Dostinex

What Dostinex tablets are for

High prolactin does not always follow a pregnancy. When it stays up, the signs are missed or irregular periods, leaking breasts, low sex drive and, over the years, thinning bones, in women and men alike. The condition is called hyperprolactinaemia (too much prolactin in the blood). Dostinex contains cabergoline, a dopamine agonist: it copies dopamine, the brain signal that tells the pituitary gland (a small gland at the base of the brain) to ease off prolactin. Levels fall and the symptoms usually follow. The same action shrinks many prolactinomas, pituitary tumours that make too much prolactin.

Fitting the dose around your week

Cabergoline stays in the body for days, so it is taken twice a week rather than every day. Plenty of people pick two fixed days — Monday and Thursday, say — and swallow the tablet with a glass of water; food makes no difference to it. Treatment normally starts at 0.25mg twice weekly, and the amount goes up in steps every few weeks until prolactin is where it should be, which is why both tablet strengths get used at different points.

Side effects worth knowing

Nausea is the most common complaint, sometimes with vomiting, heartburn or constipation. Tiredness, breast pain, painful periods and tingling or numbness in the hands and feet also turn up. Dizziness or light-headedness when you stand up quickly is common in the first days and settles; getting up slowly helps. Over months of treatment a small number of people develop fibrosis — thickening or scarring — in the heart valves, lungs or abdomen, and breathlessness, a cough that will not go or swollen ankles can be signs of it. Some people notice urges that are hard to control, such as gambling or a sharp rise in sexual urges.

Who cabergoline is not for

Heart valve disease, uncontrolled high blood pressure, or existing thickening or scarring in the lungs, heart or abdomen usually rule cabergoline out, as does a bad reaction to ergot medicines such as ergotamine or bromocriptine. Medicines that block dopamine — some antipsychotics, and the anti-sickness medicine metoclopramide — work against it. Alcohol does not stop the tablets working, but it makes the dizziness worse. Blister strips keep best in a cupboard, out of direct sun.

Dostinex or cabergoline — same thing?

Dostinex is a brand name for cabergoline, and the tablets sold here contain it in 0.25mg and 0.5mg. Choosing between the names changes the box, not the active ingredient or the strengths. Packs hold 8 to 32 tablets, and once your dose is settled a 0.5mg tablet does the work of two 0.25mg ones.