Pharmacodynamics
The drug stimulates centrally located dopamine receptors, mainly the D2 and D3 receptor subtypes, with postsynaptic D2 stimulation (downstream of the synaptic cleft) responsible for the antiparkinsonian effects and presynaptic D2 stimulation (upstream of the synaptic cleft) responsible for the neuron-protective effects.
Cabergoline's dopamine-like effects inhibit prolactin production in the pituitary gland.
Pharmacokinetics
Cabergoline is metabolized primarily in the liver by cleavage of the acylurea bond. The enzyme responsible for metabolism has not yet been identified; the cytochrome P450 enzyme plays only a minimal role.
The estimated half-life is up to 69 hours. The drug is excreted mainly in the feces.
Drug Interactions
Because of its dopamine receptor-stimulating effects, cabergoline should not be used together with dopamine receptor-inhibiting drugs (e.g., metoclopramide, phenothiazines, butyrophenones, thioxanthenes).
To avoid elevated cabergoline plasma levels, the drug should not be combined with macrolide antibiotics, such as erythromycin.