Breastfeeding is the brightest moments that remain forever in the memory of all loving mothers. However, this process cannot be eternal. Moreover, there are situations when a woman in childbirth cannot feed her baby with her milk for various reasons. In such cases, doctors prescribe Dostinex to stop lactation. Instructions for the tool are of interest to many women. It is about her that will be discussed in this article.
What is included in the medication? Is its use dangerous? What are the contraindications and side effects of Dostinex lactation pills? The instructions for this tool will answer all these questions in detail.
The most important thing is the composition
The first thing they pay attention to when deciding to purchase a particular drug is, of course, its composition. What is the active substance of the pill for stopping lactation “Dostinex”? The instruction calls the tool an inhibitor (that is, suppressing or preventing) the production of the hormone prolactin. The main component is the active substance cabergoline - a derivative of ergoline. This component, which is a derivative of ergot, is included in the composition of each tablet in an amount of 0.5 milligrams.
Additional components of the drug are leucine (in the amount of 3.6 milligrams) and lactose (in the amount of almost 76 milligrams).
How is the active substance released?
On the pharmacological market, cabergoline is available as a pill to stop lactation. The instruction to “Dostinex” shows that the drug is prescribed in other cases. However, this will be discussed below.
The product packaging includes an abstract for the drug and a brown glass bottle, in which there are two or eight flat oblong white tablets.
What effect do Dostinex tablets have on the body? Instructions and expert reviews provide an exhaustive answer to this question.
The effect of the drug on the body
Once in the body of a woman, cabergoline has an effect on certain receptors located in the pituitary gland and affecting the production of breast milk. Due to this, the level of prolactin in serum decreases, and lactation also decreases.
Many women are interested in when to expect the necessary effect after taking Dostinex. According to reviews and instructions, the cessation of lactation is observed already in the first day of the drug. This is due to the fact that only three hours after taking the pill in the blood, the level of the hormone responsible for the production of breast milk (prolactin) decreases. It is striking that the effect achieved lasts for a rather long time. In women who have hyperlactation, a decrease in plasma prolactin lasts an average of one to four weeks, and in women in labor - three to four weeks.
Is it safe for women to take Dostinex? Reviews of doctors and instructions for use explain that the main substance of the drug acts selectively. That is, it does not have any effect on other hormones or other parts of the brain (including the pituitary gland).
Nevertheless, pills can have some hypotensive effect on a woman, that is, lower blood pressure. This effect is observed during the first six hours after taking the pill and depends on the dose of the drug.
What is going on inside?
How is this effect achieved? The instruction to Dostinex (tablets that stop lactation) explains that the active substance is quickly absorbed into the blood from the digestive tract and within half an hour (in some cases, four hours) binds to plasma proteins, thus exerting an effect on the pituitary gland. It is noteworthy that the rate of absorption of cabergoline is in no way affected by food intake.
The drug is excreted through the kidneys. Its elimination half-life is observed on the third day in healthy women and on the fifth day in patients with elevated prolactin levels. Interestingly, after another ten days, the active substance is detected in the woman’s body. This was proved by clinical studies, during which cabergoline was detected in the urine and feces of patients in the amount of 18 and 72 percent of the initial dose.
And now let's figure out when it is advisable to use Dostinex. What, first of all, do experienced specialists say?
When the drug is prescribed
The main indications for using the product are, as already mentioned, the prevention of the natural production of breast milk immediately after childbirth, as well as the forced termination of the already formed lactation. In such cases, most often taking "Dostinex" is due to the desire of the woman herself.
However, in some circumstances, the drug may be prescribed directly by a specialist for exclusively medicinal purposes. This happens when the patient suffers from hyperprolactinemia, that is, an increased concentration of a hormone such as prolactin in the blood. As a result, abnormal symptoms such as:
- amenorrhea (or the absence of menstruation for a long period of time without a definition of pregnancy);
- oligomenorrhea (any violations of the menstrual cycle - scarce or, conversely, copious discharge, irregularity, and so on);
- anovulation (pathological non-maturation of the egg, which is the reason for the impossibility of conception);
- galactorrhea (a disease observed not only in women, but also in men, when breast milk is involuntarily released from the nipples).
Also, according to the instructions, the drug “Dostinex” can be prescribed for various sizes of prolactinomas (or benign neoplasms) of the pituitary gland, as well as other pathological disorders of this part of the brain.
When you can not prescribe a drug
What on this occasion is written in the instructions for tablets against lactation? "Dostinex" categorically can not be used by patients suffering from individual intolerance to any components of the drug or ergot alkaloids. Also, a contraindication to taking the drug is the age of sixteen years. This is due to the fact that the necessary studies have not been carried out regarding the safety of the use of funds by children and adolescents.
When to take with extreme caution
Some diseases are not direct contraindications to Dostinex, but if they are available, it is better to refrain from taking the drug or take it under the supervision of an experienced specialist.
Such ailments include arterial hypertension of any origin, complicated diseases of the cardiovascular system, gastric ulcer from the gastrointestinal tract, severe mental disorders or mental disorders, serious respiratory tract pathologies, severe liver failure.
Often in such cases, doctors prescribe the drug in small doses or in a hospital setting.
An interesting position and reception of “Dostinex
There have been no specific clinical studies on the effects of cabergoline on the fetus, so you should be aware that it is better not to prescribe the drug during pregnancy. If conception has occurred during the use of the product, then you must stop taking it as soon as possible. Moreover, it is best to plan a pregnancy a month after the end of treatment with this drug, when it is finally removed from the woman's body.
Lactation
If the patient is diagnosed with hyperprolactinemia, but she wants to feed the baby with breast milk, it is best to postpone the appointment of the drug. Although studies have not found that cabergoline passes into breast milk, it’s better to refrain from using it.
If a woman takes the drug to suppress lactation, then in this case it is also inappropriate to breastfeed the baby.
Very Important Information - Side Effects
Since no one is safe from the negative effects of the drug, it is very important to know what unpleasant consequences can be expected for patients taking the drug. In women who want to eliminate lactation using Dostinex, side effects were observed in fourteen cases out of a hundred. Patients who were prescribed the drug for medical reasons (to treat a disease) experienced side effects in 68 out of a hundred cases. Because of this, some women had to cancel the drug and prescribe another.
However, this situation is very rare. Often unpleasant symptoms are mild and tolerant.
According to the instructions, side effects of Dostinex are such negative manifestations as:
- heart palpitations, a slight decrease in blood pressure, in rare cases, orthostatic hypotension;
- dizziness and fainting, impaired sensation in some parts of the body, depressive disorders, headaches, causeless fatigue, constant drowsiness;
- constipation, vomiting, stomach pain, gastritis;
- nosebleeds, spasms or cramps of limbs, swelling, fever, shortness of breath and others.
With prolonged use of the drug, these symptoms worsen. Moreover, women may develop anemia or any deviations of laboratory parameters from regulatory standards.
How to take this tool so that it benefits?
General recommendations for taking the drug
It is best to use Dostinex with food. The tablets can not be chewed, it is necessary to swallow immediately with a glass of clean water.
We will talk about a specific dosage and regimen below.
How to take the drug
It all depends on when and under what circumstances the remedy is prescribed. If a woman needs to prevent for some reason lactation immediately after birth, then she should drink 2 tablets of “Dostinex”. Instructions for use recommend this to be done on the first day after delivery. It would be enough.
If a woman wants to suppress already established lactation, then she should take half a tablet twice a day for two days. Moreover, it is recommended to do this after a certain period - every twelve hours. It turns out that the course of taking the drug for a nursing mother, intending to complete the process of breastfeeding, is only one milligram in 48 hours.
What to do if the patient suffers from hyperprolactinemia? Then the attending physician should write her an individual schedule for taking the drug. According to the annotation to Dostinex, a woman will need to take one tablet every seven days. In some cases, a weekly dosage of 0.5 milligrams can be divided into two doses. For example, on Monday and Thursday, take half a tablet orally, that is, 0.25 milligrams.
However, this is the initial dose. Gradually, it will be necessary to increase the weekly dosage. Instructions for use advise you to do this every month, adding to the initial single dose another 0.5 milligrams. Typically, the weekly dosage of the drug varies between 0.25 and 2 milligrams. However, there may be exceptions. For example, the attending physician may consider it appropriate to increase the rate of Dostinex intake per week to 4.5 milligrams. This is the maximum dose of cabergoline, it is prescribed in exceptional cases.
If the patient has side effects (as mentioned above, with long-term treatment this is quite common), then the weekly dosage can be reduced to half the pill, and then then increased again.
As you can see, the instructions for use give only approximate information about taking the drug. Your doctor will prescribe a more specific treatment regimen. The dosage and schedule of therapy are selected in each case individually, based on the testimony of the patient and stage of the disease.
What if an overdose?
This can happen if you are inattentive to treatment and do not follow the doctor’s prescription. In this case, an overdose of cabergoline will manifest itself as a banal poisoning (nausea, vomiting, diarrhea). However, the situation may be aggravated by more serious symptoms, such as high blood pressure, confusion, hallucinations, or psychosis.
If such manifestations are observed, then it is urgent to rinse the stomach. If unpleasant symptoms increase, then you should seek qualified help. Dopamine antagonist therapy may be required.
Other recommendations
You should be aware that prolonged treatment with cabergoline can provoke the development of some serious diseases. In order to identify side effects in time, therapy should be accompanied by regular visits to the doctor's office. You will be offered to take tests every time, do a cardiogram and other examinations.
This is necessary in order to detect any deviations in the early stages and adjust the treatment. Disorders occurring in the body due to the use of “Dostinex” can be asymptomatic, therefore, they can be determined only by regular examination.
Sometimes patients may experience chest pain, shortness of breath, coughing and shortness of breath. Or they may be disturbed by pain in the side or lower back, swelling of the limbs, and so on.
You should also know that the drug can restore the reproductive functions of women even during various disorders of the menstrual cycle. Therefore, every four weeks, the patient must check for pregnancy with the help of special tests. If conception has occurred, cabergoline therapy should be discontinued.
Is it possible to use a vehicle to drive a car and engage in any activity that requires a special concentration of attention? Instructions for use of the drug do not recommend this.
Interaction with other drugs
It is not recommended to take Dostinex and other ergot-based drugs together, and cabergoline with antibiotics belonging to the macrolide group is contraindicated.
The combined use of the drug and phenothiazines, thioxanthenes, buterophenones, metoclopramides is not recommended, since they can weaken the pharmacological properties of cabergoline.
An important aspect - the cost
You can buy the drug only by prescription. The average price of Dostinex packaging in Russian pharmacies depends on the number of tablets in the vial. The cost of two tablets varies between 650 and 750 rubles per pack. The average price of eight tablets is two thousand rubles.
Storage Tips
Store the drug in a dark place, protected from children and animals, for two years from the date of manufacture. Recommended mode - up to 25 degrees.
What do the doctor's say
Many doctors recommend that women suffering from infertility due to increased prolactin, namely Dostinex. They also prescribe a drug to stop lactation or normalize the menstrual cycle.
What patients say
Many women are happy that they took the drug. He improved their hormonal levels, normalized the monthly cycle and contributed to conception. Also, many nursing mothers with pleasure used the drug to stop lactation.
However, not everything is so rosy. Many complain that Dostinex has a large number of contraindications and side effects. Some women were so bad at taking it that they had to call an ambulance team and do gastric lavage.
Also, as some women note, Dostinex did not always completely relieve them of lactation. Cases were recorded when the milk did not go away after taking the tablets. Moreover, discomfort in the mammary glands was observed and the woman's well-being worsened.
If side effects are observed, then most often doctors prescribe Dostinex analogues. We will consider the instructions for the use of these drugs below.
Substitutes for composition
“Bergolak” - this is the drug most often prescribed by specialists instead of “Dostinex”. The active substance of both medicines is cabergoline. What else is included in the Bergolak? In addition to the active component (in the amount of five hundred micrograms), each tablet contains leucine, magnesium stearate and anhydrous lactose (or lactopress). We can say that the testimony and method of use of “Bergolak” is similar to “Dostinex”.
“Agalates” is another drug prescribed as an analogue of the drug we are interested in. Cabergoline is also its active ingredient. Instructions for use with Agalates are almost identical to those for Dostinex.
But what if patients have individual intolerance to cabergoline? In this case, doctors prescribe Dostinex substitutes, similar to it in pharmacological effects on the human body.
Impact substitutes
In case of aggravation of side effects, experts replace Dostinex with analogues. Instructions for use of these generics will be discussed in detail below.
“Bromocriptine” - a tablet drug with the same active substance, is prescribed for menstrual irregularities, prolactin-dependent diseases, female infertility, hyperprolactinemia in male patients, benign neoplasms on the mammary glands, premenstrual syndrome, Parkinson’s disease, and also to suppress lactation. As you can see, the list of testimonies is much wider in comparison with Dostinex. Therefore, let's take a closer look at the instructions.
In Parkinson’s disease and similar diseases, “Bromocriptine” is prescribed at ten to forty milligrams per day. To suppress lactation, tablets are taken orally one to two milligrams twice or thrice a day. The same dosage is prescribed for premenstrual syndrome, which manifests itself in sharp mood swings and breast tenderness during critical days.
If we are talking about male hyperprolactinemia, characterized by symptoms such as oligospermia, impotence, loss of libido, then the dosage of the drug is increased to five to twenty milligrams per day.
In the same way, they take a remedy for prolactinoma (tumors on the pituitary gland), mastolgia, fibrocystic mastopathy, amenorrhea, oligomenorrhea and so on. A more detailed dosage and schedule of admission will be determined by the attending physician.
Contraindications to the use of “Bromocriptine” are severe diseases of the heart and blood vessels, tremors of various origins, hypertension, as well as hypotension, psychosis. When pregnancy occurs, it is better to cancel the use of the drug. The same applies to lactation. However, in some cases it will be possible to continue treatment if the possible benefits of the drug justify the likely risk.
Norprolak is another analogue of Dostinex with a similar spectrum of action. The active substance of the product is quinagolide hydrochloride, auxiliary components - colloidal anhydrous silicon dioxide, magnesium stearate, corn starch, red iron oxide and others.
The main indication for taking the drug is an increased level of prolactin, manifested in amenorrhea, infertility, galactorrhea, decreased libido, oligomenorrhea. “Norprolak” is prescribed 25 micrograms once a day, preferably before bedtime, during a light meal. Such treatment lasts three days, then the dosage is increased by another 25 micrograms. From the seventh day, the daily dose should be increased to 75 micrograms. As necessary, doctors can increase the dosage of the drug to three hundred micrograms. However, the average daily norm of quinagolide is 75-150 micrograms.
The drug should not be taken during the period of gestation and breastfeeding, as well as if the patient has a history of diseases such as mental disorders, renal or liver failure.
Side effects may include headaches, insomnia, decreased appetite, vomiting, low blood pressure, nasal congestion, and others.
“Parlodel” is another inhibitor of prolactin production, the active substance of which is bromocriptine. Therefore, the instruction for use of this tool is very similar to the drug “Bromocriptine”. What are the contraindications of Parlodel?
First of all, the drug is not prescribed for individual intolerance to the active component, for various psychoses, tremors, stomach ulcers, various pathologies of the cardiovascular system. It is also not recommended to use the drug during breastfeeding. During gestation, Parlodel is prescribed with caution. How is the drug used for various diseases?
If the patient is concerned about infertility or irregularities in the menstrual cycle, then the drug is taken orally three times a day at 1.25 milligrams. The duration of treatment is determined by the doctor, based on the effectiveness of the therapy.
In the case of the use of the drug by men, it is prescribed two or three times a day, 1.25 milligrams each. Over time, the daily dose will need to be increased to 5-7.5 milligrams.
If a woman is disturbed by unpleasant sensations during the period of menstruation, then “Parlodel” is prescribed on the fourteenth day from the beginning of the monthly cycle. The initial dose of 1.25 milligrams per day increases every day to five milligrams. Tablets should be taken until the onset of critical days.
To suppress milk production, the drug can be used at 1.25 milligrams twice a day (on the first day of administration), then you should increase the single dose twice, that is, take 2.5 milligrams of the drug twice a day. The course of therapy is fourteen days. The same treatment schedule is prescribed when detecting postpartum mastitis.
If benign neoplasms are found in the mammary glands, then Parlodel take 1.25 milligrams two or three times a day. Gradually, the dose is increased to 5, or even 7.5 milligrams per day.
With Parkinson’s disease and similar ailments, the medication is taken with a minimum dosage of 1.25 milligrams per day, gradually increasing the daily dose. The course of admission is strictly regulated by the attending physician.
“Cyclodinone” is a herbal remedy based on the Abraham tree (or sacred vitex). The active substance of the drug is a dry extract obtained from the fruits of the plant. Auxiliary components - povidone, polysorbate 20, sorbitol 70, ethanol 96 percent, purified water, mint flavor. This drug is a drop in vials for oral administration.
“Cyclodinone” is prescribed for irregularities in the menstrual cycle, mastodynia, or premenstrual syndrome. Side effects from the use of the product are extremely rare and relate more to skin allergic reactions. Very rarely, confusion or hallucinations can occur. How should I take the drug?
Annotation to Cyclodinone recommends using the product once a day early in the morning. Forty drops of the drug are mixed with a small amount of purified water and drunk. The duration of treatment usually does not exceed three months.
We disassembled the drug to stop the lactation "Dostinex". Instructions, reviews of specialists and patients, as well as analogues were indicated.