Cabergoline 1mg Tablets
Patient Information Leaflet
Read all of this leaflet carefully before you start taking this medicine because it contains important information for you.
* Keep this leaflet. You may need to read it again.
* If you have any further questions, ask your doctor or pharmacist.
* This medicine has been prescribed for you only. Do not pass it on to others. It may harm them, even if their signs of illness are the same as yours.
* If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. See section 4.
Your medicine is called Cabergoline 1 mg Tablets but will be referred to as Cabergoline throughout this Patient Information Leaflet. Please note that the leaflet also contains information about the other strength of the medicine, Cabergoline 2mg Tablets.
What is in this leaflet:
.1^ What Cabergoline is and what it is used for .2^ What you need to know before you take Cabergoline How to take Cabergoline Possible side effects How to store Cabergoline .6^ Contents of the pack and other information
^ What Cabergoline is and what it is used for
Cabergoline belongs to a group of medicines known as dopamine agonists. Cabergoline acts in a similar way to a chemical present in the nervous system called dopamine. Patients with Parkinson's disease do not have enough of this important chemical.
Cabergoline 1 mg and 2 mg is used to treat Parkinson's disease. It can be used either taken alone or in combination with levodopa, as second choice following non-ergot derived therapies.
Treatment under a specialist is required.
What you need to know before you take Cabergoline
DO NOT take Cabergoline if you:
* are allergic to cabergoline or other ergot alkaloids (e.g. bromocriptine) or to any of the other ingredients of this medicine (listed in section 6)
* have swelling of the hands, feet and a high blood pressure during pregnancy (pre-eclampsia, eclampsia)
* have uncontrolled high blood pressure
* will be treated with Cabergoline for a long period and have or had fibrotic reactions (scar tissue) affecting the lungs, back of the abdomen and kidneys or heart.
Before you are given Cabergoline your doctor will arrange for you to have tests to assess the condition of your heart. Your doctor will continue to monitor your medical condition while taking Cabergoline.
Warnings and precautions
If you have any of the following health problems you must inform your doctor before taking Cabergoline as the medicinal product may be unsuitable for you:
* cardiovascular disease
* stomach ulcer or bleeding in the gastrointestinal tract, (this condition can cause black faeces or vomiting with blood).
* impaired kidney function
* have or had fibrotic reactions (scar tissue) affecting your heart, lungs, kidneys or abdomen.
* have impaired liver function
* have (or have had in the past) psychosis or you are at risk of psychosis after childbirth
* Raynaud's disease (when it is cold the fingers and toes become bluish white, with no pulse, cold, insensitive and numb)
* low blood pressure
* serious chest complaint (e.g. pain in the chest when breathing, fluid in the lungs, inflammation or infection of the lungs)
In case you are treated with Cabergoline for a long period, your doctor will check before starting treatment whether your heart, lungs and kidneys are in a good condition. He/she will also have an echocardiogram (an ultrasound test of the heart) taken before treatment is started and at regular intervals during treatment. If fibrotic reactions occur, treatment will have to be discontinued.
Tell your doctor if you or your family/carer notices that you are developing urges or cravings to behave in ways that are unusual for you and you cannot resist the impulse, drive or temptation to carry out certain activities that could harm yourself or others. These are called impulse control disorders and can include behaviours such as addictive gambling, excessive eating or spending, an abnormally high sex drive or an increase in sexual thoughts or feelings. Your doctor may need to adjust or stop your dose.
Infertility can be reversed in women taking Cabergoline, and pregnancy can occur before the menstrual cycle has normalised. Suitable means of contraception should therefore be used during treatment if necessary.
Children and adolescents
The safety and efficacy of Cabergoline has not been established in children and adolescents less than 16 years of age.
Other medicines and Cabergoline
* Certain medicines used for reducing blood pressure and certain medicinal products (e.g. phenothiazines, butyrophenones, thioxanthene) used for the treatment of psychological illnesses (schizophrenia or psychoses), if taken at the same time as Cabergoline, can interfere with the effects of cabergoline.
The treating doctor should therefore be aware of such concomitant medication.
* There are other medicines such as other ergot alkaloids, medicines to prevent vomiting (metoclopramide), medicines for reducing high blood pressure, and macrolide antibiotics (such as erythromycin) that may affect the activity and tolerability of Cabergoline.
Tell your doctor or pharmacist if you are taking or have recently taken any other medicinal products, including those obtained without a prescription and natural medical products/natural products.
Cabergoline with food and drink
* Cabergoline should be taken by mouth, preferably with meals.
Pregnancy, breast-feeding and fertility
If you are pregnant or breast-feeding, think you may be pregnant or are planning to have a baby, ask your doctor or pharmacist for advice before taking this medicine.
Pregnancy
* There is only limited experience of the use of Cabergoline during pregnancy.
You should therefore consult your doctor if you are pregnant or plan to become pregnant before the treatment is started.
* If you are being treated with Cabergoline and become pregnant during this time you should discontinue the treatment and contact your doctor as soon as possible.
* Contraception should be continued for at least 4 weeks after stopping cabergoline.
Breast-feeding
* It is not known whether cabergoline passes into breast milk.
* Cabergoline should not be taken by mothers who intend to breast feed as it prevents lactation. Nursing mothers should note that the quantity of milk can diminish.
Fertility
If you are planning to become pregnant then Cabergoline should be discontinued one month before intended pregnancy. You should therefore consult your doctor if you are pregnant or plan to become pregnant before the treatment is started.
Driving and using machines
* Cabergoline can negatively affect the ability to react in some people and this should be considered in cases where a high level of alertness is required, e.g. driving a car and in precision work.
* Cabergoline can cause somnolence (extreme drowsiness) and sudden sleep onset. Persons affected by this should therefore not drive or take part in activities in which reduced alertness could incur a risk of serious harm (e.g. using machines), until such recurrent episodes and somnolence have resolved. If affected, consult your doctor.
Cabergoline contains lactose
* Cabergoline 1 mg and 2 mg tablets contain lactose. If you have been told by your doctor that you have an intolerance to some sugars you should contact your doctor before taking this medicine.
[3) How to take Cabergoline
Always take Cabergoline exactly as your doctor has told you. You should check with your doctor or pharmacist if you are not sure.
The tablets should be taken with meals to reduce certain side effects such as nausea, vomiting and stomach pains.
Patient Information Leaflet (continued)
* Adults and elderly patients
The dose is determined by your doctor who adjusts it individually for you. The usual dose at the start of the treatment is 0.5 - 1 mg cabergoline daily. The dose is then increased gradually as directed by the doctor up to a suitable maintenance dose.
The usual maintenance dose is from 2 mg up to 3 mg cabergoline daily.
Cabergoline 1 mg and 2 mg Tablets have a score and can be divided into two equal halves.
If you take more Cabergoline than you should
It is important not to take too many tablets. Contact your nearest hospital Accident and Emergency department or doctor for advice if you have taken too many tablets or if you think a child has swallowed any.
Symptoms of overdose may include nausea, vomiting, reduced blood pressure, stomach pain, changes in behaviour, confusion or hallucinations (seeing things).
Take this leaflet and any tablets that you still have to show the doctor.
If you forget to take Cabergoline
If you forget to take a dose at the right time, you can take it as soon as you remember it.
If it is almost time to take the next dose, skip the forgotten dose and take the next dose as usual.
If you stop using Cabergoline
If you stop using cabergoline the symptoms of your illness may become more severe and you should discuss with your doctor before you discontinue therapy. Cabergoline takes many days to be cleared from the bloodstream and effects may worsen over a 2 week period resulting in worsening of symptoms of Parkinson's disease.
If you have any further questions on the use of this medicine, ask your doctor or pharmacist.
Very rare side effects (may affect less than 1 in 10,000 users):
* formation of fibrous tissues
Not known (cannot be estimated from the available data):
* sudden sleep attacks, leg cramps, unintentional trembling or shaking movements (tremor), loss of vision, fainting, respiratory disorders and failure, breathing problems with inadequate intake of oxygen, inflammation of the lining of the lung (pleuritis), chest pain, your fingers or toes turn white or blue with a feeling of numbness after exposure to cold (digital vasospasm), hair loss (alopecia), increases in blood creatinine phosphokinase test results.
The following side effects have been reported with lower doses of cabergoline (0.25 - 2 mg per week):
depression, headache, fatigue, pins and needles, heart pounding, constipation, reduction in vision, nose bleeds, extreme drowsiness (somnolence), fainting and cramp in fingers and calves.
Reporting of side effects
If you get any side effects, talk to your doctor, pharamacist or nurse. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via the Yellow Card Scheme at: www.mhra.gov.uk/yellowcard.
By reporting side effects you can help provide more information on the safety of this medicine.
^ Possible side effects
Like all medicines, this medicine can cause side effects, although not everyone gets them.
You may experience the following side effects:
* Inability to resist the impulse, drive or temptation to perform an action that could be harmful to you or others, which may include:
* Strong impulse to gamble excessively despite serious personal or family consequences
* Altered or increased sexual interest and behaviour of significant concern to you or to others, for example, an increased sexual drive.
* Uncontrollable excessive shopping or spending
* Binge eating (eating large amounts of food in a short time period) or compulsive eating (eating more food than normal and more than is needed to satisfy your hunger).
Tell your doctor if you experience any of these behaviours; they will discuss ways of managing or reducing the symptoms.
Very common side effects (may affect more than 1 user in 10):
* swelling of your feet and ankles, feeling sick (nausea)
* heart valve and related disorders e.g., inflammation (pericarditis) or leaking of fluid in the pericardium (pericardial effusion). The early symptoms may be one or more of the following: difficulty breathing, shortness of breath, chest or back pain and swollen legs. If you experience any one of these symptoms you must tell your doctor immediately.
Common side effects (may affect 1 to 10 users in 100):
* being sick (vomiting), indigestion, stomach pain, inflammation of the stomach lining (gastritis), constipation, dizziness, low blood pressure (which can result in dizziness), spinning feeling (vertigo), chest pain (angina), shortness of breath, seeing or hearing things that are not real (hallucinations), confusion, sleep disorders, headache, excessive sleepiness (somnolence), increased sex drive, involuntary movements, lowering of red blood count in the blood, low protein in your red blood cells, muscle weakness and fatigue, abnormal liver function tests
Uncommon side effects (may affect 1 to 10 users in 1000):
* redness, swelling and pain in the extremities of the arms and legs (erythromelalgia), somnolence (extreme drowsiness), episodes of sudden sleepiness, skin rash, allergic reaction, fluid in the layers of the membrane lining the lungs and chest cavity, swelling due to accumulation of fluid in the tissues, abnormal liver function, excessive abnormal movements, delusions or psychotic disorder.
Ergot related fibrosis has been reported. Ergot related fibrosis is an inflammatory condition of the inner lining of the body cavities possibly affecting the heart, lungs and kidneys. You should become aware of this as difficulty breathing, chest pain, back pain, pelvic pain and swelling of the legs. Tell your doctor immediately if you experience such symptoms.
[5) How to store Cabergoline
* KEEP OUT OF THE SIGHT AND REACH OF CHILDREN.
* Do not store above 30°C.
* Store in the original package in order to protect from moisture.
* Keep container tightly closed.
* Once opened use within 30 days. Discard any unused product after that.
* The drying capsule or bag with silica gel must not be removed from the bottle.
* Do not take Cabergoline after the expiry date shown on the bottle label or carton. If your doctor tells you to stop using this medicine,
take any remaining medicine back to the pharmacist for safe disposal. Only keep this medicine if your doctor tells you to.
* If your medicine becomes discoloured or shows any signs of deterioration, ask your pharmacist who will advise you what to do.
* Medicines should not be disposed of via wastewater or household waste. Ask your pharmacist how to dispose of medicines no longer required. These measures will help to protect the environment.
[6) Contents of the pack and other information
What Cabergoline contains:
The active substance is cabergoline.
Each tablet contains 1mg cabergoline.
The other ingredients are: lactose anhydrous, l-leucine and magnesium stearate.
What Cabergoline looks like and contents of the pack
Cabergline tablets are white, oval-shaped biconvex, tablets with scores on both sides. One side is debossed with ‘CBG' and ‘1' on either side of the score.
Each bottle contains 20 Tablets.
Manufacturer and Licence Holder
This medicine is manufactured by Teva Czech Industries s.r.o., Ostravska 29, 747 70 Opava-Komarov, Czech Republic and is procured from within the EU and repackaged by the Product Licence Holder: Lexon (UK) Limited, Unit 18, Oxleasow Road, East Moons Moat, Redditch, Worcestershire, B98 0RE.
If you have any questions or are not sure about anything, ask your doctor or pharmacist. They will have additional information about this medicine and will be able to advise you.
pOmI PL 15184/1433 Cabergoline 1 mg Tablets
Revision date: 10/08/16
Blind or partially sighted?
Is this leaflet hard to see or read?
Phone Lexon (UK) Limited, Tel: 01527 505414 for help.