Dostinex generic is called Cabergoline is the generic name of the medicine which is prescribed by the doctors to treat hyperprolactinemic disorders or unusually high levels of prolactin in the blood.
Cabergoline belongs to a class of medications known as prolactin inhibitors. Prolactin inhibitors such as cabergoline are used to treat different types of medical problems that occur when too much prolactin, a hormone, is produced by the pituitary gland in the brain. An excess production of prolactin can result in menstrual problems in women and fertility problems in men and women.
Cabergoline stops the brain from making and releasing prolactin from the pituitary gland. Cabergoline is also used to prevent the onset of normal lactation (milk production) in cases where there is a medical need to prevent lactation.
This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here. Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.
Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.
Dostinex cabergoline finds use in situations when prolactin reaches very high levels and women may get unwanted breast milk, miss periods and face difficulties in conceiving. In men this may lead to enlarged breasts and lack of desire to have sex. It is an ergot medication and it suppresses the release of prolactin from pituitary gland.
How it is used?
This medicine has to be taken through mouth and your doctor may and vice you to take it with or without food as needed. Dostinex dosage will depend on your medical condition that is the level of prolactin in your blood. Initially the treatment will be started with a lower dose and may be increased gradually as the treatment progresses.
It is advisable to follow your doctor’s advice carefully.
Dostinex medication should be taken regularly in order to get the intended benefit. A patient may mark the dates on which he or she is supposed to take the medicine. This will help them to remember the days of medication and prevent any misses.
It is of extreme importance that you inform your doctor if there is no relief after taking the medicine or your condition worsens.
Dostinex side effects
Dizziness, vomiting, constipation, nausea, light-headedness, stomach upset, tiredness may occur in some patients. The side effects usually subside but if you continue to suffer or the problems increase you should immediately talk to your pharmacist or medical consultant.
Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.
There are certain side effects which are rare but have been reported by some patients. These include swelling of ankles or feet, shortness of breath, mood swings, increased sexual urge, painful periods, vision changes, breast pain. Other side effects may be kidney problems and chest pain. Report to your doctor instantly as these could be serious.
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Cabergoline is prescribed for a number of different medical conditions. Your doctor will tell you why it has been prescribed for you.
- Cabergoline prevents the production of a chemical called prolactin. Prolactin is involved in a number of processes within the body, including milk production after childbirth. Cabergoline is therefore helpful in preventing or reducing milk production when this is needed for medical reasons.
- High levels of prolactin occur in people with prolactinomas. A prolactinoma is a non-cancerous swelling in the pituitary gland. This can cause various symptoms including reduced fertility, breast changes, and headaches. Prolactinomas can be treated successfully with medicines which reduce the production of prolactin, such as cabergoline. In these cases, treatment is usually long-term.
- Cabergoline can be prescribed to treat Parkinson’s disease, although other treatments are usually preferred. In Parkinson’s disease, a number of cells in a small part of the brain become damaged and die. These brain cells normally pass messages down nerves in the spinal cord by producing a chemical called dopamine, and it is these messages which control the muscles of the body. As the cells are damaged, the amount of dopamine that is produced is reduced. A combination of the reduction of cells and a low level of dopamine in the cells in this part of the brain, causes nerve messages to the muscles to become slowed and abnormal. This produces the main symptoms of Parkinson’s disease, which are stiffness, shaking (tremor), and slowness of movement. Cabergoline encourages the release of dopamine which helps to ease these symptoms.
Before taking cabergoline
Some medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. For these reasons, before you start taking cabergoline it is important that your doctor knows:
- If you are pregnant or breast-feeding.
- If you have been told you have scar tissue affecting your heart, lungs or abdomen.
- If you have a heart condition or blood vessel disease.
- If you have ever had a stomach ulcer.
- If you have a problem with the way your liver works.
- If you have a circulation problem called Raynaud’s syndrome.
- If you have ever had a serious mental health problem, such as a psychotic disorder.
- If you have a rare inherited blood disorder called porphyria.
- If you are taking any other medicines. This includes any medicines you are taking which are available to buy without a prescription, such as herbal and complementary medicines.
- If you have ever had an allergic reaction to a medicine.
How to take cabergoline
- Before you start the treatment, read the manufacturer’s printed information leaflet from inside the pack. It will give you more information about cabergoline and will provide you with a full list of the side-effects which you may experience from taking it.
- The dose you will need to take will depend upon the reason you are taking cabergoline. You may be asked to take cabergoline just for a few days if it is to stop breast milk; or each day if you have Parkinson’s disease; or, if you are taking cabergoline to reduce high prolactin levels, you may only need one dose a week. Your doctor will tell you how much to take and how often to take it, and this information will also be printed on the label of the pack to remind you. Read the directions from your doctor carefully and take cabergoline exactly as you are told to. If you are taking cabergoline for the first time, your doctor may give you a small dose and then gradually increase your dose. Slowly increasing your dose like this will help to reduce side-effects, such as dizziness, which can occur during the first few days of treatment.
- Swallow the tablet with a drink of water, at a mealtime. Taking cabergoline with a meal will help to reduce the risk of feeling sick (nausea).
- Try to take cabergoline at the same time(s) of day each day; if you are taking it weekly, take it on the same day of the week each week.
- If you forget to take a dose, take it as soon as you remember. If when you remember, it is nearly time for your next dose then take your next dose when it is due but leave out the missed dose. Do not take two doses together to make up for a forgotten dose.
Getting the most from your treatment
- Try to keep your regular appointments with your doctor so your progress can be checked. Cabergoline can cause heart and lung problems, particularly in people who need to take it over a long period of time. In order for your doctor to check for this, you may need to have an ECG, lung function tests, blood tests and an X-ray from time to time if you are taking cabergoline long-term.
- There are two different brands and several different strengths of cabergoline tablets. Each time you collect a fresh supply of tablets, it’s a good idea to check the packet to make sure they are what you are expecting. If you have any questions about your tablets, ask your pharmacist for advice.
- If you are a woman, you may want to discuss what forms of contraception are suitable for you. Hormonal forms of contraception (such as ‘the pill’) may not be suitable while you are taking cabergoline.
- Sometimes people taking cabergoline can fall asleep suddenly with little or no warning of being tired beforehand. Until you know how you react, take extra care if you drive or operate machinery. If you do find yourself falling asleep suddenly, you should see your doctor as soon as possible for advice, and avoid driving or using tools and machines in the meantime.
- Treatment with medicines like cabergoline can sometimes cause problems with impulsive types of behaviour. If you notice any changes in your behaviour, such as an increased desire to gamble, binge eat, or spend excessively, or an increased sex drive, you must let your doctor know as soon as possible.
Can cabergoline cause problems?
Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains some of the most common ones associated with cabergoline. You will find a full list in the manufacturer’s information leaflet supplied with your medicine. The unwanted effects often improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following continue or become troublesome.
How to store cabergoline
- Keep all medicines out of the reach and sight of children.
- Keep the tablets in their original container – it contains a silica gel desiccant to protect the tablets from the moisture in the air. Do not swallow the desiccant.
- Store the container in a cool, dry place, away from direct heat and light.
Important information about all medicines
If you are due to have an operation or dental treatment, tell the person carrying out the treatment which medicines you are taking.
If you take any medicines that you have bought without a prescription, check with a pharmacist that they are suitable for you to take with your prescribed medicines.
Never take more than the prescribed dose. If you suspect that you or someone else might have taken an overdose of this medicine, go to the accident and emergency department of your local hospital. Take the container with you, even if it is empty.
This medicine is for you. Never give it to other people even if their condition appears to be the same as yours.
Do not keep out-of-date or unwanted medicines. Take them to your local pharmacy which will dispose of them for you.
DOSAGE AND ADMINISTRATION
The recommended dosage of DOSTINEX Tablets for initiation of therapy is 0.25 mg twice a week. Dosage may be increased by 0.25 mg twice weekly up to a dosage of 1 mg twice a week according to the patient’s prolactin level.
Before initiating treatment, cardiovascular evaluation should be performed and echocardiography should be considered to assess for valvular disease. Dosage increases should not occur more rapidly than every 4 weeks, so that the physician can assess the patient’s response to each dosage level. If the patient does not respond adequately, and no additional benefit is observed with higher doses, the lowest dose that achieved maximal response should be used and other therapeutic approaches considered. Patients receiving long term treatment with DOSTINEX should undergo periodic assessment of their cardiac status and echocardiography should be considered.
After a normal serum prolactin level has been maintained for 6 months, DOSTINEX may be discontinued, with periodic monitoring of the serum prolactin level to determine whether or when treatment with DOSTINEX should be reinstituted. The durability of efficacy beyond 24 months of therapy with DOSTINEX has not been established.
DOSTINEX Tablets are white, scored, capsule-shaped tablets containing 0.5 mg cabergoline. Each tablet is scored on one side and has the letter P and the letter U on either side of the breakline. The other side of the tablet is engraved with the number 700.
DOSTINEX is available as follows:
Bottles of 8 tablets NDC 0013-7001-12
Store at controlled room temperature 20°to 25°C (68°to 77°F) [see USP].
This product’s label may have been updated. For current full prescribing information, please visit www.pfizer.com
Distributed by: Pharmacia & Upjohn Company Division of Pfizer Inc., NY, NY 10017. Revised: Sep 2014
Are there any other precautions or warnings for this medication?
Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.
Behaviour changes: Some people have reported changes in behaviour associated with taking cabergoline. There have been occasional reports of aggressive behaviour or hostility, anxiousness, disorientation, or decreased memory. This may be more likely to happen if you have a history of mental illness, such as depression or psychotic episodes. If you experience any of these effects or notice them in a family member who is taking this medication, contact your doctor as soon as possible.
Dizziness: Cabergoline can cause severe dizziness, especially when rising from a sitting or lying position. This may occur more often when other medications with similar side effects are being taken. People taking medications that can cause dizziness should rise slowly from sitting or lying down to reduce the possibility of severe dizziness or fainting.
Drowsiness/reduced alertness: Cabergoline may affect the mental or physical abilities needed to drive or operate machinery. Avoid driving, operating machinery, or performing other hazardous tasks until you have determined how this medication affects you.
Heart, lung, and kidney function: Your doctor will assess the functioning of your heart, lungs, and kidney if prolonged treatment is required as prolonged use of this medication can cause fibrosis or dysfunction of these organs. If you experience shortness of breath, a cough that won’t go away, or chest pain, contact your doctor as soon as possible.
Liver function: Liver disease or reduced liver function may cause this medication to build up in the body, causing side effects. If you have liver problems, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. Your doctor may want to test your liver function regularly with blood tests while you are taking this medication.
Cabergoline has been reported to cause liver failure, which can cause death. This medication may also cause a decrease in liver function. If you experience symptoms of liver problems such as fatigue, feeling unwell, loss of appetite, nausea, yellowing of the skin or whites of the eyes, dark urine, pale stools, abdominal pain or swelling, and itchy skin, contact your doctor immediately.
Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.
Also, cabergoline should not be used by women with high blood pressure conditions caused by pregnancy, such as eclampsia or preeclampsia, unless the benefits outweigh the risks.
Children: The safety and effectiveness of using this medication have not been established for children less than 16 years old. This medication should not be used by this age group unless the benefits outweigh the risks.
Seniors: Studies of cabergoline have not been carried out in seniors. This medication should not be used by this age group unless the benefits outweigh the risks.
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