Injection
Gonadorelin
A copy of the brain's own GnRH signal that keeps the testes producing testosterone and sperm, used alongside testosterone therapy and in fertility care. Prescribed and dosed by a licensed physician.
Starting at $159/mo
Prolactin controlDopamine agonist
Cabergoline Tablets
RxPrescription onlyTaken by mouth · Twice a week · 0.25 mg · Prolactin control · Dopamine agonist
Starting at $239/mo
Cabergoline (Dostinex, commercial brand): dopamine agonist that lowers prolactin, used when elevated prolactin appears during hormone therapy or independently. Long-acting, dosed once or twice weekly.
Choose your plan
Real prices from our pharmacy. Longer plans cost less per month and are billed up front. Pause or cancel anytime.
- Long-acting dopamine agonist; stays effective for days after one dose
- Lowers prolactin, reducing breast sensitivity and restoring sexual interest
- Once or twice weekly dosing; high compliance
Every plan includes
- Personalized, physician-guided plan
- Monthly, 3-month and 6-month plans
- Dispensed by a US-licensed compounding pharmacy
- Unlimited protocol adjustments and messaging
- Ongoing support and check-ins
- Pause or cancel anytime
- Reviewed by our in-house physicians
- Physician-guided care
- Ongoing, expert support
- 100% online
- Free, discreet shipping
What is cabergoline?
(ca-BER-go-leen)
Cabergoline is a dopamine agonist that blocks prolactin release from the pituitary. It is used when prolactin levels are elevated, causing breast sensitivity, sexual dysfunction, or reduced desire. Cabergoline is long-acting: a single dose of 0.25–0.5 mg lasts days, so dosing is typically once or twice per week. It is a commercial pharmaceutical brand (Dostinex) with consistent potency.
- How it is taken
- Taken by mouth
- How often
- Twice a week
- Dose range
- 0.25 mg
- Form
- Prolactin control · Dopamine agonist
Long-acting
single dose lasts 24–72 hours; dosed once or twice weekly
Cabergoline is more selective for prolactin than bromocriptine and has a much longer half-life, improving compliance. Elevated prolactin can appear from certain medications (antipsychotics, antidepressants) or independently; cabergoline treats it directly.
How it works,
week by week.
Day 1
US-licensed physician reviews symptoms of high prolactin (reduced desire, erectile difficulty, breast sensitivity) and orders prolactin level. Discusses cabergoline dosing.
Week 1
Start cabergoline 0.25–0.5 mg once or twice weekly. No daily pill needed; long half-life means one dose lasts days.
Weeks 1–2
Sexual interest and erectile function often improve within 1–2 weeks as prolactin falls. Breast sensitivity may resolve.
Week 4
Prolactin level checked. If suppressed to normal range, dose is maintained. If still high, dose is increased or frequency adjusted.
Beyond
Prolactin monitored every 6–12 months. Dose adjusted as needed. Cardiac screening if long-term use (yearly with >3 mg/week).
What you may notice,
and when.
Fast sexual recovery
interest and erectile function typically improve within 1–2 weeks
Reduced breast symptoms
tenderness and sensitivity fade as prolactin normalizes
Lab-guided dosing
prolactin level drives dose adjustment
Cardiac monitoring
essential with long-term high-dose use
Individual results vary. Benefits reflect what Zepym Health members commonly report to their physician at check-ins; they are not the results of a clinical trial.
Safety first:
what to know before you start.
Important safety information and common side effects
Cabergoline is a dopamine agonist used to lower prolactin. Common side effects: dizziness, nausea, headache, orthostatic hypotension (feeling faint when standing). Rare: valvular heart disease (especially with doses >3 mg/week or long-term use >5 years). Cabergoline should not be used with uncontrolled high blood pressure. Tell your physician about cardiac history, prior stroke, or uncontrolled hypertension. If you take antipsychotics or metoclopramide (which raise prolactin), discuss this with your physician, stopping them may be an option. Stop and seek care for chest pain, shortness of breath, severe dizziness, or signs of allergic reaction.
The research behind
cabergoline.
Cabergoline is a dopamine agonist approved for high prolactin. Its heart-valve risk was first seen at Parkinson's doses; the low doses used for prolactin have been studied in several cohorts.
- Valve disease2.8% vs 2.3%
In a population cohort of primary care patients with prolactinoma, 18 cabergoline-treated patients (2.8%) reached a hard cardiac endpoint (valve surgery or heart failure), against 2.3% of matched controls. The authors found no association with low-dose cabergoline.
Stiles et al., J Clin Endocrinol Metab 2021 - Parkinson doseshigher dose
Valve disease was linked to cabergoline at much higher doses used for Parkinson's disease. Prolactin treatment uses a far smaller dose, which is why the link is not assumed to carry over.
Stiles et al., J Clin Endocrinol Metab 2021 - Randomized trialsnone found
We found no randomized trial of cabergoline for prolactin or for non-prolactin uses in men. The evidence is observational.
Search of PubMed for cabergoline in men
What the studies found
- Lowers prolactin: its labelled use is hyperprolactinemia, including prolactin-secreting tumours (FDA labelling, DailyMed).
- Low-dose use showed no association with valve surgery or heart failure in a population cohort: 2.8% of treated patients against 2.3% of controls reached a hard cardiac endpoint (Stiles et al., J Clin Endocrinol Metab 2021).
- Not a testosterone add-on in any trial we found; its benefit is in prolactin control, not hormone replacement.
Results are for cabergoline at prolactin-treatment doses in cohort studies. Compounded or generic cabergoline is not separately studied, and the drug is not a testosterone add-on in the trials we found.
What this does not say
- Heart monitoring with echocardiogram is advised by prescribing guidance even at low doses.
- Cohorts are observational and do not exclude every valve effect.
- Use in men for purposes other than prolactin is off-label.
The research
behind it.
Cabergoline is a D2 dopamine receptor agonist that directly inhibits prolactin release from lactotroph cells in the pituitary. Dopamine naturally suppresses prolactin; dopamine agonists restore this suppression.
In men with elevated prolactin, cabergoline restores sexual interest, reduces breast tenderness, and improves erectile function. It is often prescribed when prolactin rises during testosterone therapy or from other causes.
Testosterone beyond the gym:
what the trials show across body systemsSex drive, blood counts, bone, blood sugar and thinking: what the Testosterone Trials and T4DM found, and where the evidence stops.Read the researchTestosterone and the heart:
what TRAVERSE foundThe safety question most men ask first: heart events, fractures, prostate and blood counts, in the largest placebo-controlled trial of testosterone.Read the research
what the trials show across body systemsSex drive, blood counts, bone, blood sugar and thinking: what the Testosterone Trials and T4DM found, and where the evidence stops.Read the researchTestosterone and the heart:
what TRAVERSE foundThe safety question most men ask first: heart events, fractures, prostate and blood counts, in the largest placebo-controlled trial of testosterone.Read the research
Getting started
takes a few minutes.
- 1
Connect with a physician
Answer a few questions online and a US-licensed physician reviews your health, history and goals to make sure treatment is right for you. 100% online. No in-person visit required.
- 2
Get your discreet shipment
If approved, your treatment is compounded by a US-licensed, LegitScript-certified pharmacy, inspected for quality, and shipped discreetly to your door.
- 3
Receive continuous support
Start with one goal, then keep building over time. Unlimited physician messaging, easy refills and dose adjustments, all from the Zepym Health app.
Frequently asked questions
Contact supportHow do I take Cabergoline Tablets?
Taken by mouth, twice a week. The starting prescription is one half tablet (0.25 mg) each time. Your physician sets your own dose and it is printed on your label.
How much arrives in each shipment?
1 bottle at the starting strength, shipped to your door from a licensed US pharmacy.
How long does cabergoline take to lower prolactin?
Cabergoline begins to lower prolactin within hours and reaches steady levels within 2–3 days. Most men notice improvement in sexual interest and breast sensitivity within 1–2 weeks. Check prolactin levels at 2–4 weeks to confirm suppression; your physician adjusts dose if needed.
What causes high prolactin?
Common causes: antipsychotics, antidepressants (especially SSRIs), metoclopramide, domperidone. Some people have higher baseline prolactin. A pituitary tumor (prolactinoma) is rare but must be ruled out with imaging. Your physician orders prolactin and may order MRI if levels are very high.
Is cabergoline safe long-term?
Cabergoline is safe for most people in standard doses (0.25–1 mg twice weekly). Long-term use at high doses (>3 mg/week) carries a small risk of cardiac valve disease, so your physician monitors this with echocardiography if you need high-dose or multi-year treatment.
Can I combine cabergoline with testosterone therapy?
Yes. Elevated prolactin can appear with or without testosterone. If your prolactin is high, cabergoline can be used alongside testosterone therapy without issue. Prolactin and testosterone do not directly interact.
How long do I take cabergoline?
As long as your prolactin is elevated and causing symptoms. If the cause is a medication (antipsychotic), stopping that drug may allow you to discontinue cabergoline. If prolactin is naturally high or from a tumor, you may take cabergoline long-term. Your physician reassesses every 6–12 months.
Cabergoline educational content reviewed by our physician
Scott Nass, MD Doctor of Medicine, board-certified in Family Medicine
Charles R. Drew University and David Geffen School of Medicine at UCLA. Family Medicine residency at Ventura County Medical Center.
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References
- 1.Cabergoline for prolactin suppression: a review of mechanisms and clinical use. Neuroendocrinology, 2015
- 2.Cardiac safety of dopamine agonists: a systematic review and meta-analysis. Endocrine, 2018
Prescription products require an online evaluation with a licensed medical professional who will determine if a prescription is appropriate. Products are compounded by a licensed pharmacy. The FDA has not reviewed or approved compounded products for any use for safety, efficacy, or quality. Compounded medications are not FDA-approved brand-name products.