Cabolin-1 Tablet

Indications

Cabergoline is used to treat conditions caused by too much prolactin, a hormone made by the pituitary gland, including prolactin-secreting pituitary tumours (prolactinomas) and unexplained high prolactin. High prolactin can cause irregular or absent periods, infertility, breast milk discharge, low sex drive and impotence. It is also used to stop breast milk production after childbirth when breastfeeding is not wanted or not advised. In some countries it is used for Parkinson's disease, under specialist care.

How It Works

Cabergoline is a long-acting dopamine agonist. It copies the action of dopamine, a natural brain chemical that tells the pituitary gland to stop releasing prolactin. As prolactin falls, normal periods and fertility often return, milk production stops, and prolactin-secreting tumours usually shrink.

Dosage and Administration

This is a hormone treatment, so the dose is set by the doctor, as prescribed. For high prolactin it is commonly started at a low dose once or twice a week and adjusted according to blood prolactin levels. To stop milk production after delivery, a single dose is usually given on the first day after birth. Take with food to reduce nausea and dizziness.

Interactions

• Antipsychotics (e.g. Haloperidol, Risperidone) and Metoclopramide or Domperidone block dopamine and reduce its effect.
• Erythromycin, Clarithromycin and other macrolide antibiotics can raise Cabergoline levels.
• Other ergot medicines (e.g. Ergotamine) should not be combined with it.
• Blood pressure medicines may add to its blood pressure lowering effect.

Contraindications

• Allergy to Cabergoline or other ergot medicines.
• History of fibrosis (scarring) of the lungs, heart valves or abdomen.
• Heart valve disease seen on echocardiogram, when used long term.
• Pre-eclampsia, eclampsia or uncontrolled high blood pressure after childbirth.
• Severe liver disease.

Side Effects

Common effects include nausea, headache, dizziness on standing, tiredness, constipation, stomach upset, breast pain and low mood. Some people develop impulse control problems such as compulsive gambling, shopping, eating or increased sex drive. With long-term or high doses, heart valve thickening and fibrosis can occur, so regular checks may be needed.

Get urgent medical help if you have breathlessness, persistent cough, chest pain, swelling of the legs, back or side pain, fainting, sudden severe headache, visual problems or signs of a severe allergic reaction.

Pregnancy and Lactation

Stop Cabergoline once pregnancy is confirmed unless your specialist advises otherwise; your doctor may advise waiting a month after stopping before trying to conceive. Because it stops milk production, it should not be used by women who wish to breastfeed.

Precautions and Warnings

Your doctor may arrange a heart scan before and during long-term treatment. Tell your doctor about heart, lung, liver or kidney disease, mental illness, Raynaud's phenomenon or stomach ulcers. It can cause sudden sleepiness and low blood pressure; do not drive if affected. Use reliable contraception if pregnancy is not wanted, as fertility may return quickly.

Overdose

Overdose may cause nausea, vomiting, low blood pressure, confusion, hallucinations and stomach pain. Seek medical help at once; treatment is supportive.

Therapeutic Class

Dopamine agonist, prolactin inhibitor (ergot derivative).

Storage

Store below 30°C in a dry place, away from light and out of the reach of children. Keep the desiccant in the bottle if supplied.