Cabaser

Generic Name: Cabergoline
Product Name: Cabaser

Indication: What Cabaser is used for

Cabaser is primarily used in the treatment of Parkinson’s disease. This is a disease of the brain that affects movement. Patients with Parkinson’s show three classical symptoms:

Resting tremor (described as pill-rolling).
Bradykinesia- slowness of movements.
Rigidity.

Patients will display mask-like faces and an unbalanced, shuffling walk with this disease. Parkinson’s is caused by a deficiency of a chemical within the brain called dopamine. Cabaser works by enhancing the effect of dopamine thus reversing many of these signs and symptoms of Parkinson’s disease.

Note that Cabaser may have been prescribed to you for some other reason than those listed above. Ensure you ask your doctor if you have any concerns about why this medication has been prescribed to you.

Action: How Cabaser works

Cabaser contains the active ingredient cabergoline. This medication belongs to a class of drugs called dopamine agonists which bind to dopamine receptors in cells and stimulate them. This increases the action of dopamine within the brain that helps to control movement of the body.

Cabaser also binds dopamine receptors within the pituitary gland and causes a reduction in prolactin secretion. Prolactin is a hormone important in milk production that can be excessive in conditions associated with tumours of the pituitary gland. Other cabergoline drugs have been used in such conditions but Cabaser has not yet been marketed for these conditions.

In addition to these therapeutic effects, Cabaser also causes a reduction in blood pressure. This is greatest approximately six hours after the dose of medication. The higher the dose of Cabaser, the more likely it will cause a fall in your blood pressure.

Cabaser comes as white oval tablets of three different strengths, containing 1mg, 2mg or 4mg of the active ingredient cabergoline. All tablets come in child-proof amber glass bottles containing 30 tablets.

Dose advice: How to use Cabaser

Precautions

You should not take Cabaser in the following circumstances:

If you are allergic to cabergoline, any other ergot alkaloid or any of the other ingredients contained within the tablet (lactose anhydrous and leucine).
If you have experienced lung problems associated with the used of dopamine agonists. Cabaser can cause fibrotic changes in the lungs after long-term treatment.
If you are pregnant or intend to become pregnant. There is limited experience with this medication during pregnancy so we are not sure of the possible adverse effects it could have on the fetus.
If you are breastfeeding as it can impair your milk supply.
If you are a child. There is no experience of this drug in children as it is indicated for Parkinson’s which is an adult disease.

In addition, you should let your doctor know if you have liver problems, lung disease, cardiovascular disease, Raynaud’s syndrome (where the circulation in the digits is poor causing the fingers and toes to turn pale or blue), stomach ulcer, gastrointestinal bleeding, history of mental illness or low blood pressure. In these cases Cabaser needs to be used carefully.

Dosage

Cabaser tablets are intended to be swallowed (whole or half tablets with a full glass of water) and should be taken with food to reduce side effects of nausea or stomach upsets.

Cabaser should always be taken as prescribed by your doctor. They will be able to decide the best dose suited for you according to your condition and other comorbidities.

Cabaser is often used in combination with other Parkinson’s medications, especially levodopa.

The normal starting dose is either half or one 1mg tablet daily. Your doctor will then increase this dose gradually over several weeks. This is usually by adding half-one tablet to the daily dose once every week. If you have not had dopamine medications before, the final dose is usually between 2-4mg but if Cabaser is being used with levodopa you may take up to 6mg/day.

Cabaser is intended for long-term use to prevent symptoms and complications of Parkinson’s. You should therefore take it every day even if you feel well. Cabaser should be continued for as long as your doctor tells you.

Whilst you are taking Cabaser you need to take additional precautions driving and operating machinery as Cabaser can cause sleepiness, light-headedness or sudden onset of sleep in some patients. You should refrain from these activities until you have a good idea how this medication affects you. In addition, particularly early in the course of your treatment, you should make sure you stand up slowly to reduce the light-headedness caused by this medication.

Schedule of Cabaser

S4 (prescription required). Cabaser has a restricted benefit for the use in Parkinson’s disease.

Side effects of Cabaser

Common side effects

Like any other medication, Cabaser can cause side effects. Studies have shown that the majority of people taking Cabaser either alone or in combination with other medications will experience at least some side effects. This reflects the fact that the medicine has to disrupt the chemical balance in the body in order to treat disease. Most of the side-effects are however mild and only last for a short period of time, while the body gets used to the drug.

If you experience any of the following side-effects that are worrying you, do not hesitate to discuss them with your doctor. Note that the following lists of side effects are not necessarily exhaustive as new side effects can be discovered as more patients use the drug.

The most commonly reported side effects of Cabaser are listed below. In studies these have occurred in between 3 to 20 percent of patients taking the drug alone or in combination with levodopa.

Nausea and vomiting.
Dyskinesias– Abnormal movements.
Abdominal pain.
Constipation.
Headache.
Fatigue.
Weakness or unusual sleepiness.
Dry mouth.
Loss of appetite.
Nasal congestion.
Postural hypotension- A fall in blood pressure when standing suddenly. This can lead to dizziness or fainting.
Peripheral oedema- Swelling of the hands or feet.
Mental symptoms such as paranoia or excessive gambling.

Uncommon side effects

More serious side effects occur in less than 1% of patients. These however are serious and required urgent medical attention. The most serious side effects of Cabaser that have been reported include:

Allergic reactions which can be potentially life-threatening. Signs of allergy may include rash, itching or hives, swelling of the face, lips and tongue, shortness of breath, wheezing or difficulty breathing. If any of these symptoms develop make sure you see your doctor or go to hospital immediately. This emphasises the importance of letting your doctor know any allergies that you may have prior to the commencement of the medication.
Lung damage such as pleural effusion, inflammation, pleural and pulmonary fibrosis. If you develop any breathing problems whilst on Cabaser see your doctor and they will probably order a chest x-ray.
Irregular heart beat.
Severe psychiatric side effects such as hallucinations and irrational thoughts or ideas.