Cabolac

Indications

Cabolac is primarily prescribed to suppress breast milk production (lactation) shortly after childbirth, stillbirth, abortion, or miscarriage. It may also be recommended for those who choose to discontinue breastfeeding. Additionally, Cabolac is effective in addressing various conditions caused by hormonal imbalances, which can lead to elevated prolactin levels.

Consult your registered physician before using this medication.

Description

Cabolac belongs to the class of medications known as dopamine receptor agonists. Its primary function is to lower the secretion of prolactin—a hormone released from the pituitary gland. This medication is utilized to treat hyperprolactinemia, a condition characterized by excessive prolactin in the bloodstream.

Pharmacology

Cabergoline, the active ingredient in Cabolac, acts as a dopamine receptor agonist. Prolactin secretion from the anterior pituitary is mainly regulated by the hypothalamus, through dopamine released by tuberoinfundibular neurons. Cabergoline boasts a long-acting profile and a high affinity for D2 receptors. In vitro studies have shown that Cabergoline directly inhibits prolactin secretion from rat pituitary lactotrophs and effectively reduces serum prolactin levels in reserpinized rats. Binding studies indicate a low affinity for D1 dopamine, α1, and α2 adrenergic receptors, as well as serotonin receptors (5HT1 and 5HT2).

Dosage & Administration

For initiating therapy, the recommended dose of Cabergoline is 0.25 mg, taken twice weekly. This dosage can be gradually increased by 0.25 mg twice weekly, up to a maximum of 1 mg twice weekly, based on the patient’s serum prolactin levels. Dosage adjustments should occur no more frequently than every four weeks, allowing the physician to evaluate the patient’s response. If adequate response is not achieved, the lowest effective dose should be maintained, while considering alternative treatments.

• To prevent milk production after delivery: Take one 1 mg Cabergoline tablet on the first day post-delivery.
• To halt lactation after breastfeeding has begun: Administer 0.25 mg Cabergoline every 12 hours for two days.
• To lower prolactin levels in other conditions: Begin with a 0.5 mg Cabergoline tablet (divided into two doses) over one week (e.g., half a tablet on Monday and the other half on Thursday). The dose may be increased to a maximum of 4.5 mg or until satisfactory treatment response is achieved.

Consult your registered physician before using this medication.

Interactions

Cabolac may interact with medications that lower blood pressure, antipsychotic drugs (e.g., chlorpromazine, haloperidol), anti-nausea medications (e.g., domperidone), and treatments for severe migraines (e.g., bromocriptine, ergometrine).

Contraindications

Cabolac is contraindicated in individuals with:

• A history of severe mental disorders, particularly psychotic conditions
• Liver or kidney disease
• High blood pressure during pregnancy (toxemia)
• Antipsychotic treatment or previous mental health issues related to childbirth (puerperal psychosis)

Side Effects

Women who are pregnant or planning to conceive should consult their doctor before starting treatment with Cabolac, which is classified as pregnancy category B. It is advised to discontinue Cabolac at least one month prior to conception, as it inhibits milk production. If breastfeeding is intended, Cabolac should not be used.

Pregnancy & Lactation

Prior to initiating Cabergoline, confirm that the patient is not pregnant. After stopping Cabergoline, if pregnancy occurs within a month, the use of Cabergoline should be discontinued to prevent milk production. Breastfeeding is not compatible with Cabergoline use.

Precautions & Warnings

Cabolac should be avoided in patients with:

• Hypersensitivity to Cabolac or other ergot alkaloids (e.g., bromocriptine, pergolide)
• Severe liver disease
• Pregnancy-induced hypertension (e.g., pre-eclampsia)
• A history of mental health issues connected to childbirth

Care should be taken when using Cabolac with other medications that can lower blood pressure. It is not indicated for suppressing physiological lactation. Prolonged use may lead to fibrotic reactions affecting the heart.

Overdose Effects

Overdose may result in symptoms such as nasal congestion, syncope, or hallucinations. Blood pressure support measures should be employed as needed.

Therapeutic Class

Antiparkinson drugs

Storage Conditions

Store in a cool, dry place away from light and out of reach of children.