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Is Cabergoline Safe and Effective for Postpartum Lactation Inhibition? A Systematic Review

Authors Yang Y, Boucoiran I, Tulloch KJ, Poliquin V

Received 29 September 2019

Accepted for publication 7 February 2020

Published 9 March 2020 Volume 2020:12 Pages 159—170


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 3

Editor who approved publication: Professor Everett F. Magann

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, Canada

Correspondence: Vanessa Poliquin
Health Sciences Centre, RS430 – 810 Sherbrook St, Winnipeg, MB R3A 1R8, Canada
Tel +1 204 612-3867
Fax +1 204 787-2314

Background: 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

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