Celance (pergolide)

How does it work?

Celance tablets contain the active ingredient pergolide mesilate, which is a type of medicine called a dopamine agonist. (NB. Pergolide tablets are also available without a brand name, ie as the generic medicine.) Pergolide 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. Pergolide works by stimulating these same receptor sites. This produces the same effects as dopamine and acts as a dopamine substitute. In this way pergolide helps to restore the dopamine activity in the brain, which helps reduce the symptoms of Parkinson's disease.

Pergolide 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.

Pergolide 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 pergolide 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.

Warning!

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.

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 rare, 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.

You should not suddenly stop taking this medicine unless your doctor tells you otherwise, as abruptly stopping treatment can lead to the development of serious side effects known as the neuroleptic malignant syndrome. If this medicine is to be stopped it should be withdrawn gradually, following the instructions given by your doctor.

Use with caution in

Heart disease.

Irregular heart beats (arrhythmias).

People taking blood pressure lowering medicines (see end of factsheet for more details).

People who have difficulty performing voluntary movements (dyskinesia).

History of psychosis, hallucinations or confusion.

Hereditary blood disorders called porphyrias.

Not to be used in

Allergy to other ergot derived medicines, eg bromocriptine, cabergoline, ergotamine.

History of fibrotic disorders, eg affecting the lungs, lower back, kidneys or heart.

Heart valve disorders.

Breastfeeding.

Children.

Rare hereditary problems of galactose intolerance, the Lapp lactase deficiency or glucose-galactose malabsorption (Celance tablets contain lactose).

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 safety of this medicine for use during pregnancy has not been established. It is not recommended for use in pregnancy unless considered essential by your doctor. Seek medical advice from your doctor.

It is not known whether this medicine passes into breast milk. In addition it may decrease the production of breast milk. As a result it is not recommended for use during breastfeeding. Seek medical advice from your doctor.

Side effects

Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.

Disturbances of the gut such as nausea, vomiting, diarrhoea, constipation, indigestion or abdominal pain.

Difficulty breathing or shortness of breath (dyspnoea).

Inflammation of the lining of the nose (rhinitis) causing a blocked or runny nose.

Sleepiness.

Suddenly falling asleep.

Difficulty performing voluntary movements, resulting in jerky or involuntary movements or muscle twitches (dyskinesia).

False perceptions of things that are not really there (hallucinations).

Double vision.

Difficulty in sleeping (insomnia).

Confusion.

Dizziness.

A drop in blood pressure that occurs when moving from a lying or sitting position to sitting or standing, which results in dizziness and lightheadedness (postural hypotension).

Fainting (syncope).

Rash.

Fever (pyrexia).

Alteration in results of liver function tests.

Increased heart rate (tachycardia).

Fibrosis or inflammation affecting the lower back, heart or lungs.

Inability to resist impulses to gamble (pathological gambling).

Increased sex drive (libido) and excessive interest or involvement in sexual activity (hypersexuality).

The side effects listed above may not include all of the side effects reported by the drug's manufacturer. For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.

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