Dostinex Tablet: Uses, Dosage, Side Effects, Precautions and Alternates

Quick overview

Dostinex Tablet contains cabergoline, a dopamine agonist that lowers prolactin levels in the body. It is used to treat hyperprolactinemic disorders and to stop or reduce breast milk production after childbirth, stillbirth, abortion, or miscarriage, though some guidance advises caution with this particular use. By lowering prolactin, it can help restore normal menstrual cycles and fertility and improve related hormone-driven symptoms. It is taken as tablets, usually with or after food.

What is Dostinex Tablet

Dostinex contains the active ingredient cabergoline, which belongs to a group of medicines called dopamine agonists. It works by lowering the levels of a hormone called prolactin in the body.

Dostinex Tablet uses

• Treatment of hyperprolactinemic disorders (abnormally high levels of the hormone prolactin), which can be idiopathic or caused by pituitary tumors
• Stopping or reducing breast milk production after childbirth, stillbirth, abortion, or miscarriage (note: the US prescribing information advises avoiding this use due to risk of serious side effects)

Benefits of Dostinex Tablet

• Lowers high prolactin levels, which can help restore normal menstrual cycles and fertility in women, and improve related hormone-driven symptoms in men and women
• Can reduce or stop unwanted breast milk production

How Dostinex Tablet works

Dostinex works by acting like dopamine in the body. It directly stimulates dopamine receptors on cells in the pituitary gland, which reduces the release of the hormone prolactin. Since prolactin is the hormone that tells the breast to make milk, lowering it reduces milk production and helps correct hormone-related problems caused by too much prolactin.

Dostinex Tablet dosage

Take with or after food, which can help lessen nausea or feelings of sickness. Swallow tablets with a glass of water. Try to take your dose at about the same time each day to help you remember and get the best effect. If you forget a dose, skip the missed dose and take your next dose at the normal time — do not take a double dose. This medicine is not suitable for children or teenagers under 16 years of age. Keep taking the medicine for as long as your doctor tells you, even if you feel better, and do not stop without talking to your doctor first.

Available forms and strengths

• Tablets

Side effects of Dostinex Tablet

Common

• Nausea
• Headache
• Dizziness/vertigo
• Stomach pain, heartburn, or indigestion
• Constipation
• Nosebleed
• Weakness or tiredness
• Temporary vision problems
• Breast pain
• Hot flushes
• Rash
• Hair loss
• Drowsiness
• Fainting
• Low blood pressure, including feeling dizzy or lightheaded on standing

Serious

• Signs of heart valve problems or scarring (fibrosis) such as shortness of breath, chest pain, persistent cough, difficulty breathing when lying down, swelling in the arms or legs, pain in the side/flank, or a lump or tenderness in the abdomen
• Irregular or strong heartbeat (palpitations)
• New or unusual strong urges such as compulsive gambling, shopping, eating, or increased sexual drive
• Aggression, depression, or unusual/abnormal thoughts (delusions, psychotic disorder)
• Severe allergic reaction: widespread itchy rash, difficulty breathing with or without wheezing, feeling faint, swelling of the face, lips, tongue, or body
• Seizures, sudden chest pain that does not go away with rest, or stroke symptoms (trouble walking, speaking, understanding, or numbness of the face, arm, or leg on one side)
• Signs of increased blood pressure or a severe headache that keeps getting worse, with or without vision changes

Warnings and precautions

• Do not take this medicine if you have a history of heart valve problems, or scarring (fibrosis) affecting the heart, lungs, or abdomen, since this medicine itself can cause these problems.
• Before starting long-term treatment, your doctor will check your heart with an ultrasound (echocardiogram) and may do other tests like chest X-rays and blood tests, and will repeat these regularly during treatment to watch for scarring or heart valve problems.
• This medicine can lower blood pressure, especially when standing up, which can cause dizziness or fainting. Stand up slowly from sitting or lying down.
• Some people taking this medicine have developed strong, uncontrollable urges such as gambling, increased sexual urges, or compulsive spending or eating. Tell your doctor if this happens.
• Using this medicine to stop breast milk production after childbirth is generally not recommended because of the risk of serious problems like high blood pressure, stroke, heart attack, seizures, and death, based on experience with a similar medicine.
• Do not take this medicine if you have uncontrolled high blood pressure or are allergic to ergot-derived medicines.
• Tell your doctor if you are pregnant, think you might be pregnant, or are planning a pregnancy. You should use a barrier method of contraception during treatment and for at least one month after stopping the medicine. If you become pregnant, stop taking it and contact your doctor right away.
• Do not take this medicine if you are breastfeeding or planning to breastfeed, because it stops milk production.
• Tell your doctor if you have kidney problems before starting this medicine, as your doctor may need to check your kidney function.
• People with severe liver problems should generally not take this medicine, and those with moderate liver impairment may need closer monitoring for side effects. Lower doses may be needed in people with severe liver problems.
• It is recommended to avoid alcohol while taking this medicine, since alcohol can add to drowsiness and increase the risk of dizziness.
• This medicine can cause drowsiness and sudden episodes of sleepiness, sometimes without warning. Be careful driving or using machines until you know how it affects you, and do not drive if you feel sleepy.

Storage

• Keep this medicine out of the sight and reach of children
• Do not use this medicine after the expiry date shown on the carton and bottle label
• Do not store above 30°C. Keep the bottle tightly closed to protect from moisture
• The bottle caps contain desiccant granules — do not remove them from the cap or transfer tablets to another container
• Keep Dostinex in its original container until it is time to take it
• Keep in a cool, dry place away from moisture, heat or sunlight — do not store in the bathroom, near a sink, in the car, or on window sills
• If you no longer need the medicine or it is out of date, take it to a pharmacy for safe disposal

When to see a doctor

• Call your doctor right away or go to the nearest hospital emergency department if you have signs of heart or lung scarring, such as shortness of breath, chest pain, persistent cough, trouble breathing when lying down, or swelling in the arms or legs.
• Get urgent medical help if you have seizures, sudden chest pain that does not go away with rest, or signs of a stroke such as trouble walking, speaking, or understanding, or numbness of the face, arm, or leg on one side.
• Seek emergency care if you notice signs of a severe allergic reaction, such as a widespread itchy rash, difficulty breathing, swelling of the face, lips, tongue, or body, or feeling faint shortly after taking the medicine.
• If you think you have taken too much of this medicine, contact your doctor immediately or go to the nearest hospital emergency department, even if you feel fine.
• Tell your doctor as soon as possible if you notice a rise in blood pressure or a severe headache that keeps getting worse, with or without vision changes.

Alternatives

• Bromocriptine
• Parlodel
• Quinagolide where available