Cabergoline is a dopaminergic derivative of ergoline and is characterized by a pronounced and prolonged prolactin-lowering effect due to direct stimulation of D 2 -dophamine receptors of lactotrophic pituitary cells. In addition, when taking higher doses compared to doses to reduce serum prolactin levels, cabergoline exhibits a central dopaminergic effect due to stimulation of D 2receptors.
Reduction in the concentration of prolactin in the blood plasma is observed within 3 hours after taking the drug and persists for 7-28 days in healthy volunteers and patients with hyperprolactinemia and up to 14-21 days – in women in the postpartum period.
Side effects of Dostinex are additive, So when developing strong effects, it is recommended first to reduce the dosage, then try to increase it again if necessary (by 0.25 mg per week for 2 weeks). If the side effects are severe, which requires withdrawal of the drug, the symptoms disappear after 1-2 days.
• late gestosis;
• increased sensitivity to ergot alkaloids, cabergoline or other components of Dostinex;
• anamnestic indication of postpartum psychosis
Is taken orally, with food.
Prevention of lactation: 1 mg (2 tab.) Once on the first day after childbirth.
Suppression of steady lactation: 250 mcg (1/2 tab.) 2 times / day every 12 hours for 2 days (total dose is 1 mg). In order to reduce the risk of orthostatic hypotension in breast-feeding mothers, a single dose of Dostinex should not exceed 250 mcg.
Treatment of violations associated with hyperprolactinemia: the recommended initial dose is 500 mcg per week in 1 (1 tab.) Or 2 doses (1/2 table, for example, on Monday and Thursday). An increase in the weekly dose should be carried out gradually – by 500 mcg with an interval of 1 month until the optimal therapeutic effect is achieved. The therapeutic dose is usually 1 mg per week, but can range from 250 μg to 2 mg per week. The maximum dose for patients with hyperprolactinemia is 4.5 mg per week.
Depending on the tolerance, a weekly dose can be taken once or divided into 2 or more receptions per week. The division of the weekly dose into several doses is recommended when the drug is administered at a dose of more than 1 mg per week.
In patients with hypersensitivity to dopaminergic drugs, the likelihood of developing side effects can be reduced by starting the Dostinex ® therapy at a lower dose (250 mcg once a week), then gradually increasing it until a therapeutic dose is achieved. To improve the tolerability of the drug in the occurrence of severe side effects, it is possible to temporarily reduce the dose, followed by a gradual increase, for example, 250 μg per week every 2 weeks.