Cabergoline is available for oral administration as tablets. The dosage must be established by the doctor on the basis of the type of pathology to be treated. Furthermore, the response to the dosage of the drug administered – both as regards the effectiveness of the treatment and the side effects – seems to depend on the sensitivity of each patient.
Initial dose of Dostinex may be either 0.25mg or 0.5mg, subject to prescriber’s decision. Normally, the optimal dosage of cabergoline is achieved by gradually increasing the initial dose of the drug. The usual doses range from 0.25 mg to 3 mg of the drug. In any case, you should not exceed 3 mg of cabergoline per day.
The dosage should be adapted:
- depending on the prolactin level used the day before taking a tablet;
- in the opinion of your doctor who will decide whether or not to break the weekly dose.
The dosage should be maintained or increased in increments according to the measured prolactin, until an optimal response to treatment is obtained. In all events, follow your doctor’s instructions down to the letter.
Method and route of administration: peroral use.
Frequency of administration: cabergoline should be taken once or several times a week in the middle of a meal, preferably in the evening or at bedtime with a light snack.
Duration of treatment: at all instances, take the drug in strict compliance with your prescriber’s instructions. The course of Dostinex therapy is disrupted when prolactin levels have been stabilized at normal values for 6 months. If they go up again, the course can be renewed.
Why does Dostinex (cabergoline) come in different doses?
Currently, Dostinex is only available in form of cabergoline 0.5mg tablets. However, the doses required in certain populations can go both below and above that quantity. It is not an unusual scene for patients to get prescribed Dostinex 0.25mg. What to do when the prescribed dose is less than the amount of active substance contained in one pill?
In any event, you should always proceed from the actual instructions of your prescriber. The rule of thumb here is that for doses that are below the standard Dostinex 0.5mg dividing a tablet is required. Splitting a tablet might also be required in case an increment in dose is set to 0.25mg.
Who can take Dostinex 0.5mg?
Dostinex is administered at the dose of 0.5mg in patients with excessive levels of prolactin caused by pituitary tumors, as well as for suppression of lactation during postpartum period.
Who can take Dostinex 0.25mg?
The initial dose of Dostinex 0.25mg is prescribed to patients with excessive prolactin secretion caused by pituitary tumor. The dose is taken twice a week during the first 4 weeks of treatment. Eventually, the dose may be revised by prescriber if not found efficient, and stepped up to 1mg taken twice every week.
The recommended therapeutic dosage regimen for lactation suppression is 0.25 mg (half a 0.5 mg tablet) every 12 hours for two days (1 mg of total dose). The dosage regimen should not be exceeded in women who are breast-feeding and are treated for suppression of lactation initiated in order to avoid potential postural hypotension.
Does the Dostinex dosage I need depend on my weight?
The dose of Dostinex does not depend on patient’s weight directly; it is only established after consideration of the clinical picture that presents itself after the first weeks of treatment. If patient’s response towards the initial therapy is considered insufficient, the dose is increased with a maximal step of cabergoline 0.5mg.
Can I increase the dosage if it doesn’t work?
Any changes in dosing and posological pattern are subject to prescriber’s decision. Your prescriber will then increase your dose gradually, with a step of 0.5mg every next week, running blood panels in order to establish the therapeutic efficacy of every new dose. An interval of 4 weeks should be observed when implementing dose increment. When the effective dose is established, the therapy continues at this dose as appointed by the healthcare supervisor. Patients should be monitored during the dosage adjustment phase to determine the lowest dosage that produces the therapeutic response.
Be careful so as not to take more than one recommended dose of Dostinex. Overdosing can have detrimental effects for your general health condition. The symptoms of any overdose may result from excessive stimulation of dopamine receptors. These symptoms are hypotension, nausea, vomiting, gastric upset, orthostatic hypotension, confusion or psychosis and / or hallucinations. If necessary, the non-absorbed drug must be eliminated from the body. For the treatment of symptoms, the use of dopaminergic antagonists could be useful.
How often can I take Dostinex?
The recommended initial dose is 0.5 mg cabergoline / week administered in one or two doses (for example on Sundays and Wednesdays) during each week. The weekly dose can be administered in a single solution or divided into two or more doses per week in relation to the patient’s degree of tolerability. When doses higher than 1 mg of cabergoline per week are indicated, it is advisable to divide the weekly dose into multiple doses because the tolerability of doses higher than 1 mg of cabergoline in a single solution weekly was evaluated only in a few patients.
With this in mind, let us look at the differences in the frequency of Dostinex administration across different subsets of patients based on their indication:
Lactation inhibition:
Cabergoline should be administered within the first 24 hours after delivery. The recommended dosage is 1 mg administered as a single dose.
Use in patients with hepatic or renal dysfunction:
Lower doses should be considered in patients with severe hepatic impairment who receive prolonged treatment with cabergoline. Compared to healthy volunteers and those with less hepatic impairment, an increase in AUC was observed in patients with severe hepatic impairment (Child-Pugh C) who received a single dose of 1 mg.
Use in children and adolescents:
Dostinex risks vs. benefits ratio has not been established in children (individuals under 16 years of age), therefore the general recommendation is to avoid use of the drug in this category of patients.
Use in senior citizens:
As a result of the indications for which cabergoline is currently recommended, the experience in the elderly is very scarce. The data accrued from practical use of the drug does not implement any particular risks.
There is only limited experience with the use of cabergoline during pregnancy. If you discover that you are pregnant during treatment, you should stop treatment and consult your doctor as soon as possible. Contraception should be continued for at least four weeks after stopping cabergoline. No information is available on the passage in milk in women. As it prevents lactation, Dostinex should not be given to women with hyperprolactinemic disorders who wish to breastfeed their child. Ask your doctor or pharmacist for advice before taking any medicine.
