International Journal of Women's Health (Mar 2020)
Is Cabergoline Safe and Effective for Postpartum Lactation Inhibition? A Systematic Review
Abstract
Yang Yang,1 Isabelle Boucoiran,2 Karen J Tulloch,3 Vanessa Poliquin4 1University of Manitoba, Winnipeg, MB, Canada; 2Department of Obstetrics & Gynecology, Université de Montréal, Montreal, QC, Canada; 3BC Women’s Hospital, Vancouver, BC, Canada; 4Department of Obstetrics & Gynecology, University of Manitoba, Winnipeg, MB, CanadaCorrespondence: Vanessa PoliquinHealth Sciences Centre, RS430 – 810 Sherbrook St, Winnipeg, MB R3A 1R8, CanadaTel +1 204 612-3867Fax +1 204 787-2314Email [email protected]: Despite its benefits, there are some situations where breastfeeding is impossible or not recommended. Breast milk secretion and engorgement can be distressing to these non-breastfeeding women. There is currently no universal guideline on the most appropriate management for these women. Our objective is to evaluate the effectiveness and safety of cabergoline, a dopamine agonist, in lactation inhibition in postpartum women.Methods: Studies were identified through electronic database searching (Cochrane library, EMBASE, Medline, IPA and Scopus) to identify all relevant studies that evaluated the use of cabergoline as a lactation inhibitor in postpartum women. Citations were screened and a narrative synthesis was undertaken given the heterogeneity of study designs.Results: A total of six randomized trials met the inclusion criteria. Majority of the studies recruited healthy postpartum women electing for lactation inhibition for personal reasons. A range of 0.4 mg to 1 mg of cabergoline was given within 0 to 50 hrs of delivery. Dose–response relationship is established, and the highest rate of complete success was achieved with 1 mg of cabergoline, with time to cessation between 0 and 1 day. Cabergoline is non-inferior to bromocriptine for lactation inhibition while also associated with fewer rebound symptoms and adverse effects. Commonly reported adverse effects of cabergoline (eg, dizziness, headache and nausea) are self-limited.Conclusion: Cabergoline is simple, effective and generally safe when given to postpartum women either wishing or needing to suppress lactation. Further research is needed to improve postpartum care of these women.Keywords: cabergoline, dostinex, lactation suppression, lactation inhibition, postpartum
