Cabergoline for postpartum lactation suppression: Effect on blood pressure and pulse

Objective: To evaluate the effect of cabergoline on maternal blood pressure and pulse immediately postpartum.

Methods: We conducted a retrospective cohort study of 224 post-partum women who delivered at the University of Washington and did not breastfeed. Women who received 1 mg cabergoline within 48 h post-partum were compared to unexposed non-breastfeeding women. Systolic and diastolic blood pressure and pulse were assessed at 4-h intervals up to 24 h after cabergoline administration, and compared to unexposed women using delivery as the reference time point. Mean systolic and diastolic blood pressure and pulse were compared using linear regression and 95% confidence intervals, adjusting for age, indication for lactation suppression and weeks' gestation at delivery.

Results: Cabergoline-exposed women had lower mean systolic blood pressure at all time intervals. The maximum systolic blood pressure decrease with cabergoline was -10.88 mmHg (95% confidence interval -18.15 to -3.61) at >20-24 h. Mean diastolic blood pressure among cabergoline-exposed women decreased by -8.15 mmHg (95% confidence interval -13.94 to -2.36) at >20-24 h only. We found no significant difference in maternal pulse. Cabergoline was well tolerated with no adverse effects observed.

Conclusion: Cabergoline has minimal clinically-relevant hemodynamic effects and was well tolerated among normotensive postpartum women.