorvastatin: (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including amlodipine. Cabergoline has been associated with hypotension. Initial doses higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure.
Amlodipine; Benazepril: (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including amlodipine. Cabergoline has been associated with hypotension. Initial doses higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure. (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including angiotensin-converting enzyme inhibitors. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure.
Amlodipine; Celecoxib: (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including amlodipine. Cabergoline has been associated with hypotension. Initial doses higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure.
Amlodipine; Olmesartan: (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including amlodipine. Cabergoline has been associated with hypotension. Initial doses higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure. (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including angiotensin II receptor antagonists. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure.
Amlodipine; Valsartan: (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including amlodipine. Cabergoline has been associated with hypotension. Initial doses higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure. (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including angiotensin II receptor antagonists. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure.
Amlodipine; Valsartan; Hydrochlorothiazide, HCTZ: (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including amlodipine. Cabergoline has been associated with hypotension. Initial doses higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure. (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including angiotensin II receptor antagonists. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure. (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including thiazide diuretics. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure.
Amyl Nitrite: (Moderate) Cabergoline should be used cautiously with drugs that can lower blood pressure, including systemic nitrates. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure.
Angiotensin II receptor antagonists: (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including angiotensin II receptor antagonists. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure.
Angiotensin-converting enzyme inhibitors: (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including angiotensin-converting enzyme inhibitors. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure.
Aripiprazole: (Moderate) Cabergoline should not be coadministered with aripiprazole due to mutually antagonistic effects on dopaminergic function. The dopamine antagonist action of aripiprazole may diminish the prolactin-lowering ability of cabergoline while the dopamine agonist effects of cabergoline may exacerbate a psychotic disorder, reducing the effectiveness of antipsychotics such as aripiprazole.
Asenapine: (Moderate) Cabergoline should not be coadministered with asenapine due to mutually antagonistic effects on dopaminergic function. The dopamine antagonist action of asenapine may diminish the prolactin-lowering ability of cabergoline while the dopamine agonist effects of cabergoline may exacerbate a psychotic disorder, reducing the effectiveness of antipsychotics such as asenapine.
Atenolol: (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including beta-blockers. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure.
Atenolol; Chlorthalidone: (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including beta-blockers. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure. (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including thiazide diuretics. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure.
Azilsartan: (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including angiotensin II receptor antagonists. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure.
Azilsartan; Chlorthalidone: (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including angiotensin II receptor antagonists. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure. (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including thiazide diuretics. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure.
Belladonna Alkaloids; Ergotamine; Phenobarbital: (Moderate) Cabergoline is an ergot derivative that has been associated with valvulopathy and fibrosis; the risk may increase with chronic. prolonged use. Cabergoline should be used with caution in patients exposed to other medications associated with valvulopathy and fibrosis, such as ergot alkaloids. Monitor patients taking these drugs for possible signs and symptoms, which may include dyspnea, persistent cough, chest pain, heart failure, renal insufficiency, or urethral/abdominal obstruction.
Benazepril: (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including angiotensin-converting enzyme inhibitors. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure.
Benazepril; Hydrochlorothiazide, HCTZ: (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including angiotensin-converting enzyme inhibitors. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure. (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including thiazide diuretics. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure.
Bendroflumethiazide; Nadolol: (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including beta-blockers. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure. (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including thiazide diuretics. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure.
Beta-blockers: (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including beta-blockers. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure.
Betaxolol: (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including beta-blockers. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure.
Bisoprolol: (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including beta-blockers. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure.
Bisoprolol; Hydrochlorothiazide, HCTZ: (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including beta-blockers. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure. (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including thiazide diuretics. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure.
Brexpiprazole: (Moderate) Cabergoline should not be coadministered with brexpiprazole due to mutually antagonistic effects on dopaminergic function. The dopamine antagonist action of brexpiprazole may diminish the prolactin-lowering ability of cabergoline while the dopamine agonist effects of cabergoline may exacerbate a psychotic disorder, reducing the effectiveness of antipsychotics such as brexpiprazole.
Brimonidine; Timolol: (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including beta-blockers. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure.
Bumetanide: (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including loop diuretics. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure.
Candesartan: (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including angiotensin II receptor antagonists. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure.
Candesartan; Hydrochlorothiazide, HCTZ: (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including angiotensin II receptor antagonists. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure. (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including thiazide diuretics. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure.
Captopril: (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including angiotensin-converting enzyme inhibitors. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure.
Captopril; Hydrochlorothiazide, HCTZ: (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including angiotensin-converting enzyme inhibitors. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure. (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including thiazide diuretics. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure.
Cariprazine: (Moderate) Cabergoline should not be coadministered with cariprazine due to mutually antagonistic effects on dopaminergic function. The dopamine antagonist action of cariprazine may diminish the prolactin-lowering ability of cabergoline while the dopamine agonist effects of cabergoline may exacerbate a psychotic disorder, reducing the effectiveness of antipsychotics such as cariprazine.
Carteolol: (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including beta-blockers. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure.
Carvedilol: (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including beta-blockers. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure.
Chlorothiazide: (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including thiazide diuretics. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure.
Chlorpromazine: (Moderate) Cabergoline should generally not be coadministered with phenothiazines due to mutually antagonistic effects on dopaminergic function. The dopamine antagonist action of phenothiazines may diminish the prolactin-lowering ability of cabergoline while the dopamine agonist effects of cabergoline may exacerbate a psychotic disorder, reducing the effectiveness of antipsychotics such as phenothiazines.
Chlorthalidone: (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including thiazide diuretics. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure.
Chlorthalidone; Clonidine: (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including clonidine. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure. (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including thiazide diuretics. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure.
Clomipramine: (Moderate) Cabergoline should not be coadministered with clomipramine, if possible. The prolactin-lowering effect of cabergoline may be diminished by medications that may increase prolactin levels such as clomipramine.
Clonidine: (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including clonidine. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure.
Clozapine: (Moderate) Cabergoline should not be coadministered with clozapine due to mutually antagonistic effects on dopaminergic function. The dopamine antagonist action of clozapine may diminish the prolactin-lowering ability of cabergoline while the dopamine agonist effects of cabergoline may exacerbate a psychotic disorder, reducing the effectiveness of antipsychotics such as clozapine. It should be noted that the effect of clozapine on prolactin is generally not clinically relevant.
Codeine; Phenylephrine; Promethazine: (Moderate) Cabergoline should generally not be coadministered with phenothiazines due to mutually antagonistic effects on dopaminergic function. The dopamine antagonist action of phenothiazines may diminish the prolactin-lowering ability of cabergoline while the dopamine agonist effects of cabergoline may exacerbate a psychotic disorder, reducing the effectiveness of antipsychotics such as phenothiazines.
Codeine; Promethazine: (Moderate) Cabergoline should generally not be coadministered with phenothiazines due to mutually antagonistic effects on dopaminergic function. The dopamine antagonist action of phenothiazines may diminish the prolactin-lowering ability of cabergoline while the dopamine agonist effects of cabergoline may exacerbate a psychotic disorder, reducing the effectiveness of antipsychotics such as phenothiazines.
Deutetrabenazine: (Moderate) Cabergoline should not be coadministered with deutetrabenazine, if possible. The prolactin-lowering effect of cabergoline may be diminished by medications that increase prolactin levels such as deutetrabenazine.
Diethylpropion: (Moderate) Cabergoline has been associated with valvulopathy and should be used with caution in patients exposed to other medications associated with valvulopathy. Valvulopathy has been very rarely reported with diethylpropion, but the causal relationship remains uncertain. The potential risk of possible serious adverse effects such as valvular heart disease should be assessed carefully against the potential benefit of the use of these drugs together.
Dihydroergotamine: (Moderate) Cabergoline is an ergot derivative that has been associated with valvulopathy and fibrosis; the risk may increase with chronic. prolonged use. Cabergoline should be used with caution in patients exposed to other medications associated with valvulopathy and fibrosis, such as ergot alkaloids. Monitor patients taking these drugs for possible signs and symptoms, which may include dyspnea, persistent cough, chest pain, heart failure, renal insufficiency, or urethral/abdominal obstruction.
Diltiazem: (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including diltiazem. Cabergoline has been associated with hypotension. Initial doses of carbergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure.
Dorzolamide; Timolol: (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including beta-blockers. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure.
Doxazosin: (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including alpha-blockers. Cabergoline has been associated with hypotension. Initial doses higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure.
Droperidol: (Moderate) Cabergoline should not be coadministered with droperidol due to mutually antagonistic effects on dopaminergic function. The dopamine antagonist action of droperidol may diminish the prolactin-lowering ability of cabergoline while the dopamine agonist effects of cabergoline may exacerbate a psychotic disorder, reducing the antipsychotic effect of droperidol. In addition, both cabergoline and droperidol may cause hypotension, and additive effects may occur during coadministration. It may be advisable to monitor blood pressure.
Eletriptan: (Major) When possible, avoid concomitant use of serotonin-receptor agonists (triptans) within 24 hours of cabergoline administration to minimize the risk for serious coronary ischemia. Ergot alkaloids have been reported to cause prolonged vasospastic reactions which may be additive with the effects of triptans. The risk for vasospastic adverse reactions may be less with cabergoline, a semisynthetic ergot alkaloid derivative, than with other ergot alkaloids as cabergoline is a relatively selective dopamine agonist. In select patients, the combination of cabergoline and "triptans" has been utilized in the management of some headache types, but more data are needed regarding safety and efficacy.
Enalapril, Enalaprilat: (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including angiotensin-converting enzyme inhibitors. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure.
Enalapril; Felodipine: (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including angiotensin-converting enzyme inhibitors. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure. (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including felodipine. Cabergoline has been associated with hypotension. Initial doses higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure.
Enalapril; Hydrochlorothiazide, HCTZ: (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including angiotensin-converting enzyme inhibitors. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure. (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including thiazide diuretics. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure.
Eprosartan: (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including angiotensin II receptor antagonists. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure.
Eprosartan; Hydrochlorothiazide, HCTZ: (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including angiotensin II receptor antagonists. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure. (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including thiazide diuretics. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure.
Ergoloid Mesylates: (Moderate) Cabergoline is an ergot derivative that has been associated with valvulopathy and fibrosis; the risk may increase with chronic. prolonged use. Cabergoline should be used with caution in patients exposed to other medications associated with valvulopathy and fibrosis, such as ergot alkaloids. Monitor patients taking these drugs for possible signs and symptoms, which may include dyspnea, persistent cough, chest pain, heart failure, renal insufficiency, or urethral/abdominal obstruction.
Ergonovine: (Moderate) Cabergoline is an ergot derivative that has been associated with valvulopathy and fibrosis; the risk may increase with chronic. prolonged use. Cabergoline should be used with caution in patients exposed to other medications associated with valvulopathy and fibrosis, such as ergot alkaloids. Monitor patients taking these drugs for possible signs and symptoms, which may include dyspnea, persistent cough, chest pain, heart failure, renal insufficiency, or urethral/abdominal obstruction.
Ergot alkaloids: (Moderate) Cabergoline is an ergot derivative that has been associated with valvulopathy and fibrosis; the risk may increase with chronic. prolonged use. Cabergoline should be used with caution in patients exposed to other medications associated with valvulopathy and fibrosis, such as ergot alkaloids. Monitor patients taking these drugs for possible signs and symptoms, which may include dyspnea, persistent cough, chest pain, heart failure, renal insufficiency, or urethral/abdominal obstruction.
Ergotamine: (Moderate) Cabergoline is an ergot derivative that has been associated with valvulopathy and fibrosis; the risk may increase with chronic. prolonged use. Cabergoline should be used with caution in patients exposed to other medications associated with valvulopathy and fibrosis, such as ergot alkaloids. Monitor patients taking these drugs for possible signs and symptoms, which may include dyspnea, persistent cough, chest pain, heart failure, renal insufficiency, or urethral/abdominal obstruction.
Ergotamine; Caffeine: (Moderate) Cabergoline is an ergot derivative that has been associated with valvulopathy and fibrosis; the risk may increase with chronic. prolonged use. Cabergoline should be used with caution in patients exposed to other medications associated with valvulopathy and fibrosis, such as ergot alkaloids. Monitor patients taking these drugs for possible signs and symptoms, which may include dyspnea, persistent cough, chest pain, heart failure, renal insufficiency, or urethral/abdominal obstruction.
Esmolol: (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including beta-blockers. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure.
Ethacrynic Acid: (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including loop diuretics. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure.
Felodipine: (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including felodipine. Cabergoline has been associated with hypotension. Initial doses higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure.
Fluphenazine: (Moderate) Cabergoline should generally not be coadministered with phenothiazines due to mutually antagonistic effects on dopaminergic function. The dopamine antagonist action of phenothiazines may diminish the prolactin-lowering ability of cabergoline while the dopamine agonist effects of cabergoline may exacerbate a psychotic disorder, reducing the effectiveness of antipsychotics such as phenothiazines.
Fosinopril: (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including angiotensin-converting enzyme inhibitors. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure.
Fosinopril; Hydrochlorothiazide, HCTZ: (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including angiotensin-converting enzyme inhibitors. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure. (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including thiazide diuretics. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure.
Frovatriptan: (Major) When possible, avoid concomitant use of serotonin-receptor agonists (triptans) within 24 hours of cabergoline administration to minimize the risk for serious coronary ischemia. Ergot alkaloids have been reported to cause prolonged vasospastic reactions which may be additive with the effects of triptans. The risk for vasospastic adverse reactions may be less with cabergoline, a semisynthetic ergot alkaloid derivative, than with other ergot alkaloids as cabergoline is a relatively selective dopamine agonist. In select patients, the combination of cabergoline and "triptans" has been utilized in the management of some headache types, but more data are needed regarding safety and efficacy.
Furosemide: (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including loop diuretics. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure.
Guanfacine: (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including guanfacine. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure.
Haloperidol: (Moderate) Cabergoline should not be coadministered with haloperidol due to mutually antagonistic effects on dopaminergic function. The dopamine antagonist action of haloperidol may diminish the prolactin-lowering ability of cabergoline while the dopamine agonist effects of cabergoline may exacerbate a psychotic disorder, reducing the effectiveness of antipsychotics such as haloperidol.
Hydralazine: (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including hydralazine. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure.
Hydralazine; Hydrochlorothiazide, HCTZ: (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including hydralazine. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure. (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including thiazide diuretics. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure.
Hydralazine; Isosorbide Dinitrate, ISDN: (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including hydralazine. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure. (Moderate) Cabergoline should be used cautiously with drugs that can lower blood pressure, including systemic nitrates. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure.
Hydrochlorothiazide, HCTZ: (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including thiazide diuretics. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure.
Hydrochlorothiazide, HCTZ; Methyldopa: (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including methyldopa. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure. In addition, the prolactin-lowering effect of cabergoline may be diminished by medications that increase prolactin levels such as methyldopa. Monitor for reduced response to cabergoline. (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including thiazide diuretics. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure.
Hydrochlorothiazide, HCTZ; Moexipril: (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including angiotensin-converting enzyme inhibitors. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure. (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including thiazide diuretics. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure.
Iloperidone: (Moderate) Cabergoline should not be coadministered with iloperidone due to mutually antagonistic effects on dopaminergic function. The dopamine antagonist action of iloperidone may diminish the prolactin-lowering ability of cabergoline while the dopamine agonist effects of cabergoline may exacerbate a psychotic disorder, reducing the effectiveness of antipsychotics such as iloperidone.
Indapamide: (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including indapamide. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure.
Irbesartan: (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including angiotensin II receptor antagonists. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure.
Irbesartan; Hydrochlorothiazide, HCTZ: (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including angiotensin II receptor antagonists. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure. (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including thiazide diuretics. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure.
Isosorbide Dinitrate, ISDN: (Moderate) Cabergoline should be used cautiously with drugs that can lower blood pressure, including systemic nitrates. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure.
Isosorbide Mononitrate: (Moderate) Cabergoline should be used cautiously with drugs that can lower blood pressure, including systemic nitrates. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure.
Isradipine: (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including isradipine. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure.
Labetalol: (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including beta-blockers. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure.
Levamlodipine: (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including amlodipine. Cabergoline has been associated with hypotension. Initial doses higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure.
Levobetaxolol: (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including beta-blockers. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure.
Levobunolol: (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including beta-blockers. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure.
Lisinopril: (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including angiotensin-converting enzyme inhibitors. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure.
Lisinopril; Hydrochlorothiazide, HCTZ: (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including angiotensin-converting enzyme inhibitors. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure. (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including thiazide diuretics. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure.
Loop diuretics: (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including loop diuretics. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure.
Lorcaserin: (Moderate) The prolactin-lowering effect of cabergoline may be diminished by medications that increase prolactin levels such as lorcaserin. Lorcaserin moderately elevates prolactin levels.
Losartan: (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including angiotensin II receptor antagonists. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure.
Losartan; Hydrochlorothiazide, HCTZ: (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including angiotensin II receptor antagonists. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure. (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including thiazide diuretics. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure.
Loxapine: (Moderate) Cabergoline should not be coadministered with loxapine due to mutually antagonistic effects on dopaminergic function. The dopamine antagonist action of loxapine may diminish the prolactin-lowering ability of cabergoline while the dopamine agonist effects of cabergoline may exacerbate a psychotic disorder, reducing the effectiveness of antipsychotics such as loxapine.
Lumateperone: (Moderate) Cabergoline should not be coadministered with lumateperone due to mutually antagonistic effects on dopaminergic function. The dopamine antagonist action of lumateperone may diminish the prolactin-lowering ability of cabergoline while the dopamine agonist effects of cabergoline may exacerbate a psychotic disorder, reducing the effectiveness of antipsychotics such as lumateperone.
Lurasidone: (Moderate) Cabergoline should not be coadministered with lurasidone due to mutually antagonistic effects on dopaminergic function. The dopamine antagonist action of lurasidone may diminish the prolactin-lowering ability of cabergoline while the dopamine agonist effects of cabergoline may exacerbate a psychotic disorder, reducing the effectiveness of antipsychotics such as lurasidone.
Mecamylamine: (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including mecamylamine. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure.
Meperidine; Promethazine: (Moderate) Cabergoline should generally not be coadministered with phenothiazines due to mutually antagonistic effects on dopaminergic function. The dopamine antagonist action of phenothiazines may diminish the prolactin-lowering ability of cabergoline while the dopamine agonist effects of cabergoline may exacerbate a psychotic disorder, reducing the effectiveness of antipsychotics such as phenothiazines.
Mesoridazine: (Moderate) Cabergoline should generally not be coadministered with phenothiazines due to mutually antagonistic effects on dopaminergic function. The dopamine antagonist action of phenothiazines may diminish the prolactin-lowering ability of cabergoline while the dopamine agonist effects of cabergoline may exacerbate a psychotic disorder, reducing the effectiveness of antipsychotics such as phenothiazines.
Methyclothiazide: (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including thiazide diuretics. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure.
Methyldopa: (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including methyldopa. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure. In addition, the prolactin-lowering effect of cabergoline may be diminished by medications that increase prolactin levels such as methyldopa. Monitor for reduced response to cabergoline.
Methylergonovine: (Moderate) Cabergoline is an ergot derivative that has been associated with valvulopathy and fibrosis; the risk may increase with chronic. prolonged use. Cabergoline should be used with caution in patients exposed to other medications associated with valvulopathy and fibrosis, such as ergot alkaloids. Monitor patients taking these drugs for possible signs and symptoms, which may include dyspnea, persistent cough, chest pain, heart failure, renal insufficiency, or urethral/abdominal obstruction.
Methysergide: (Moderate) Cabergoline is an ergot derivative that has been associated with valvulopathy and fibrosis; the risk may increase with chronic. prolonged use. Cabergoline should be used with caution in patients exposed to other medications associated with valvulopathy and fibrosis, such as ergot alkaloids. Monitor patients taking these drugs for possible signs and symptoms, which may include dyspnea, persistent cough, chest pain, heart failure, renal insufficiency, or urethral/abdominal obstruction.
Metoclopramide: (Moderate) Cabergoline should not be coadministered with metoclopramide. The prolactin-lowering effect of cabergoline may be diminished by medications that increase prolactin levels such as metoclopramide. Metoclopramide increases prolactin levels through central dopamine blockade while cabergoline decreases prolactin levels through dopamine agonist effects.
Metolazone: (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including thiazide diuretics. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure.
Metoprolol: (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including beta-blockers. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure.
Metoprolol; Hydrochlorothiazide, HCTZ: (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including beta-blockers. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure. (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including thiazide diuretics. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure.
Minoxidil: (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including minoxidil. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure.
Moexipril: (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including angiotensin-converting enzyme inhibitors. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure.
Molindone: (Moderate) Cabergoline should not be coadministered with molindone due to mutually antagonistic effects on dopaminergic function. The dopamine antagonist action of molindone may diminish the prolactin-lowering ability of cabergoline while the dopamine agonist effects of cabergoline may exacerbate a psychotic disorder, reducing the effectiveness of antipsychotics such as molindone.
Nadolol: (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including beta-blockers. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure.
Naratriptan: (Major) When possible, avoid concomitant use of serotonin-receptor agonists (triptans) within 24 hours of cabergoline administration to minimize the risk for serious coronary ischemia. Ergot alkaloids have been reported to cause prolonged vasospastic reactions which may be additive with the effects of triptans. The risk for vasospastic adverse reactions may be less with cabergoline, a semisynthetic ergot alkaloid derivative, than with other ergot alkaloids as cabergoline is a relatively selective dopamine agonist. In select patients, the combination of cabergoline and "triptans" has been utilized in the management of some headache types, but more data are needed regarding safety and efficacy.
Nebivolol: (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including beta-blockers. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure.
Nebivolol; Valsartan: (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including angiotensin II receptor antagonists. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure. (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including beta-blockers. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure.
Nicardipine: (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including nicardipine. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure.
Nifedipine: (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including nifedipine. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure.
Nisoldipine: (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including nisoldipine. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure.
Nitrates: (Moderate) Cabergoline should be used cautiously with drugs that can lower blood pressure, including systemic nitrates. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure.
Nitroglycerin: (Moderate) Cabergoline should be used cautiously with drugs that can lower blood pressure, including systemic nitrates. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure.
Nitroprusside: (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including sodium nitroprusside. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure.
Olanzapine: (Moderate) Cabergoline should not be coadministered with olanzapine due to mutually antagonistic effects on dopaminergic function. The dopamine antagonist action of olanzapine may diminish the prolactin-lowering ability of cabergoline while the dopamine agonist effects of cabergoline may exacerbate a psychotic disorder, reducing the effectiveness of antipsychotics such as olanzapine.
Olanzapine; Fluoxetine: (Moderate) Cabergoline should not be coadministered with olanzapine due to mutually antagonistic effects on dopaminergic function. The dopamine antagonist action of olanzapine may diminish the prolactin-lowering ability of cabergoline while the dopamine agonist effects of cabergoline may exacerbate a psychotic disorder, reducing the effectiveness of antipsychotics such as olanzapine.
Olanzapine; Samidorphan: (Moderate) Cabergoline should not be coadministered with olanzapine due to mutually antagonistic effects on dopaminergic function. The dopamine antagonist action of olanzapine may diminish the prolactin-lowering ability of cabergoline while the dopamine agonist effects of cabergoline may exacerbate a psychotic disorder, reducing the effectiveness of antipsychotics such as olanzapine.
Olmesartan: (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including angiotensin II receptor antagonists. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure.
Olmesartan; Amlodipine; Hydrochlorothiazide, HCTZ: (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including amlodipine. Cabergoline has been associated with hypotension. Initial doses higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure. (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including angiotensin II receptor antagonists. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure. (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including thiazide diuretics. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure.
Olmesartan; Hydrochlorothiazide, HCTZ: (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including angiotensin II receptor antagonists. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure. (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including thiazide diuretics. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure.
Paliperidone: (Moderate) Cabergoline should not be coadministered with paliperidone due to mutually antagonistic effects on dopaminergic function. The dopamine antagonist action of paliperidone may diminish the prolactin-lowering ability of cabergoline while the dopamine agonist effects of cabergoline may exacerbate a psychotic disorder, reducing the effectiveness of antipsychotics such as paliperidone.
Penbutolol: (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including beta-blockers. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure.
Pergolide: (Moderate) Cabergoline is an ergot derivative that has been associated with valvulopathy and fibrosis; the risk may increase with chronic. prolonged use. Cabergoline should be used with caution in patients exposed to other medications associated with valvulopathy and fibrosis, such as ergot alkaloids. Monitor patients taking these drugs for possible signs and symptoms, which may include dyspnea, persistent cough, chest pain, heart failure, renal insufficiency, or urethral/abdominal obstruction.
Perindopril: (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including angiotensin-converting enzyme inhibitors. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure.
Perindopril; Amlodipine: (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including amlodipine. Cabergoline has been associated with hypotension. Initial doses higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure. (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including angiotensin-converting enzyme inhibitors. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure.
Perphenazine: (Moderate) Cabergoline should generally not be coadministered with phenothiazines due to mutually antagonistic effects on dopaminergic function. The dopamine antagonist action of phenothiazines may diminish the prolactin-lowering ability of cabergoline while the dopamine agonist effects of cabergoline may exacerbate a psychotic disorder, reducing the effectiveness of antipsychotics such as phenothiazines.
Perphenazine; Amitriptyline: (Moderate) Cabergoline should generally not be coadministered with phenothiazines due to mutually antagonistic effects on dopaminergic function. The dopamine antagonist action of phenothiazines may diminish the prolactin-lowering ability of cabergoline while the dopamine agonist effects of cabergoline may exacerbate a psychotic disorder, reducing the effectiveness of antipsychotics such as phenothiazines.
Phenothiazines: (Moderate) Cabergoline should generally not be coadministered with phenothiazines due to mutually antagonistic effects on dopaminergic function. The dopamine antagonist action of phenothiazines may diminish the prolactin-lowering ability of cabergoline while the dopamine agonist effects of cabergoline may exacerbate a psychotic disorder, reducing the effectiveness of antipsychotics such as phenothiazines.
Phenoxybenzamine: (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including alpha-blockers. Cabergoline has been associated with hypotension. Initial doses higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure.
Phentolamine: (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including alpha-blockers. Cabergoline has been associated with hypotension. Initial doses higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure.
Pimozide: (Moderate) Cabergoline should not be coadministered with pimozide due to mutually antagonistic effects on dopaminergic function. The dopamine antagonist action of pimozide may diminish the prolactin-lowering ability of cabergoline while the dopamine agonist effects of cabergoline may exacerbate a psychotic disorder, reducing the effectiveness of antipsychotics such as pimozide.
Pindolol: (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including beta-blockers. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure.
Potassium-sparing diuretics: (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including potassium-sparing diuretics. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure.
Prazosin: (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including alpha-blockers. Cabergoline has been associated with hypotension. Initial doses higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure.
Prochlorperazine: (Moderate) Cabergoline should generally not be coadministered with phenothiazines due to mutually antagonistic effects on dopaminergic function. The dopamine antagonist action of phenothiazines may diminish the prolactin-lowering ability of cabergoline while the dopamine agonist effects of cabergoline may exacerbate a psychotic disorder, reducing the effectiveness of antipsychotics such as phenothiazines.
Promethazine: (Moderate) Cabergoline should generally not be coadministered with phenothiazines due to mutually antagonistic effects on dopaminergic function. The dopamine antagonist action of phenothiazines may diminish the prolactin-lowering ability of cabergoline while the dopamine agonist effects of cabergoline may exacerbate a psychotic disorder, reducing the effectiveness of antipsychotics such as phenothiazines.
Promethazine; Dextromethorphan: (Moderate) Cabergoline should generally not be coadministered with phenothiazines due to mutually antagonistic effects on dopaminergic function. The dopamine antagonist action of phenothiazines may diminish the prolactin-lowering ability of cabergoline while the dopamine agonist effects of cabergoline may exacerbate a psychotic disorder, reducing the effectiveness of antipsychotics such as phenothiazines.
Promethazine; Phenylephrine: (Moderate) Cabergoline should generally not be coadministered with phenothiazines due to mutually antagonistic effects on dopaminergic function. The dopamine antagonist action of phenothiazines may diminish the prolactin-lowering ability of cabergoline while the dopamine agonist effects of cabergoline may exacerbate a psychotic disorder, reducing the effectiveness of antipsychotics such as phenothiazines.
Propranolol: (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including beta-blockers. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure.
Propranolol; Hydrochlorothiazide, HCTZ: (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including beta-blockers. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure. (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including thiazide diuretics. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure.
Quetiapine: (Moderate) Cabergoline should not be coadministered with quetiapine due to mutually antagonistic effects on dopaminergic function. The dopamine antagonist action of quetiapine may diminish the prolactin-lowering ability of cabergoline while the dopamine agonist effects of cabergoline may exacerbate a psychotic disorder, reducing the effectiveness of antipsychotics such as quetiapine.
Quinapril: (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including angiotensin-converting enzyme inhibitors. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure.
Quinapril; Hydrochlorothiazide, HCTZ: (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including angiotensin-converting enzyme inhibitors. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure. (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including thiazide diuretics. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure.
Ramelteon: (Moderate) Cabergoline should not be coadministered with ramelteon, if possible. The prolactin-lowering effect of cabergoline may be diminished by medications that increase prolactin levels such as ramelteon.
Ramipril: (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including angiotensin-converting enzyme inhibitors. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure.
Reserpine: (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including reserpine. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure. In addition, the prolactin-lowering effect of cabergoline may be diminished by medications that increase prolactin levels such as reserpine. Monitor for decreased response to cabergoline.
Risperidone: (Moderate) Cabergoline should not be coadministered with risperidone due to mutually antagonistic effects on dopaminergic function. The dopamine antagonist action of risperidone may diminish the prolactin-lowering ability of cabergoline while the dopamine agonist effects of cabergoline may exacerbate a psychotic disorder, reducing the effectiveness of antipsychotics such as risperidone.
Rizatriptan: (Major) When possible, avoid concomitant use of serotonin-receptor agonists (triptans) within 24 hours of cabergoline administration to minimize the risk for serious coronary ischemia. Ergot alkaloids have been reported to cause prolonged vasospastic reactions which may be additive with the effects of triptans. The risk for vasospastic adverse reactions may be less with cabergoline, a semisynthetic ergot alkaloid derivative, than with other ergot alkaloids as cabergoline is a relatively selective dopamine agonist. In select patients, the combination of cabergoline and "triptans" has been utilized in the management of some headache types, but more data are needed regarding safety and efficacy.
Sacubitril; Valsartan: (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including angiotensin II receptor antagonists. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure.
Serotonin-Receptor Agonists: (Major) When possible, avoid concomitant use of serotonin-receptor agonists (triptans) within 24 hours of cabergoline administration to minimize the risk for serious coronary ischemia. Ergot alkaloids have been reported to cause prolonged vasospastic reactions which may be additive with the effects of triptans. The risk for vasospastic adverse reactions may be less with cabergoline, a semisynthetic ergot alkaloid derivative, than with other ergot alkaloids as cabergoline is a relatively selective dopamine agonist. In select patients, the combination of cabergoline and "triptans" has been utilized in the management of some headache types, but more data are needed regarding safety and efficacy.
Sotalol: (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including beta-blockers. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure.
Spironolactone: (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including potassium-sparing diuretics. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure.
Spironolactone; Hydrochlorothiazide, HCTZ: (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including potassium-sparing diuretics. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure. (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including thiazide diuretics. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure.
Sumatriptan: (Major) When possible, avoid concomitant use of serotonin-receptor agonists (triptans) within 24 hours of cabergoline administration to minimize the risk for serious coronary ischemia. Ergot alkaloids have been reported to cause prolonged vasospastic reactions which may be additive with the effects of triptans. The risk for vasospastic adverse reactions may be less with cabergoline, a semisynthetic ergot alkaloid derivative, than with other ergot alkaloids as cabergoline is a relatively selective dopamine agonist. In select patients, the combination of cabergoline and "triptans" has been utilized in the management of some headache types, but more data are needed regarding safety and efficacy.
Sumatriptan; Naproxen: (Major) When possible, avoid concomitant use of serotonin-receptor agonists (triptans) within 24 hours of cabergoline administration to minimize the risk for serious coronary ischemia. Ergot alkaloids have been reported to cause prolonged vasospastic reactions which may be additive with the effects of triptans. The risk for vasospastic adverse reactions may be less with cabergoline, a semisynthetic ergot alkaloid derivative, than with other ergot alkaloids as cabergoline is a relatively selective dopamine agonist. In select patients, the combination of cabergoline and "triptans" has been utilized in the management of some headache types, but more data are needed regarding safety and efficacy.
Telmisartan: (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including angiotensin II receptor antagonists. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure.
Telmisartan; Amlodipine: (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including amlodipine. Cabergoline has been associated with hypotension. Initial doses higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure. (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including angiotensin II receptor antagonists. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure.
Telmisartan; Hydrochlorothiazide, HCTZ: (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including angiotensin II receptor antagonists. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure. (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including thiazide diuretics. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure.
Terazosin: (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including alpha-blockers. Cabergoline has been associated with hypotension. Initial doses higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure.
Tetrabenazine: (Moderate) Cabergoline should not be coadministered with tetrabenazine, if possible. The prolactin-lowering effect of cabergoline may be diminished by medications that increase prolactin levels such as tetrabenazine.
Thiazide diuretics: (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including thiazide diuretics. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure.
Thiethylperazine: (Moderate) Cabergoline should generally not be coadministered with phenothiazines due to mutually antagonistic effects on dopaminergic function. The dopamine antagonist action of phenothiazines may diminish the prolactin-lowering ability of cabergoline while the dopamine agonist effects of cabergoline may exacerbate a psychotic disorder, reducing the effectiveness of antipsychotics such as phenothiazines.
Thioridazine: (Moderate) Cabergoline should generally not be coadministered with phenothiazines due to mutually antagonistic effects on dopaminergic function. The dopamine antagonist action of phenothiazines may diminish the prolactin-lowering ability of cabergoline while the dopamine agonist effects of cabergoline may exacerbate a psychotic disorder, reducing the effectiveness of antipsychotics such as phenothiazines.
Thiothixene: (Moderate) Cabergoline should not be coadministered with thiothixene due to mutually antagonistic effects on dopaminergic function. The dopamine antagonist action of thiothixene may diminish the prolactin-lowering ability of cabergoline while the dopamine agonist effects of cabergoline may exacerbate a psychotic disorder, reducing the effectiveness of antipsychotics such as thiothixene.
Timolol: (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including beta-blockers. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure.
Tobacco: (Minor) In theory, concurrent use of vasoconstrictors, such as nicotine, with cabergoline may result in enhanced vasoconstriction. Nicotine acts indirectly as a sympathomimetic agent by releasing catecholamines, potentially resulting in effects such as hypertension, which may be additive with ergot derivatives such as cabergoline. Use of the ergot derivative bromocriptine with some sympathomimetics has resulted in adverse effects such as worsening headache, hypertension, ventricular tachycardia, seizures, sudden loss of vision, and cerebral vasospasm. Caution is advisable during use of tobacco or other nicotine-containing products while taking cabergoline.
Torsemide: (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including loop diuretics. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure.
Trandolapril: (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including angiotensin-converting enzyme inhibitors. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure.
Trandolapril; Verapamil: (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including angiotensin-converting enzyme inhibitors. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure. (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including verapamil. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure. In addition, the prolactin-lowering effect of cabergoline may be diminished by medications that increase prolactin levels such as verapamil. Monitor for reduced response to cabergoline.
Triamterene: (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including potassium-sparing diuretics. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure.
Triamterene; Hydrochlorothiazide, HCTZ: (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including potassium-sparing diuretics. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure. (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including thiazide diuretics. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure.
Trifluoperazine: (Moderate) Cabergoline should generally not be coadministered with phenothiazines due to mutually antagonistic effects on dopaminergic function. The dopamine antagonist action of phenothiazines may diminish the prolactin-lowering ability of cabergoline while the dopamine agonist effects of cabergoline may exacerbate a psychotic disorder, reducing the effectiveness of antipsychotics such as phenothiazines.
Valbenazine: (Moderate) Cabergoline should not be coadministered with valbenazine, if possible. The prolactin-lowering effect of cabergoline may be diminished by medications that increase prolactin levels such as valbenazine.
Valsartan: (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including angiotensin II receptor antagonists. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure.
Valsartan; Hydrochlorothiazide, HCTZ: (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including angiotensin II receptor antagonists. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure. (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including thiazide diuretics. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure.
Verapamil: (Moderate) Cabergoline should be used cautiously with antihypertensive agents, including verapamil. Cabergoline has been associated with hypotension. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. It may be advisable to monitor blood pressure. In addition, the prolactin-lowering effect of cabergoline may be diminished by medications that increase prolactin levels such as verapamil. Monitor for reduced response to cabergoline.
Ziprasidone: (Moderate) Cabergoline should not be coadministered with ziprasidone due to mutually antagonistic effects on dopaminergic function. The dopamine antagonist action of ziprasidone may diminish the prolactin-lowering ability of cabergoline while the dopamine agonist effects of cabergoline may exacerbate a psychotic disorder, reducing the effectiveness of antipsychotics such as ziprasidone.
Zolmitriptan: (Major) When possible, avoid concomitant use of serotonin-receptor agonists (triptans) within 24 hours of cabergoline administration to minimize the risk for serious coronary ischemia. Ergot alkaloids have been reported to cause prolonged vasospastic reactions which may be additive with the effects of triptans. The risk for vasospastic adverse reactions may be less with cabergoline, a semisynthetic ergot alkaloid derivative, than with other ergot alkaloids as cabergoline is a relatively selective dopamine agonist. In select patients, the combination of cabergoline and "triptans" has been utilized in the management of some headache types, but more data are needed regarding safety and efficacy.