Cabergoline

How Medicare covers it

Part D (forms used at home). Part A during a covered inpatient stay. No Part B clinician-administered form in the CMS Part B spending file.

What it treats

Cabergoline treats hyperprolactinemic disorders — conditions where the body makes too much of the hormone prolactin — either with no known cause (idiopathic) or due to pituitary adenomas (small pituitary tumors), in adults. The label says it should not be used to stop normal milk production after childbirth.

What it is for, in depth

Cabergoline is prescribed for adults with hyperprolactinemic disorders — too much prolactin in the blood — either idiopathic (no cause found) or caused by a pituitary adenoma, a usually benign pituitary tumor that secretes prolactin. High prolactin can cause infertility, sexual problems, unwanted milk production, and bone loss in women who are not breastfeeding and in men, and bringing prolactin back to normal is the goal of treatment. Cabergoline is a first-line oral option in this path because it directly switches off prolactin release and only needs to be taken twice a week. It comes as a single 0.5 mg scored tablet; treatment starts at half a tablet (0.25 mg) twice weekly and is titrated up slowly, no faster than every 4 weeks, to a maximum of 1 mg twice weekly until serum prolactin is normal. The label is explicit that it must not be used to inhibit or suppress normal postpartum milk production, because of the risk of serious reactions.

How it works

Cabergoline is an ergot derivative and a dopamine receptor agonist with a strong pull on D2 receptors. It acts directly on the prolactin-making cells of the pituitary gland to stop them releasing prolactin, which lowers prolactin levels in the blood.

How it is taken

It comes as a 0.5 mg tablet taken by mouth twice a week, starting at 0.25 mg (half a tablet) twice weekly. The dose is raised slowly, by 0.25 mg twice weekly no more often than every 4 weeks, up to a maximum of 1 mg twice weekly, aiming for normal prolactin levels.

Common side effects

The label extract does not list a separate table of common side effects; it names the clinically significant reactions described in the label — heart valve and pericardial fibrosis, fibrosis of the lungs and abdomen lining, low blood pressure on standing, and impulse-control problems. In the label's trial data, low blood pressure on standing (orthostatic hypotension) occurred in 4% of treated patients versus 0% on placebo.

Serious warnings

Before starting, every patient needs a heart check including an echocardiogram, because cabergoline can cause heart valve damage and pericardial fibrosis, and it must not be started if valve disease is found. The label also warns about pleural, pulmonary, and retroperitoneal fibrosis, low blood pressure when standing, and impulse-control disorders such as new gambling, sexual, or spending urges — the dose should be lowered or the drug stopped if these urges appear.

Who should be careful

People with uncontrolled high blood pressure, any history of heart valve disorders or fibrotic disorders of the lungs, chest, or abdomen, or allergy to ergot drugs must not take cabergoline. During treatment, patients need repeat heart ultrasounds every 6 to 12 months, blood pressure checks, and monitoring for chest pain, heart failure signs, and new compulsive urges; if pregnancy occurs during therapy, the risks and benefits of continuing must be weighed.

Major interactions

Cabergoline should not be used together with D2-blocking drugs (dopamine antagonists) such as phenothiazines, butyrophenones, thioxanthenes, or metoclopramide, because they work against each other. The label extract does not list other major interactions.

Cost and saving notes

If this drug is hard to afford on your Part D plan, you can ask the plan for a tier exception to move it to a lower cost tier, and your doctor can help explain why you need it. If you have limited income, Extra Help (the Part D Low-Income Subsidy) can lower premiums and drug costs, and you can apply through Social Security. Part D also has an annual out-of-pocket cap, so once your covered drug spending for the year reaches the cap, you pay nothing more for covered Part D drugs that year.

Why it is in its tier

Cabergoline sits on Tier 3 in 75.2% of the plans that list it (4132 of 5495 listing plans). Tier 3 is the preferred brand tier — mid-level copays or coinsurance. The data-visible drivers: It is a generic product, and the CMS dashboard puts its average Part D spending at about $312 per beneficiary for 2024 — a relatively low-cost drug, which matches where plans place it. It is listed by 100.0% of Part D plans. The tier shown is the most common one; individual plans vary.

Sources

• CABERGOLINE TABLET [CRANBURY PHARMACEUTICALS, LLC] — DailyMed
• MedlinePlus — National Library of Medicine
• MedlinePlus

What official patient guides say

Cabergoline fits an easy twice-a-week routine — it is taken with or without food, your doctor will start low and raise the dose no more often than once every 4 weeks, and you should not stop it suddenly without talking to your doctor, who will lower the dose gradually. Get up slowly from lying down, resting your feet on the floor for a few minutes first, because it can cause dizziness or fainting when you stand quickly, especially at the start. If you miss a dose, take it as soon as you remember unless it is almost time for the next one, and never double up. Store it in its original container, tightly closed, at room temperature away from heat and moisture, and keep all appointments, since your doctor will order lab tests and heart checks during treatment.

Source: MedlinePlus

Part D formulary coverage

Source: CMS Prescription Drug Plan Formulary, Pharmacy Network, and Pricing Information Files — Monthly file 2026-10-15 (plan year 2027), file 2027_20261008.zip (data.cms.gov dataset ed1496ea-23e7-41f1-9292-172fa842ccfb): basic drugs formulary file + plan information file, both dated 20261031 inside the zip; downloaded and aggregated 2026-10-30. Medication RxCUI sets resolved through the NLM RxNav (RxNorm) API.

What you pay

Without insurance, the cash benchmark is 1.28924 per unit (CABERGOLINE 0.5 MG TABLET) — about nan for 30 units. NADAC benchmark — the average price pharmacies pay (CMS, as of 2026-11-04). Pharmacy shelf prices vary.

A tier is not a price; what you pay depends on your plan, pharmacy, and benefit stage; Extra Help or Medicaid can lower it further.

Sources: CMS Plan Benefit Package + formulary data; CMS NADAC · Checked 2026-11-07

Coverage by plan and tier

Of the 5,495 Medicare drug plans we track for 2027, 5,495 list Cabergoline — 100% of plans. Most of those plans put it on Tier 3: 4,132 plans, 75.2% of the plans that list it. Other plans place it on Tier 2 (909 plans), Tier 1 (389 plans) or Tier 4 (65 plans). For example: Aetna Medicare Dual Extra (HMO D-SNP) puts it on Tier 3; Aetna Medicare Dual Extra Care (PPO D-SNP) puts it on Tier 3; Aetna Medicare Value Plus (PPO) puts it on Tier 3. You can compare these plans side by side on our Medicare Advantage hub. A tier is not a price. What you pay also depends on whether you have met your plan';s deductible, whether the drug costs a flat copay or a share of the price, and whether you get Extra Help or Medicaid.

Read next

• Part D in 2027: The $700 Deductible, the $2,400 Cap, and the $35 Insulin Rule
• Extra Help in 2027: Lower Drug Copays and Who Qualifies
• Checking Medicare Savings Programs and Extra Help

Part D spending averages (2024)

Source: CMS Medicare Part D Spending by Drug (Drug Spending Dashboard), release RY26 P04 V10, data through 2024 (DSD_PTD_RY26_P04_V10_DY24_BGM.csv), downloaded 2026-10-30

Companies covering this drug

Part D and Medicare Advantage plan sponsors that list this drug on a formulary, 50 at a time.