DOSTINEX (cabergoline) works by acting on the pituitary gland which is located at the base of the brain. By stimulating this gland, it prevents the production of the hormone prolactin.
DOSTINEX is indicated for:
1. Treatment of hyperprolactinemic disorders: DOSTINEX is indicated for the treatment of hyperprolactinemic disorders, either idiopathic or due to pituitary adenomas.
2. Inhibition of physiological lactation: DOSTINEX is indicated for the prevention of the onset of physiological lactation in the puerperium for clearly defined medical reasons. These medical reasons may include birth of a still born baby, neonatal death, conditions interfering with suckling (cleft lip or palate of the baby), severe acute or chronic mental illness or medical conditions, maternal disease which may be transmitted to the baby that require medications which are excreted in the milk.
DOSTINEX is not indicated for the purpose of suppression of already established postpartum lactation.
DOSTINEX is contraindicated in patients who are pregnant or plan to get pregnant; are breast feeding or plan to breast feed; have kidney problems, have liver problems; have cardiovascular problems (high or low blood pressure); have Raynaud’s syndromes; have ulcer or bleeding in the stomach or intestines; have had pregnancy complications with high blood pressure (preeclampsia or eclampsia) or have a history of mental illness.
Warnings and Precautions:
- Dopamine agonists in general should not be used in patients with pregnancy-induced hypertension, preeclampsia and eclampsia, unless the potential benefit is judged to outweigh the possible risk.
- Initial doses higher than 1 mg may produce orthostatic hypotension. Care should be exercised when administering DOSTINEX with other medications known to lower blood pressure.
- Before DOSTINEX administration, pregnancy should be excluded and after treatment pregnancy should be prevented for at least one month.
Drug-drug interactions include:
- High blood pressure medications, ergot alkaloids, macrolide antibiotic and dopamine antagonists.
Dosage:
- To treat hyperprolactinemia: initial dose is 0.5 mg per week as single dose or two divided doses. The dose may be increased monthly. Recommended dose ranges from 0.25 mg to 2 mg per week.
- To prevent the production of milk, the recommended dose is two tablets taken once, on the first day after delivery of the child.
- DOSTINEX should be swallowed, preferably with food.
Side Effects
- The most common side effects include nausea, headache, dizziness/vertigo, decreases in blood pressure without any symptoms and abdominal pain.
- Less commonly reported side effects are palpitations, pain in the upper middle of the abdomen, somnolence, nose bleeding, and temporary blindness in one half of the visual field of one or both eyes.
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Resource Person: Lobna Adi