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Dostinex (Cabergoline) - Patient Guide for South Africa

What is Dostinex?

Dostinex is a dopamine-agonist medication used primarily to treat hyperprolactinaemia, a condition where excess prolactin disrupts menstrual cycles and fertility. It belongs to the class of ergot-derived agents that lower prolactin production. The product is marketed as a tablet and is approved by the South African Health Products Regulatory Authority (SAHPRA) and international bodies such as the FDA and EMA.

Who Should Use Dostinex?

• Adults diagnosed with elevated prolactin levels (hyperprolactinaemia).
• Women experiencing unexplained menstrual irregularities or infertility linked to high prolactin.
• Patients with prolactin-secreting pituitary adenomas (micro- or macro-adenomas).
• Individuals whose healthcare provider has determined that dopamine-agonist therapy is appropriate.

How Does It Work?

Dostinex mimics dopamine, the brain chemical that naturally inhibits prolactin release from the pituitary gland. By activating dopamine receptors, it reduces the amount of prolactin circulating in the blood, allowing normal hormone balance to return. This can restore regular menstrual cycles, improve fertility, and shrink prolactin-producing tumors over time.

Why Choose Dostinex?

• Proven efficacy in normalising prolactin levels and restoring menstrual function.
• Convenient once-weekly dosing, which improves adherence compared with daily regimens.
• Brand reliability with a long-track record; generic cabergoline is also available at lower cost, offering the same therapeutic effect when proven bioequivalent.

Dosage, Administration, Lifestyle and Dietary Recommendations

Recommended Dosage

• Initial dose: .25 mg once weekly.
• Typical maintenance: .5 mg once weekly, adjusted by the prescribing clinician based on blood prolactin response.

How to Take

• Swallow the tablet whole with a full glass of water.
• Take on the same day each week, preferably in the evening to minimise daytime dizziness.
• Food does not significantly affect absorption, but a light snack can reduce stomach upset.

Missed Dose

• If you forget a dose, take it as soon as you remember provided it is at least 2 days before the next scheduled dose.
• If the next dose is due in less than 48 hours, skip the missed tablet and continue with the regular schedule.

Overdose

• In the event of an accidental overdose, seek urgent medical attention or call emergency services.
• Common signs include severe nausea, vomiting, low blood pressure, and fainting.

Special Populations

• Elderly: Start at the lower .25 mg dose; monitor for orthostatic hypotension.
• Renal or hepatic impairment: No dose adjustment required, but close monitoring is advised.
• Pregnancy & breastfeeding: Use only if the benefit outweighs potential risk; discuss with a healthcare professional.

Lifestyle & Diet

• Avoid grapefruit or grapefruit juice as they can increase cabergoline levels.
• Limit alcohol intake; excessive consumption may worsen dizziness.
• Stay hydrated and rise slowly from sitting or lying positions to reduce faintness.

Precautions and Warnings

• May cause orthostatic hypotension - stand up slowly.
• Rarely, it can trigger valvular heart disease; periodic cardiac evaluation is recommended for long-term users.
• Report any signs of unexplained chest Pain, shortness of breath, or rapid weight gain to a healthcare professional promptly.

Drug Interactions

Potential Side Effects

Common Side Effects

• Nausea
• Headache
• Dizziness (especially when standing)
• Fatigue

Less Common Side Effects

• Constipation
• Dry mouth
• Nasal congestion

Serious Side Effects

• Chest pain or tightness
• Shortness of breath
• Unexplained swelling of ankles or feet
• Sudden visual changes

If any serious symptom occurs, seek immediate medical care.

Who Should Avoid This Medication?

• Individuals with known hypersensitivity to cabergoline or any tablet excipients.
• Patients with uncontrolled hypertension or recent myocardial infarction.
• Those with severe liver disease (caution advised).

Storage Instructions

• Keep the tablet at room temperature (15-30 °C), away from direct sunlight.
• Store out of reach of children and pets.
• Do not use if the blister pack is damaged or if tablets appear discoloured.

Dostinex Alternatives

Frequently Asked Questions

How long does it take for prolactin levels to normalise?

Most patients see a significant reduction within 4-6 weeks, though full normalisation may take up to 3 months.

Can I drink coffee while taking Dostinex?

Yes, moderate coffee consumption does not affect cabergoline’s efficacy.

Is it safe to travel abroad while on Dostinex?

Travel is permitted, but keep tablets in your original packaging and carry a copy of your medical record in case of border checks.

What should I do if I feel faint after taking the tablet?

Sit or lie down immediately, elevate your feet, and drink water. If dizziness persists, contact a healthcare professional.

Can Dostinex be used for conditions other than high prolactin?

It is occasionally prescribed off-label for Parkinson’s disease, but such use should only occur under specialist supervision.

Will Dostinex affect my menstrual cycle immediately?

Cycles often become more regular within 1-2 months, but individual response varies.

Are there any dietary supplements that interact with Dostinex?

High-dose vitamin B6 may enhance dopaminergic activity; discuss any supplements with a healthcare professional.

How should I store the medication during a power outage?

Room temperature storage does not require refrigeration, so normal conditions are safe during temporary outages.

Glossary

• Hyperprolactinaemia: Elevated blood levels of the hormone prolactin, often causing menstrual problems and infertility.
• Dopamine-agonist: A drug that stimulates dopamine receptors, mimicking dopamine’s natural actions.
• Ergot-derived: Refers to compounds structurally related to the fungus Claviceps purpurea, used in several hormonal medicines.

Disclaimer

The information provided here is for general educational purposes and does not replace professional medical advice. Off-label use should only be considered after discussion with a qualified healthcare provider. Our service offers medication information and facilitates access to approved medicines; it does not prescribe or deliver drugs directly. Always consult your own healthcare professional before starting, stopping, or changing any medication regimen.