Cabaser (cabergoline)

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How does it work?

Cabaser tablets contain the active ingredient cabergoline, which is a type of medicine called a dopamine agonist. (NB. Cabergoline is also available without a brand name, ie as the generic medicine.) Cabergoline works by mimicking the activity of a substance in the brain called dopamine.

Dopamine is a substance known as a neurotransmitter. Neurotransmitters are present in the brain and nervous system and are involved in transmitting messages between nerves. These messages allow the normal functioning of the body. The neurotransmitter dopamine is known to be reduced or absent in the brains of people with Parkinson's disease, and this is thought to be the cause of the disease symptoms.

Dopamine normally transmits messages by stimulating specific receptor sites in the brain. Cabergoline works by stimulating these same receptor sites. This produces the same effects as dopamine, and acts as a dopamine substitute. In this way cabergoline helps to restore the dopamine activity in the brain, which helps reduce the symptoms of Parkinson's disease.

Cabergoline can be used by itself or in conjunction with levodopa to treat Parkinson's disease, and is particularly useful in people for whom levodopa alone is no longer providing adequate control of symptoms.

Cabergoline can cause a drop in blood pressure when you first start treatment, and this may cause dizziness or fainting. To minimise these side effects the dose of cabergoline is increased slowly, usually over three to four weeks. Follow the instructions given by your doctor or pharmacist.

What is it used for?

- Parkinson's disease.

(NB. Cabergoline is also used in lower doses to treat disorders that result from high levels of the hormone prolactin in the blood. The Cabaser brand of cabergoline is not licensed for these uses. See the Dostinex factsheet linked at the end of this article for more information about these other uses of cabergoline.)

Warning!

- Cabaser tablets should be taken with or after food to minimise the chance of experiencing side effects such as nausea or indigestion.
- This medicine can occasionally cause your blood pressure to drop when you move from a lying down or sitting position to sitting or standing, especially when you first start taking the medicine. This may make you feel dizzy or unsteady. To avoid this try getting up slowly. If you do feel dizzy, sit or lie down until the symptoms pass. Drinking alcohol may increase the chance of feeling dizzy.
- This medicine can cause sleepiness and on rare occasions people have experienced a sudden onset of sleep during their daily activities. In some cases this occured without any warning signs. Although this is uncommon, you should exercise caution when driving or performing other potentially hazardous activities.

People who have experienced sleepiness or an episode of sudden onset of sleep while taking this medicine should not drive or operate machinary. Caution should be observed when drinking alcohol or taking other medicines that cause drowsiness, as this may increase the risk of drowsiness.
- On rare occasions people taking this medicine have developed a fibrous thickening of the lining that covers some of the internal organs including the kidneys, the heart or the lungs. This is called a fibrotic reaction. Your doctor may want you to have a chest X-ray and blood tests before starting treatment and regularly during treatment to monitor for this. Consult your doctor if you develop any of the following symptoms while taking this medicine, so they can be investigated: shortness of breath, persistent cough, chest pain, swelling of the lower legs, pain in the lower back, or abdominal pain or tenderness.
- Pathological gambling, increased sex drive and hypersexuality have been reported in people taking dopamine agonists such as this one for Parkinson's disease. If you think this medicine is affecting you in this way, you should consult your doctor.
- Cabaser tablets absorb moisture, so you should always replace the cap after taking your tablets. Do not remove the special dessicant granules from the cap, and do not transfer your tablets to another container.
- You should not suddenly stop taking this medicine unless your doctor tells you otherwise.

Use with caution in

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- Severely decreased liver function.
- Severe disease involving the heart and blood vessels (cardiovascular disease).
- Narrowing of the blood vessels in the hands, causing numb and painful fingers (Raynaud's disease).
- Low blood pressure (hypotension).
- Peptic ulcer.
- Bleeding from the stomach or intestines.
- History of serious mental illness, particularly psychosis.
- Hereditary blood disorders called porphyrias.

Not to be used in

- Allergy to other ergot alkaloid derived medicines, eg pergolide, bromocriptine, lisuride, ergotamine.
- History of fibrotic disorders affecting the lungs, lower back, kidneys or heart.
- Heart valve disorders.
- Pregnancy.
- Breastfeeding.

This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy. If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.

Pregnancy and breastfeeding

Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby.

Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.

- The manufacturer states that this medicine should not be used in pregnancy because its safety has not been fully established. They recommend that women who want to try for a baby should stop taking this medicine one month beforehand. Seek further medical advice from your doctor.
- This medicine should not be used by breastfeeding mothers because it is expected to suppress the production of breast milk. Seek medical advice from your doctor.

Label warnings

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- Take this medication with or after food.

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