To open the vial, first press the lid, then rotate it, as shown on the lid. A bag of silica gel from a vial can not be removed or consumed.
Data on the efficacy and safety of Agalates in patients with impaired hepatic or renal function are limited. In patients with severe hepatic insufficiency (Child-Pugh class C), if necessary, prolonged therapy, Agalates should be used at lower doses.
The pharmacokinetics of cabergoline does not change significantly with moderate or severe renal failure. It is not studied in patients with terminal stage of renal failure or hemodialysis. Therefore, in such patients, Agalates should be used with caution. The effect of alcohol on the overall tolerance of the drug Agalates is not established.
The use of the drug Agalates can cause symptomatic arterial hypotension, especially when taken together with drugs that lower blood pressure.It is recommended to regularly measure blood pressure in the first 3-4 days after the start of treatment.
With long-term use of the drug Agalates and other ergot derivatives, which are active against serotonin 5HT2B receptors, the risk of fibrotic and seizure-inflammatory diseases such as exudative pleurisy, pleural fibrosis, pulmonary fibrosis, pericarditis, damage to one or more valves heart (aortic, mitral, tricuspid), retroperitoneal fibrosis. Abolition of the drug Agalates in the case of the development of the above diseases led to an improvement in the patients' condition. Prior to the onset of prolonged therapy with Agalates, all patients should undergo a complete examination to detect cardiac valve lesions, to determine the functional state of the lungs and kidneys to prevent worsening of the course of concomitant diseases. When new clinical symptoms appear on the part of the respiratory system, fluoroscopy of the lungs is recommended. In patients with pleural effusions / fibrosis, there was an increase in the rate of erythrocyte sedimentation (ESR),therefore at an elevated erythrocyte sedimentation rate without overt clinical signs should conduct radiography of the chest, as well as to determine the concentration of creatinine in plasma.
During prolonged therapy with Agalates possible gradual development of fibrotic disorders, so during treatment should monitor the appearance of symptoms such as dyspnea, shortness of breath, cough, chest pain, back pain, lower extremity edema, signs of retroperitoneal fibrosis (pain , malaise), heart failure. After the start of therapy with Agalates to prevent fibrotic disorders should monitor the status of the heart valves and spend echocardiography (echocardiography) study for the first time in 3-6 months after initiation of therapy. Further, the frequency of EchoCG control is set by the doctor individually for each patient, but not less than once every 6-12 months.
In case of deterioration or valvular regurgitation, thickening or narrowing of the lumen of the valve wall Agalates drug therapy should be discontinued. The need for the patient in other types of clinical examination is established by the doctor on an individual basis.With the use of Agalates, drowsiness and episodes of "sudden falling asleep" can occur, especially in patients with Parkinson's disease (see "Impact on the ability to drive vehicles and mechanisms").
When using the drug Agalates, there was an increase in libido, hypersexuality, pathological attraction to gambling. These symptoms were reversible and disappeared with a decrease in the dose or withdrawal of Agalates. Hyperprolactinaemia in combination with amenorrhea and infertility can be associated with tumors of the pituitary gland, therefore, before the beginning of therapy with Agalates, a pituitary function check should be performed. It is recommended to check the serum content of prolactin every month, since after achieving an effective therapeutic regimen, the normal concentration of prolactin persists for 2-4 weeks.
After the abolition of the drug Agalates, hyperprolactinaemia usually occurs again.
However, in some patients there has been a persistent decrease in prolineact concentrations for several months. The use of the drug Agalates restores ovulation and fertility in women with hyperprolactinemic hypogonadism.Because pregnancy can occur before the resumption of menstruation, pregnancy tests are recommended during the amenorrhea period, and after the recovery of the menstrual cycle - in all cases, their delay is more than 3 days. Women who do not plan pregnancy are recommended to use effective non-hormonal contraceptives during treatment with Agalates and after it is finished. Women planning pregnancy, conception is recommended not earlier than 1 month after the abolition of the drug Agalates.