Dostinex

Description overdue on 03.02.2013

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Dopamine receptor agonists.   The active component acts Cabergoline . The basic substance is ergolinovym derivatives, stimulants produce dopamine. The drug inhibits the secretion of prolactin and growth hormone hypersecretion. Under the influence of the drug normalized prolactin levels stabilized Phase of the menstrual cycle is restored fertility . In high doses, Dostinex exerts a central dopaminergic effect. By reducing prolactin levels in females increases the concentration of estrogen, are eliminated anovulatory cycles, stabilizes the release of LH in the middle of the menstrual cycle is restored throbbing gonadotropin secretion, reduces the severity of hyperandrogenic ( hirsutism Acne and others) and hypoestrogenic (osteoporosis, water retention, weight gain) symptoms.

In males medication eliminates laktoreyu Softening and reduction of testicle, gynecomastia , Impotence, libido caused by hyperprolactinemia. Under the influence of the drug starts reverse development pituitary microadenomas , Reduces the severity of symptoms associated with the disease (violation of sharpness of vision, visual field changes, headaches, functional disorders of the pituitary gland and cranial nerves). Dostinex is able to reduce prolactin levels in patients with psevdoprolaktinomoy (not influence the size of the pituitary adenomas) and prolactinoma.

The drug inhibits the synthesis of growth hormone by the pituitary adenoma, and reduces the severity of headaches, neurological disorders, visual perception; slows the development and progression of acromegaly .  In 70-90% of patients have clinical improvement with treatment, but the completion of a course of therapy of growth hormone levels may increase again .  Due to stimulation of dopamine receptors is reduced neurochemical balance in the black nucleus and the striatum in the brain, which leads to a reduction in depressive symptoms, rigidity, tremor and acceleration of motion for all stages of Parkinson's disease .  Reducing the concentration of prolactin recorded 3 hours after the administration, lasting for 14-21 days in the suppression of lactation postpartum and 7-28 days in patients with hyperprolactinemia .  The concentration of prolactin to normal within 2-3 weeks of therapy .  Dostinex available in tablet dosage form .

Indications:

anovulation , Oligomenorrhea, amenorrhea), impotence, infertility, postpartum lactation suppressants, with a decrease in libido in males, the syndrome of "empty" sella at idiopathic hyperprolactinemia If prolactin pituitary adenomas (mikroprolaktinomy, macroprolactinoma). The drug is prescribed for acromegaly as maintenance therapy after radiotherapy, surgery.

Contraindications:

Instructions for use of the drug Dostinex contains the following contraindications: postpartum hypertension , Breastfeeding, intolerance and active ingredient of ergot derivatives, Preeclampsia When gastrointestinal bleeding, liver pathology system in , Diseases of the cardiovascular system, with ulcers of the digestive tract, with severe mental illness, severe renal pathology of medication prescribed with caution. Dostinex and pregnancy: the drug is contraindicated during pregnancy gestation.

Side effects:

During the first two weeks of treatment, side effects of the drug Dostinex are alone. Nervous system: insomnia , Headaches, dizziness, weakness, fainting, paresthesia , Fatigue, hypersomnia, depression. The digestive tract:   gastritis, vomiting, epigastric pain, dry mouth, nausea, constipation. Cardiovascular system:   feeling heart palpitations, a drop in blood pressure, orthostatic hypotension . It is also possible development , Allergic reactions, transient hemianopsia, "tides" of blood flow to the face, decrease in hemoglobin levels, muscle twitching legs.

Overdose:

Manifested orthostatic hypotension, a fall in blood pressure, constipation, epigastric pain, nausea, vomiting, excessive sweating, convulsions   psychoses , Agitation, hallucinations, severe asthenia. Requires emergency gastric lavage, control blood pressure, administration of dopamine antagonists (thioxanthene, butyrophenone, metoclopramide, phenothiazines ).

Mode of application:

Dostinex tablets are taken orally during meals. Suppression of established lactation:   for 2 weeks twice daily at 0, 25 mg. Prevention of postpartum lactation: the first days after delivery, single 1 mg. When hyperprolactinemia 1-2 times a week 0, 5 mg. The average therapeutic dose 2 times a week for 0, 5 mg; therapeutic dose - 2 mg / week. The allowable increase in weekly dosage - no more than 0, 5 mg / month. In a week, you can take no more than 4, 5 mg.

Special instructions:

Before the appointment of the drug Dostinex conducted a thorough examination of the functional state of the pituitary gland .  During treatment every month determine the level of prolactin .  Women are advised to refrain from pregnancy: before prescribing medication exclude pregnancy, recommended mechanical methods of contraception, be sure to conduct a monthly pregnancy tests; after the restoration of the menstrual cycle - a pregnancy test is performed at a delay of more than three days .  .  Pregnant women who take Dostinex, you must be observed at the physician for timely diagnosis signs of increasing the size of the pituitary gland (in the period of gestation of pregnancy may increase the already existing tumors in the pituitary gland) .  There are data on the effect of the drug on the fetus: the appointment of cabergoline dose of 0, 5-2 mg per week in pathological conditions associated with hypersecretion of prolactin, does not lead to the development of , Abnormalities of pregnancy does not increase the risk of premature birth and miscarriage.

With long-term treatment requires regular inspection gynecologist with mandatory histological examination of the endometrium and cervix cervix . After stabilization of the menstrual cycle 30 days before the possible conception medication overturned. Requires monitoring the functional state of the digestive system due to the risk of bleeding, requires monitoring of blood pressure.

With the development of severe and persistent adverse reactions require a short-term decrease in the amount of the drug followed by a gradual increase to the required dosage. When the first symptoms neurotoxicity , In the event of headaches, with increasing levels of blood pressure medication discontinued. Appointment of cisapride and domperidone, and reduced dosage to reduce the severity of nausea. Against the background of the therapy may develop orthostatic hypotension (must be taken into account while carrying out antihypertensive therapy). After discontinuation of treatment in some cases, relapse hyperprolactinemia. In certain groups of patients with persistent gipoprolaktinemiya persists for several months. In females appear ovulatory cycles   within six months after cessation of treatment.

The lack of positive dynamics during treatment with cabergoline suggests other reasons for prolactin hypersecretion (chronic renal failure, particularly during hemodialysis, a decrease in clearance of prolactin in the pathology of hepatic system). Responses to the drug Dostinex indicate a high efficiency of the medication in compliance with all recommendations. Unacceptable use of alcohol in the treatment of drug Dostinex.

Drug Interactions:

Thioxanthene, butyrophenone, metoclopramide, phenothiazine derivatives adversely affect the effectiveness of the drug. Macrolides increase the concentration of active substance in the blood plasma, which greatly increases the risk of side reactions. Not permitted combination with antihypertensive drugs, derivatives of ergot alkaloids. Ethanol and antipsychotic drugs