Goserelin

Drugs affecting Gonadotrophin · GnRH analogue

Indications

Endometriosis. Prostatic cancer. Advanced breast cancer in pre- and peri-menopausal women. Pre-thinning of endometrium prior to endometrial ablation or resection.

Dosage

Depot Inj 3.6 mg: Endometriosis: Adults: One 3.6 mg depot SC into anterior abdominal wall every 28 days for max 6 mth. Prostatic cancer, advanced breast cancer in pre- and peri-menopausal women: Adults: One 3.6 mg depot SC into anterior abdominal wall every 28 days. Pre-thinning of endometrium prior to endometrial ablation or resection: Adults: One 3.6 mg depot SC into anterior abdominal wall every 28 days for 4 or 8 wk. Children: Not recommended. LA Depot Inj 10.8 mg: Males: One 10.8 mg depot SC into the anterior abdominal wall, every 12 wk. Females & Children: Not recommended.

Administration

Subcutaneous Implant: Insert the hypodermic needle into the subcutaneous fat. Do not try to aspirate with the goserelin syringe. If the needle is in a large vessel, blood will immediately appear in the syringe chamber. Change the direction of the needle so it parallels the abdominal wall. Push the needle in until the barrel hub touches the patient's skin. Fully depress the plunger to discharge. Withdraw needle and bandage the site. Confirm discharge by ensuring tip of the plunger is visible within the tip of the needle. Stability: The unit is sterile and comes in a sealed, light and moisture-proof, aluminum foil laminate pouch containing a dessicant capsule. Store at room temperature (do not exceed 25°C; 77°F).

Adverse Effects

Hot flushes, headaches, emotional lability, vaginal dryness, change in breast size tenderness, libido, rashes, hypercalcaemia, mood changes, depression, paraesthesia, abnormal BP, hyperhidrosis, inj site reactions, decreased bone density, wt gain, acne, alopecia, arthralgia, vulvovaginal dryness.

Risk Factor (Pregnancy/Lactation)

Pregnancy: Contraindicated in pregnancy. Lactation: Contraindicated or not recommended. Contraindications: Non-hormonal methods of contraception should be used throughout treatment. Precautions: Patients at risk of osteoporosis. Male patients at risk from ureteric compression or spinal cord compression; monitor for 4 weeks. Consider use of antiandrogens to prevent initial flare. Risk of resistance when dilating cervix. Risk of inj site injury; use extra caution if low BMI and/or taking anticoagulants.

Interactions

Drugs that prolong QT interval or cause torsade de pointes.

Advice to Patient

Contact prescriber if there is chest pain; difficulty in breathing; palpitations; swelling of ankles, hands or feet; constipation; nausea; vomiting; chest pain; unrelieved dizziness or skin rash. Maintain appointments schedule as the medication has to be implanted under the skin of abdomen every 28 days. Wear cool clothes and stay in cool environment to prevent hot flashes. During first week of treatment, symptoms may become more worsened.

Pharmacokinetics

Onset: Females: Oestradiol suppression reaches postmenopausal levels within 3 wks and FSH and LH are suppressed to follicular phase levels within 4 wks of initiation. Males: Testosterone suppression reaches castrate levels within 2-4 wks after initiation. Duration: Females: Oestradiol, LH and FSH generally return to baseline levels within 12 wks following the last monthly implant. Males: Testosterone levels maintained at castrate levels throughout the duration of therapy. Absorption: SC: Rapid and can be detected in serum in 30-60 mins. 3.6 mg: Released slowly in first 8 days, then rapid and continuous release for 28 days. Metabolism: Hepatic. Time to peak, serum: SC: Male: 12-15 days, Female: 8-22 days. Excretion: Urine (>90%).

Compiled by Healify Pharmacy from published drug references. How we compile it →

Always consult a pharmacist or doctor.