Name of the Procedure:

Cabergoline, oral, 0.25 mg (HCPCS Code J8515)

Summary

Cabergoline is a medication taken orally in tablet form and is often used to treat conditions related to high levels of the hormone prolactin. This medication works by inhibiting prolactin secretion from the pituitary gland.

Purpose

Cabergoline is used to address medical conditions involving elevated levels of prolactin, such as:

• Prolactinomas (benign pituitary tumors)
• Hyperprolactinemia (high levels of prolactin) The goal is to normalize prolactin levels and alleviate associated symptoms like irregular menstrual periods, infertility, and unwanted breast milk production.

Indications

• Women with irregular menstrual cycles or fertility issues due to high prolactin levels.
• Men experiencing symptoms like decreased libido or erectile dysfunction linked to hyperprolactinemia.
• Patients with prolactin-secreting pituitary tumors (prolactinomas).

Preparation

• There is generally no special preparation required for taking cabergoline.
• Patients should inform their healthcare provider about all medications they are currently taking.
• Blood tests might be conducted to measure prolactin levels before initiating treatment.

Procedure Description

1. Administration: Take the cabergoline tablet orally, typically twice a week.
2. Dosage: Start with a low dose (0.25 mg) and adjust based on response and prolactin level assessments.
3. Monitoring: Regular follow-up appointments to monitor blood prolactin levels and adjust dosages as necessary.

Duration

• Cabergoline is an ongoing treatment and may be required for several months to manage prolactin levels effectively.

Setting

• Usually prescribed and managed during regular outpatient visits with a healthcare provider.

Personnel

• Managed by an endocrinologist or primary care physician.
• Nurses may assist in monitoring patient progress and coordination.

Risks and Complications

• Common: Nausea, dizziness, headache, and fatigue.
• Rare: Cardiac valvulopathy (issues with heart valves), psychiatric effects like hallucinations.
• Management: Side effects are managed by adjusting the dosage or frequency.

Benefits

• Efficient in reducing prolactin levels.
• Helps in normalizing menstrual cycles, improving fertility, and reducing symptoms caused by prolactinomas.
• Positive effects are typically noticed within several weeks of treatment initiation.

Recovery

• No specific recovery phase, as the patient continues regular life activities while taking the medication.
• Follow doctor’s instructions about dosage adjustments and regular blood tests.

Alternatives

• Other medications like bromocriptine; however, cabergoline is often preferred due to fewer side effects.
• Surgical options for prolactinomas if medication is ineffective.

Patient Experience

• During Treatment: May experience mild discomforts like nausea or dizziness, which often decrease over time.
• Pain Management: Not typically necessary, but any side effects experienced can be discussed with the doctor for appropriate management.