Composition

Synergo Tablet: Each tablet contains 0.5 mg Cabergoline BP.

Pharmacology

Synergo is in a group of drugs called dopamine receptor agonists. It works by reducing the amount of prolactin (a hormone) that is released from the pituitary gland. Synergo is used to treat a hormone imbalance in which there is too much prolactin in the blood (also called hyperprolactinemia).

Indication

Synergo is used to stop breast milk production (lactation) soon after childbirth, stillbirth, abortion or miscarriage. It can also be used if you do not want to continue to breastfeed. Synergo can also be used to treat other conditions caused by hormonal disturbance which can result in high levels of prolactin being produced. This includes high levels of prolactin caused by tumours of the pituitary gland in both men and women.

Dosage & Administration

The recommended dosage of Synergo Tablets for initiation of therapy is 0.25 mg twice a week. Dosage may be increased by 0.25 mg twice weekly up to a dosage of 1 mg twice a week according to the patient’s serum prolactin level. Dosage increases should not occur more rapidly than every 4 weeks, so that the physician can assess the patient’s response to each dosage level. If the patient does not respond adequately and no additional benefit is observed with higher doses, the lowest dose that achieved maximal response should be used and other therapeutic approaches considered. After a normal serum prolactin level has been maintained for 6 months, Synergo may be discontinued, with periodic monitoring of the serum prolactin level to determine whether or when treatment with Synergo should be reinstituted.

To prevent milk production (lactation): 1mg (two 0.5 mg tablets) on the first day after delivery. To stop lactation once have started to breastfeed: 0.25 mg (one half of Synergo l 0.5 mg tablet) every 12 hours for two days.

To reduce prolactin levels in other conditions: Initially take one 0.5 mg tablet (to be taken in two doses) spread out over a week (e.g. half a tablet on Monday and the other half of the tablet on Thursday). Dose will be increased up to a maximum dose of 4.5 mg or until have responded fully to treatment.

Contraindication

History of serious mental disease, particularly psychotic disorders Liver or kidney disease High blood pressure in pregnancy associated with swelling and protein in the urine (toxaemia of pregnancy) Anti-psychotics or have a history of mental illness associated with childbirth (puerperal psychosis)

Precaution & Warning

Hypersensitive (allergic) to Synergo l, to other medicines called ergot alkaloids, (e.g. pergolide, bromocriptine, lisuride, ergotamine or ergometrine) or to any of the other ingredients in the tablet

Severe liver disease

High blood pressure in pregnancy associated with swelling and protein in the urine (toxaemia of pregnancy)

Anti-psychotics or have a history of mental illness associated with childbirth (puerperal psychosis)

Pregnant or breastfeeding

Treated with Synergo for a long period and have or had fibrotic reactions (scar tissue) affecting your heart

Drug Interaction

Medicines to lower blood pressure

Medicines used to treat mental illness (e.g. antipsychotic medicines like chlorpromazine, haloperidol)

Medicines for nausea and vomiting (e.g. domperidone, metoclopramide).

Medicines for severe migraine headaches (e.g. pergolide bromocriptine, lisuride, ergotamine, dihydroergotamine, ergometrine or methysergide)

Use In Pregnancy & Lactation

Pregnant or planning to get pregnant, discuss this with doctor before treatment though the pregnancy category B. Before start using Synergo check that patient not pregnant. Pregnant for at least one month once have stopped taking Synergo, As Synergo will stop producing milk. If someone plan to breastfeed should not take Synergo.

Storage

Store at below 30 C in a dry place, protected from light and moisture.

Keep out of the reach of the children.