In the article, we consider the instructions and reviews for Dostinex with increased prolactin in women.
The termination of breastfeeding occurs in each woman individually, at different times and for various reasons. The easiest and safest way for mom and baby is a gradual, natural rejection of lactation with an increase in the amount of complementary foods. However, lactation often has to be stopped artificially for certain medical reasons (illness, taking antibacterial drugs) or for life reasons (going to work). In such cases, experts prescribe pills to suppress the lactation process, for example, Dostinex.
The drug belongs to the class of inhibitors of prolactin secretion, the other name of which is lactogenic hormone, which speaks of its main purpose: stimulation of the formation of mammary glands, increase in the number of their ducts, the formation of initially colostrum, and then milk. Suppressing the production of prolactin, this drug gradually stops the lactation process. Reviews about "Dostinex" are available in large numbers.
Pharmacological properties
He is an agonist of dopamine receptors. In the composition of the drug there is a substance - cabergoline - a derivative of ergoline, which is characterized by a long and pronounced prolactin-lowering effect. The principle of action is based on direct stimulation of dopamine D 2 receptors that are found in pituitary lactotropic cells. In dosages to lower the level of prolactin in the blood, the drug has a central dopaminergic effect, which is due to the activation of dopamine D 2 receptors.
A decrease in the level of lactogenic hormone in the blood plasma is observed after taking the drug after about three hours and persists for 1-4 weeks in healthy women and patients suffering from hyperprolactinemia, as well as 2-3 weeks in women in the postpartum period. The overwhelming effect of prolactin exposure is dose-dependent both in duration and in terms of severity.
The main active element has a selective effect, does not affect the basal production of other hormones produced by the pituitary gland, and cortisol.
The pharmacological actions of cabergoline that are not related to the therapeutic effect include lowering blood pressure. With a single use of this medication, maximum hypotensive activity is noted during the first six hours and is dose-dependent.
Reviews on Dostinex tablets are mostly positive.
Release form and composition of the medication
This drug is made in the form of white tablets, on which there is a special notch for ease of separation. Tablets are packaged in bottles of 2 and 8 pieces.
The active ingredient of the drug is cabergoline, in addition to which it includes some additional elements: anhydrous lactose (milk sugar) and leucine (amino acid).
Reviews on the use of Dostinex will be considered later.
Indications for appointment
In accordance with the instructions for use, this medication is prescribed in the following cases:
- the need to completely prevent lactation after childbirth;
- the need to stop the already formed lactation;
- prolactin-secreting pituitary adenomas;
- empty Turkish saddle syndrome in combination with hyperprolactinemia;
- idiopathic hyperprolactinemia;
- other disorders associated with hyperprolactinemia (anovulation, galactorrhea, oligomenorrhea, amenorrhea).
But most often, the drug is prescribed to reduce prolactin. According to reviews, Dostinex is suitable for most women.
Contraindications
Despite the fact that this drug is not in the initial sense hormonal, it can significantly change the hormonal background of a woman. Enhancing the performance of the neurotransmitter dopamine, which suppresses the secretion of prolactin, is a serious intervention in natural human physiology, and therefore the drug "Dostinex" has a certain list of contraindications. These include:
- age less than 16 years (relevant clinical trials have not been conducted, therefore the safety and effectiveness of the use of a medicinal product in adolescence is unknown);
- intolerance or individual sensitivity to cabergoline, additional substances of the drug (lactose and leucine) and to any ergot alkaloids (a type of parasite mushroom).
According to women, Dostinex is generally well tolerated.
In addition to taking into account the main contraindications, negative consequences when using the product can occur when:
- severe stages of liver failure;
- peptic ulcers and intestinal or stomach bleeding;
- severe stages of diseases of the cardiovascular system, as well as with Raynaud's disease;
- violations of the normal respiratory process and heart function due to fibrotic changes (including a history);
- severe forms of mental and cognitive disorders;
- arterial hypertension that occurred during pregnancy (this medication is allowed to be taken only when the effectiveness of treatment significantly exceeds the risk of potential negative consequences).
Pharmacodynamics and excretion
After taking the medication, cabergoline (the active component) is absorbed as soon as possible through the intestinal wall and enters the general bloodstream, reaching its maximum concentration after 1-3 hours. Food does not affect the concentration and absorption of this active substance. It provokes a response of dopamine receptors located in pituitary lactotropic cells and an increase in the level of dopamine, which is a neurotransmitter that significantly inhibits the secretion of prolactin.
The level of lactogenic hormone begins to decline about four hours after taking the medication and remains at a constant level for a rather long time: in healthy women and women suffering from hyperprolactinemia - from 7 to 28 days, during breastfeeding - from 14 to 21 days. There is a direct relationship between the dosage of the drug and the duration, severity of a decrease in prolactin levels.
Cabergoline selectively acts and does not significantly affect the synthesis of other hormones, but it can lower blood pressure. After a single dose of the drug, it remains lowered for several hours, and the strength of the reduction directly depends on the dosage.
If you stop breast-feeding only for a certain period of time, you can restore the lactation process after completely eliminating the reasons that forced it to interrupt. It must be remembered that the longer a woman took this medication, the more difficult it is to restore milk production.
According to reviews, Dostinex leads to the cessation of lactation very quickly.
Dosage and route of administration
The dosage of the drug is determined by the reason for the appointment of Dostinex. In order to stop already established lactation, half a tablet is taken twice a day for two days (i.e., in a total volume of 1 mg). If there is a risk of hypotension, a single dose should not be higher than 0.25 mg (half a tablet).
In order to prevent lactation that has not yet formed, take a single dose in a volume of 1 mg (2 tablets) on the second day after birth.
In cases of the development of hyperprolactinemia (increased secretion of prolactin), it is recommended to take the medicine 1 tablet per week or divide the dose in half, half the tablet. Increase the weekly dosage of Dostinex should be extremely careful - by 0.5 mg once a month until the desired therapeutic effect is achieved. The maximum dose for women with hyperprolactinemia is 9 tablets per week.
Since the tolerability of this drug in each case is individual, a specialist can recommend taking a single dose in several approaches. This is done, as a rule, if the dosage of the drug exceeds 2 tablets per week.
Reviews about Dostinex are best read in advance.
Overdose symptoms
In such situations, the following pathological conditions are observed:
- vomiting, nausea;
- orthostatic hypotension (sharp decrease in pressure);
- dyspeptic disorder (stomach pain, indigestion);
- psychosis, hallucinations, confused consciousness.
These phenomena are eliminated by maintaining a normal level of blood pressure, washing the stomach. In some cases, the use of dopamine antagonists may be required.
Adverse reactions
According to reviews of Dostinex, side effects still occur.
Similar negative effects are found in most women. Thus, in tests with a single dose of 1 mg (to prevent the lactation process) and a dosage of 0.25 mg twice a day for two days (to stop lactation), side effects were observed in 13% of the subjects. With the extension of the duration of the study to six months, adverse reactions began to concern 70% of women.
The list of main side effects from the use of this medication is very large. Among them:
- Nervous system: severe headaches, excessive drowsiness, asthenic phenomena, paresthesias, fatigue, dizziness, fainting, depressive disorders.
- Digestive system: gastritis, dyspepsia, pain in the abdomen and epigastric region, vomiting, nausea, stool retention.
- Cardiovascular system: orthostatic hypotension, lowering blood pressure during the first few days after childbirth.
- Other: spasm of capillary vessels in the fingers, leg cramps (as a result of the vasoconstrictor effect of the drug), flushing of the face, nosebleeds, hemianopsia, alopecia, mastodynia, dyspnea, valvulopathy, fibrosis, swelling, impaired liver function, rashes, respiratory failure, other respiratory disorders, an increase in the level of creatine phosphokinase, mania.
All this is confirmed by reviews of Dostinex. The cessation of lactation, of course, occurs, but it is important to understand that against the background of an impressive list of side effects, you should not continue breast-feeding a baby while using this medication.
Decantation during use of the drug
After taking the initial dose of this drug, significant changes can not be replaced, the chest is very full, there is no discomfort, according to reviews of the termination of lactation by Dostinex.
Whether it is necessary to express in a given period is an individual question. Nevertheless, the engorgement of the glands, their overflow are the first signs of lactostasis. In this case, it is mandatory to express milk. With lactostasis, the likelihood of developing mastitis and infection is high, so it is extremely important not to start such a process. It should be remembered that pumping should not cause significant discomfort. At the same time, a relaxing massage of the glands is done, which normalizes the outflow of milk and eliminates the existing seals. There is no need to completely empty the chest. It needs to be expressed only to relief, and the milk remaining in the chest burns out on its own. In the case of lactostasis, it is necessary to massage the breast as often as possible in order to prevent the occurrence of stagnation.
At the next arrival of milk, you don’t have to worry about this, because its quantity decreases every time you take the drug and it will disappear completely soon.
That is why the reviews of Dostinex with elevated prolactin are mostly positive, despite the large number of side effects.
Many women are advised to dress the breasts, because it is believed that in this way milk disappears faster, but this should not be done in any case, as this results in obstruction of the ducts, which subsequently leads to the development of lactostasis. It is very important to reduce the amount of fluid consumed so that milk does not continue to be produced.
Reviews of Dostinex tablets are presented at the end of the article, but for now, let's consider analogues.
Analogs
Drugs similar in effect are:
- Bromkriptin is a domestic drug that stimulates dopamine receptors. This medication reduces the production of prolactin, as a result of which the lactation process is suppressed. In addition to stopping lactation, this medicine is also prescribed for menstruation, premenstrual syndrome, breast tumors, hyperprolactinemia in men and Parkinson's disease.
- "Bromocriptine" is a medical product manufactured in Hungary. It has the same properties as Dostinex, effectively stops lactation processes.
- "Norprolak" - is a tool that suppresses the secretion of prolactin using the active substance quinagolide. The indications for this are the cessation of lactation and hyperprolactinemia.
Reviews about Dostinex
Reviews about this medication are mostly good, and especially with regard to the cessation of lactation, but there are also negative ones that describe numerous side effects from the use of this medication.
Patients who used Dostinex observed that their milk ceased to be produced a maximum of a week after the start of the intake, but this is in cases where the hormonal background of the woman is normal and there is no hyperprolactinemia. In some patients, a decrease in mammary gland activity was noted already on the second day. The reviews about Dostinex also describe isolated cases in which milk ceased to form on the first day, and women did not even have to express it.
Almost all who were treated with this medication when breastfeeding stopped there were numerous side effects. The most common of them is pronounced nausea, severe dizziness, weakness.
We reviewed the reviews of pills for the termination of lactation "Dostinex".