Active substance - cabergoline 0.5 mg, auxiliary substances: lactose anhydrous, leucine. Buy cabergoline online over the counter. Tablets of oblong form, with a flat white surface, marked "P" and "U", with a risk on one side and the number "700" - on the other hand with short notches above and below the central "0" in the figure.
Kabergoline is rapidly absorbed from the gastrointestinal tract, the maximum concentration in the blood plasma is reached after 0.5 to 4 hours, the connection with the proteins of the blood plasma is 41 - 42%. The half-life of cheap cabergoline for sale without prescription, estimated by the rate of excretion in the urine, is 63 - 68 hours in healthy volunteers and 79 - 115 hours in patients with hyperprolactinemia. Due to the long half-life, the equilibrium concentration is reached after 4 weeks. After 10 days after taking the drug, about 18% and 72% of the dose are detected in urine and stool, respectively, and the proportion of unchanged drug in urine is 2 - 3%. The main product of cabergoline without prescription metabolism, identified in urine, is 6-allyl-8β-carboxy-ergoline at a concentration of up to 4-6% of the dose. The content in the urine of 3 additional metabolites does not exceed 3% of the accepted dose. It has been established that metabolic products have a significantly lower effect on the inhibition of prolactin secretion compared to cabergoline for sale otc. Biotransformation of radiolabeled labeled cabergoline was also studied in healthy volunteers, while it was rapid and significant. Experiments in vitro have shown that buy cabergoline without prescription at concentrations of 0.1-10 ng / ml binds to blood plasma proteins by 41-42%. The intake of food does not affect the absorption and distribution of cabergoline price cheap.
Buy cabergoline online without prescription is a dopaminergic derivative of ergoline and is characterized by a prolactin-lowering effect due to direct stimulation of the D2-dopamine receptors of lactotrophic pituitary cells. In addition, with higher doses compared to those for lowering serum prolactin levels, dostinex for sale has a central dopaminergic effect due to stimulation of D2 receptors. Reduction in the concentration of prolactin in the blood plasma is observed within 3 hours after taking the drug and persists for 7-28 days in healthy volunteers and patients with hyperprolactinemia, and up to 14-21 days - in women in the postpartum period. Buy dostinex without prescription has a strictly selective effect, does not affect the basal secretion of other hormones of the pituitary and cortisol. Prolactin-lowering effect of the drug is dose-dependent both in terms of severity and duration of action.
To the pharmacodynamic effects of buy cabergoline online, not related to the therapeutic effect, only the reduction in blood pressure (BP) refers. With a single dose of the drug, the maximum hypotensive effect is noted during the first 6 hours and is dose-dependent.
Prevention of lactation: 1 mg once (2 tablets of 0.5 mg), on the first day after childbirth. Suppression of steady lactation: 0.25 mg (1/2 tablet) twice a day every 12 hours for two days (total dose is 1 mg). In order to reduce the risk of orthostatic hypotension in breast-feeding mothers, a single dose of buy cabergoline online should not exceed 0.25 mg. Dostinex online for sale cheap price. Treatment of disorders associated with hyperprolactinemia: the recommended initial dose is 0.5 mg per week in a single dose (1 tablet 0.5 mg) or in two divided doses (1/2 tablet 0.5 mg, for example, on Monday and Thursday) . The increase in the weekly dose should be carried out gradually - by 0.5 mg with a monthly interval until the optimal therapeutic effect is achieved. The therapeutic dose is usually 1 mg per week, but can range from 0.25 to 2 mg per week. The maximum dose for patients with hyperprolactinemia should not exceed 4.5 mg per week.
Depending on the tolerance, a weekly dose can be taken once or divided into 2 or more receptions per week. The division of the weekly dose of cheap cabergoline cost into several doses is recommended when the drug is administered at a dose of more than 1 mg per week. During the selection of a dose, patients should be monitored in order to determine the lowest effective dose. The serum prolactin level should be determined monthly, since its normalization is usually observed within 2-4 weeks after the selection of the effective dose. After the abolition of the drug buy dostinex for sale no prior prescription, a relapse of hyperprolactinemia is usually observed. However, in some cases there has been a persistent decrease in prolactin levels for several months. In most women, ovulatory cycles persist for at least 6 months after discontinuation of the Dostinex® drug buy cabaser for sale. The maximum recommended dose is 3 mg per day cabergoline 0.5 mg pills over the counter.
In patients with hypersensitivity to dopaminergic drugs, the likelihood of developing side effects can be reduced by initiating buy cabergoline online therapy at a lower dose (eg, 0.25 mg once a week), then gradually increasing it until a therapeutic dose is achieved. To improve the tolerability of the drug in the occurrence of severe side effects, it is possible to temporarily reduce the dose, followed by a more gradual increase (for example, an increase of 0.25 mg per week every two weeks). Where to buy caber? The duration of treatment is determined by the attending physician.
Information on the interaction of cabergoline price over the counter and other ergot alkaloids is absent, so the simultaneous use of these medicines during long-term therapy with buy cabergoline online is not recommended. Since Dostinex® has a therapeutic effect by direct stimulation of dopamine receptors, it can not be administered concomitantly with drugs acting as dopamine antagonists (phenothiazines, butyrophenones, thioxanthenes, metoclopramide, etc.) because They can weaken the action of Dostinex®, aimed at reducing the level of prolactin. Dostinex® can not be used concurrently with macrolide antibiotics (eg, erythromycin), because This can lead to an increase in the systemic bioavailability of cabergoline. Dostinex® should be used with caution with drugs that lower blood pressure, The drug contributes to the development of symptomatic hypotension.
Dostinex® should be administered with caution under the following conditions and / or diseases:
Before using the drug, you must exclude pregnancy. After the treatment with Dostinex price cheap, pregnancy should be avoided for at least one month. Careful use of Dostinex® with other medications that lower blood pressure should be used to avoid postural hypotension. Before the appointment of Dostinex ® in order to treat violations associated with hyperprolactinemia, it is necessary to conduct a full study of the pituitary gland function. Before the long-term treatment with the drug Before the beginning of long-term treatment it is necessary to conduct examinations: heart echocardiography, chest X-ray, ultrasound of the kidneys, as well as blood and urine tests for the presence of an inflammatory process.
To identify a possible asymptomatic pathology of the heart valves, all patients need to perform cardiovascular examination, including echocardiography. Also, before the start of treatment, it is advisable to determine the erythrocyte sedimentation rate (ESR) or the level of other markers of inflammation, to assess lung function, perform chest radiography and assess renal function. Data on the possible worsening of the course of the underlying disease in patients with valvular regurgitation are absent. If cardiac fibrosis is diagnosed, cabergoline should not be prescribed.
In the course of long-term treatment. Fibrous changes can develop asymptomatically, so patients. It should be monitored regularly to identify possible manifestations of progressive fibrosis. Therefore, during treatment it is necessary to pay attention to the signs and symptoms of the following conditions and diseases:
In order to identify fibrotic changes, it is recommended that proper clinical diagnostic monitoring be performed. After the beginning of treatment, the first echocardiographic examination should be performed within 3-6 months; Subsequently the need for echocardiographic examination should be determined by the results of a proper clinical examination in each specific case, with special attention to the aforementioned signs and symptoms, but it must be performed at least once every 6-12 months. If the valvular regurgitation is detected for the first time in echocardiography, restriction of the mobility of valve flaps or their thickening, and also when signs of weight increase of these states are revealed, treatment with cabergoline should be stopped. The need to use other methods of examination (for example, a clinical examination involving heart auscultation, X-ray examination and computed tomography) should be determined individually.
Additional laboratory tests, such as the determination of erythrocyte sedimentation rate (ESR) and serum creatinine, should be performed if fibrotic changes are necessary. In the case of an increase in ESR in a general blood test in patients with pleural effusion / fibrosis, an X-ray diagnosis of the chest is necessary. Symptoms detected after long-term treatment with buy cabergoline online, such as fibrous and serous inflammatory disorders (pleurisy, pleural effusion, pleural fibrosis, pulmonary fibrosis, pericarditis, pericardial effusion, heart failure), in some cases, stop after discontinuation of the drug. With increasing doses, patients should be under the supervision of a physician in order to establish the lowest effective dose providing a therapeutic effect.
After the effective dosing regimen is selected, it is recommended to conduct a regular (once a month) determination of the concentration of prolactin in the blood serum. Normalization of prolactin levels is usually observed within 2-4 weeks of treatment. After the abolition of Dostinex®, a recurrence of hyperprolactinemia is usually observed, however, in some patients there is persistent inhibition of prolactin levels for several months. In most women, ovulatory cycles persist for at least 6 months after the abolition of Dostinex®. Dostinex® restores ovulation and fertility in women with hyperprolactinemic hypogonadism. Since pregnancy can occur before the recovery of menstruation, it is recommended to conduct pregnancy tests at least once every 4 weeks during the amenorrhea period, and after the recovery of menstruation - every time the menstruation is delayed for more than 3 days. Women who wish to avoid pregnancy should use barrier methods of contraception during treatment with buy cabergoline online, and after discontinuing the drug prior to recurrence of anovulation. Women who have become pregnant should be under the supervision of a doctor to detect symptoms of pituitary gland enlargement, because during pregnancy it is possible to increase the size of pre-existing pituitary tumors.
When using Dostinex®, a regular examination should be performed to identify impulse control disorders in which behavioral symptoms such as gambling, increased libido, hypersexuality, compulsive expenditure or purchases, a constant need for food and compulsive overeating can be expressed. When these symptoms occur, you need to reduce the dose and / or gradually cancel the drug.
Patients with severe hepatic insufficiency (class C according to the Child-Pugh classification) who are shown prolonged therapy with Dostinex® should consider taking the drug at a lower dose. A single dose of 1 mg of these patients showed an increase in AUC (area under the concentration / time curve) compared with healthy volunteers and patients with less severe hepatic insufficiency.
After prolonged use of buy cabergoline online, patients experienced pleural effusion / pleural fibrosis and valvulopathy. In some cases, patients received previous therapy with ergoline dopamine agonists. Therefore, Dostinex® should be used with caution in patients with existing signs and / or clinical symptoms of cardiac dysfunction or with such conditions in the anamnesis. After discontinuation of Dostinex ® in patients with pleural effusion / pleural fibrosis and valvulopathy, symptoms improved. Studies to identify the deterioration after taking Dostinex ® patients with valvular regurgitation were not performed. If the patient has fibrous valvular disorder, treatment with Dostinex® is not recommended.
In patients with fibrotic disorders in the period of prolonged drug treatment, constant monitoring is necessary for a timely diagnosis of the increase in symptoms of pleuropulmonary diseases, renal failure, ureteral or abdominal vascular obstruction, heart defects; And also it is necessary to conduct additional regular methods of research: general and biochemical blood tests (level of ESR, creatinine).
The use of buy cabergoline online causes drowsiness, and in patients with Parkinson disease it can cause a sudden falling asleep. In such cases it is recommended to reduce the dose of Dostinex® or to stop therapy. Studies on the use of the drug in elderly patients with Disorders associated with hyperprolactinemia, was not carried out.
The safety and effectiveness of the drug in children younger than 16 years is not established.