Cabergoline-Wellbutrin Interaction

[poorlawyer]

Can Cabergoline .25MGS twice weekly and Wellbutrin 100 MGS sr once daily be taken together? I know one is a dopamaine agonist and the other a dopamine reputake inhibitor.
keep in mind both are low doses and I want to see if its safe before asking my doctor to prescribe it.
Thank you

[poorlawyer]

Thank you for your response, I wanted to talk to my doctor about the cabergoline because where I was treated for so long with SSRIs, I now suffer from Post SSRI sexual dysfunction and we are looking into treatments to help relieve this effect. Thank you very much

[Carrie Fu, PharmD]

Dear poorlawyer:

There are no documented drug interaction between cabergoline and bupropion (Wellbutrin). However, it does not mean it is safe to take cabergoline, bupropion, and riluzole all together.

From the previous post, I know you are taking riluzole (Rilutek) for treating "treatment-refractory obsessive-compulsive disorder". However, I do not know why you are taking cabergoline, in addition to wanting to ask your physician to prescribe bupropion.

Cabergoline, as you stated, is a dopamine receptor agonist. It is indicated for "the treatment of hyperprolactinemic disorders, either idiopathic or due to pituitary adenomas." From the drug label, "post-marketing cases of cardiac valvulopathy have been reported in patients receiving cabergoline. These cases have generally occurred during administration of high doses of cabergoline (> 2 mg/day) for the treatment of Parkinson’s disease. Cases of cardiac valvulopathy have also been reported in patients receiving lower doses of cabergoline for the treatment of hyperprolactinemic disorders."

As I mentioned in all my posts, medications are not without risks. It is important to weigh the risks vs benefits with your provider before considering pharmacological therapy, especially if you have complicated medical history, like treatment-resistant OCD.

There is a black box warning on bupropion and you need to discuss this with your psychiatrist, since I am not sure if you also have depression, in addition to OCD. Bupropion needs be used with caution in patients with major depressive disorder, history of seizures, and patients with liver impairment.

Please note from manufacture drug label, "RILUTEK should be used with caution in patients with concomitant liver insufficiency" and "RILUTEK should be prescribed with care in patients with current evidence or history of abnormal liver function indicated by significant abnormalities in serum transaminase (ALT/SGPT; AST/SGOT), bilirubin, and/or gamma-glutamate transferase (GGT) levels (see PRECAUTIONS and DOSAGE AND ADMINISTRATION sections). Baseline elevations of several LFTs (especially elevated bilirubin) should preclude the use of RILUTEK." Also, "In postmarketing experience, cases of clinical hepatitis associated with riluzole have been reported, including with fatal outcome."

Please consult your provider closely regarding the medical benefits and adverse effect profile before considering taking the three medications together.

Good luck!

For more information, please go to:
1. Wellbutrin SR (bupropion) - Daily Med
http://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=cbc8c074-f080-4489-a5ae-207b5fadeba3

2. Cabergoline - Daily Med
http://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=0e2a2cb6-e453-4060-95f4-a8ce4ccecc10

3. Rilutek (riluzole) - Daily Med
http://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=e49d207d-8e32-4183-94ba-cd264f124090#nlm34084-4