Caber tablet: Each tablet contains Cabergoline BP 0.5 mg.
Caber ® is the preparation of Cabergoline practical which is a dopamine receptor agonist. The secretion of prolactin by the anterior pituitary is mainly under hypothalamic inhibitory control, likely exerted through release of dopamine by tuberoinfundibular neurons. Cabergoline is a long acting dopamine receptor agonist with a high affinity for D 2 receptors. Results of in vitro studies demonstrate that Cabergoline exerts a direct inhibitory effect on the secretion of prolactin by rat pituitary lactotrophs. Cabergoline decreased serum prolactin levels in reserpinized rats. Receptor binding studies indicate that Cabergoline has low affinity for dopamine D 1 , a 1 and a 2 adrenergic and 5HT 1 , 5HT 2 serotonin receptors.
The recommended dosage of Caber ® for initiation of therapy is 0.25 mg twice a week. Dosage may be increased by 0.25 mg twice weekly up to a dosage of 1 mg twice a week according to the patient's serum prolactin level. Dosage increases should not occur more rapidly than every 4 weeks, so that the physician can assess the patient's response to each dosage level. If the patient does not respond adequately and no additional benefit is observed with higher doses, the lowest dose that achieved maximal response should be used and other therapeutic approaches considered. After a normal serum prolactin level has been maintained for 6 months, Caber ® may be discontinued, with periodic monitoring of the serum prolactin level to determine whether or when treatment with Caber ® should be reinstituted.
To prevent milk production (lactation): 1 mg (two Caber ® 0.5 mg tablets) on the first day after delivery.
To stop lactation once have started to breastfeed: 0.25 mg (one half of Caber ® 0.5 mg tablet) every 12 hours for two days.
To reduce prolactin levels in other conditions: Initially take one Caber ® 0.5 mg tablet (to be taken in two doses) spread out over a week (e.g., half a tablet on Monday and the other half of the tablet on Thursday). Dose will be increased up to a maximum dose of 4.5 mg or until have responded fully to treatment.
Dopamine antagonists (phenothiazines, butyrophenones, thioxanthenes, metoclopramide) diminish cabergoline therapeutic efficacy; macrolide antibiotics (erythromycin) increase cabergoline systemic exposure; ergot alkaloids increase risk of vasoconstrictive adverse effects.
Cabergoline is contraindicated in patients with known hypersensitivity to cabergoline or any components of this product. Cabergoline is also contraindicated in patients with uncontrolled hypertension or known hypersensitivity to ergot derivatives.
Common: Nausea, constipation, abdominal pain, dyspepsia, vomiting, headache, dizziness, paresthesia, vertigo, asthenia, fatigue, hot flashes, somnolence, depression, postural hypotension. Less Common: Facial edema, syncope, palpitation, dry mouth, flatulence, diarrhea, anorexia, anxiety, epistaxis.
Overdose
Overdosage might be expected to produce nasal congestion, syncope or hallucinations. Measures to support blood pressure should be taken if necessary.
Category B. Discontinue when pregnancy is detected unless medically required. Lactation: Suppresses prolactin secretion and lactation; do not use while breastfeeding.
Store below 25°C in a cool, dry place. Protect from light and moisture. Keep away from the reach of children.