Brief Answer:
Follow the Advises as below..

Detailed Answer:
Hello XXXXXXX Welcome back,
Yes I've remembered your case history, thanks for following up with these details,

It's good to know that No tumor was detected in the MRI, can you please upload the printed MRI report here so that I can take a detailed look at it..

First of all, please answer these following questions so that I can guide you more specifically in this regard :

1. Are you certain that "Cabergoline (Caberlin 0.5 mg) for 1 month/ 5 days a week with 2 days gap" - was prescribed to you and not the opposite (i.e. Twice a week), if any doubt I'd request you to please upload the prescription here for my review immediately..

2. All those side effects are primarily due to Cabergoline only, and the Congestion feeling inside the ear and inner structures are mainly denoting Cabergoline Over dosage..

3. Usually it is recommended to initiate Cabergoline therapy twice a week with a low dose (0.25/ 0.125 mg) and dosage can be further titrated as per the drug tolerance and other factors..

So, it's advised to reduce the dosage to 0.25 mg as well as the duration and frequency without any further delay..in fact you need to closely follow-up with your doctor every weekly to check your progress as well as further titration of dosage..

I can understand your doctor is out of town, but you must inform him/her as he/she must be kept in the loop (there has to be phone no. please try to get hold of him/her)..alternatively try to contact their clinic, to know which other Gynecologist (I believe your still under the same gynec as you've informed me last time) is covering up in his/her absence, so that you can get yourself checked and get the necessary dose revision without any further delay, this is extremely important, so get on to it at the earliest..

For the dizziness, please try to remain seated for 10 min extra time after getting up from sleep and drink a lot of water..don't try to get up from the bed abruptly..

These symptoms are expected to be reduced after the dose and frequency revision, so don't worry..

For the appetite, please continue taking Tab RANITIDINE 150 mg twice daily 15-20 min before breakfast for next 15 days.. there's a need to get a fresh LFT and KFT along with at the earliest..

If the nauseated feeling is too much bothersome then you can try Tab ONDANSETRON 4 mg (available in mouth dissolving form as ONDEM-MD, which can be taken 10-15 min prior to food), simply suck it like lozenges twice daily before food for next few days till the new dosage takes full effect..

Chewing of clove and few ginger streaks prior to food will help too..

Take steam inhalation twice to thrice daily it'll help you with those congestion symptoms to some extent, but the definitive cure is immediate dose revision of Cabergoline as I've already mentioned..

Let me know all those details as I've mentioned..

Let me know how you stay in the due course..

Since your contacting me directly, do follow-up with me from time to time so that I can keep an eye on your progress and guide you accordingly in such case..

Best wishes

Take Care
Kind Regards

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Brief Answer:
follow-up consultation..

Detailed Answer:
Hello XXXXXXX Welcome back,
I've reviewed all the images, and yes MRI report looks apparently within normal limits only..

Please note that MRI can only pick up tumors of certain size, very small tumors is usually not picked up in the MRI..

There's an excessive intake of Cabergoline happened over such a short period of time (which I've already mentioned in my previous reply), and the dose reduction has to be done at the earliest(please discuss with your gynec at the earliest if there's delay happening due to her absence then please seek out for another Gynec/Endocrinologist at the earliest)..

Along with these, the frequency of cabergoline needs to be reduced as I've already mentioned, it's recommended only Twice weekly(means only two times in a week) and in suspected overdose and severely symptomatic cases it can even be advised once a week only..Please seek out for an Endocrinologist/Gynec to get it done after a thorough clinical examination, and as I've already mentioned, you must stay under strict follow-up of him/her and report your health status on weekly basis till they gets normalized..

For the appetite, please continue taking Tab RANITIDINE 150 mg twice daily 15-20 min before breakfast and dinner for next 15 days(if still taking Neksium, then please stop it and start the Ranitidine instead).. there's a need to get a fresh LFT and KFT along with at the earliest..

Coming to your questions :

1. Bad taste - once again can be due numerous factors, in fact right now there are so many symptoms involved, that it's hardly possible to comment which one is primary..but one thing for sure that this is not the primary concern right now.. it's a secondary concern, let's focus on getting rid of the potential hazardous side effects in the first place, and over a period of time you yourself can observe if this is also improving or remaining the same- then it can be easily attributed accordingly..

Simply try chewing the cloves and ginger streak as already advised, you'll be benefited to some extent..

2. You Should not do it on your own, inform the Gynec in the first place or seek out for an additional specialist since she's absent (an Endocrinologist will be most suited), yes definitely the dosage should be reduced to 0.25 mg or even 0.125 mg twice weekly but you have to be closely monitored for the symptomatic improvement (as I certainly don't have the privilege to examine you physically, it's better that you should do it under supervision of the Endocrinologist/Gynecologist)..

3. NO, because sudden stoppage of Cabergoline can be quite risky, can trigger several serious withdrawal effects, so it's always advisable to taper down the dose as I've mentioned, under strict medical supervision..

4. Please don't go for any more OTC's , just try the steam inhalation as already mentioned, be patient, too many medications without proper direction are equally hazardous, specially considering when there's already an ongoing drug overdose..

5. There are certain food particles, but alone this is not sufficient, however do avoid foods rich in caffeine, cheese, chocolate, eggs etc., avoid stress of any kind, stay relaxed, keep your mind busy so that no anxiety can get in side..

6. Please note that MRI can only pick up tumors of certain size, very small tumors is usually not picked up in the MRI, a review of the same MRI-film by a NEURO-RADIOLOGIST will give you the exact idea in this regard..

7. Your next Prolactin levels should be done after 1 month for further assessment..
For these queries, I'd like to share an article, a rather brief discussion in this regard, please read it thoroughly, it is particularly designed for patient education, let me know your queries afterwards :

http://www.reproductivefacts.org/uploadedFiles/ASRM_Content/Resources/Patient_Resources/Fact_Sheets_and_Info_Booklets/Prolactin_Excess.pdf

(I think after reading this, not only most of your queries will be clarified, but also you'll be able to assess further on the systematic approaches and when and how to pursue them)..

Let me know the queries afterwards..please don't delay any more and seek out for the 2nd Gynec/ Endocrinologist for these necessary steps of management as I've explained in details..

Let me know how you stay in the due course..

Take Care
Kind Regards

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