NAFARELIN

COMMON BRAND NAME(S): Synarel

GENERIC NAME(S): NAFARELIN ACETATE

 

Description: Nafarelin is a gonadotrophin-releasing hormone (GnRH) causes stimulation of gonadotrophin release in the initial phase (single dose) but with continued admin, stimulation is reversed resulting in the inhibition of gonadotrophin release.

Pharmacokinetics:

Absorption: Rapidly absorbed (intranasal). Peak plasma concentrations within 20 min; bioavailability: About 3%.

Distribution: Protein-binding: 80%.

Metabolism: Metabolised by peptidases.

Excretion: SC admin: Via urine (as metabolites) and faeces (as unchanged drug).

  • Used for
    • Treatment of endometriosis
      • Aids in decrease the abnormal tissue and also the symptoms of endometriosis (e.g., pelvic pain, painful menstrual cramps, and pain during/after sex)
      • Also used in children to treat gonadotropin-dependent central precocious puberty
        • Slows bone aging and height growth rate to almost normal and to stop or reverse signs of early puberty (e.g., breast growth in girls, growth of sexual organs in boys)
      • It is man-made hormone that is similar to a natural hormone made by the body (gonadotropin-releasing hormone-GnRH)
        • Decreasesthe testosterone hormones in boys and estrogen hormones in women and girls.

 

  • Always refer to your doctors instructions before taking this medication. Duration and dosage will be determined by your medical condition and its response to the medication. Make sure to take this mediciation in the prescribed amount and time period even after symptoms disappear. Discontinuing the medication before completion of treatment may cause incomplete treatment of condition. If Symptoms persist, consult your doctor
  • Nose must be clear before using this drug by gently blowing your nose. A bulb syringe may be used to clear the nose of very young children
  • Nasal spray; usually twice a day
  • If used with a nasal decongestant spray, wait at least 2 hours after using this medication

 

When you first start this medication, worsening of symptoms may occur (e.g., increased vaginal bleeding in endometriosis, or vaginal bleeding/period, increase in breast size/pubic hair, oily skin, or body odor in early puberty). Such symptoms should get better after the first month of treatment. Inform your doctor if your symptoms worsen or persist after 2 months.

    • Minor side effects (if these symptoms persist or worsen, inform your doctor)
      • Nasal irritation, hot flashes, vaginal discharge, or mood swings may occur in children. Nasal irritation, hot flashes, headaches, mood swings, decreased sexual interest, muscle pain, vaginal dryness, acne, or decrease in breast size
      • Increased vaginal bleeding in endometriosis, or vaginal bleeding/period, increase in breast size/pubic hair, oily skin, or body odor in early puberty

     

    • Serious side effects (inform your doctor immediately)
      • abdominal/lower back pain, bone pain, depression
      • fast/pounding heartbeat, numbness/tingling of arms/legs, eye pain
      • Pitutitary apoplexy
        • sudden severe headache, mental/mood changes (e.g., confusion), vision changes, vomiting.

     

    • Severe allergic reactions are rare. Get immediate medical help if you notice the following:
      • Rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing
    • Precautions:
      • Inform your doctor
        • Allergy to the medication or to GnRH or other GnRH-like hormones (e.g., leuprolide) or any allergies
        • Medical History of unexplained abnormal vaginal bleeding smoking, daily alcohol use, bone loss (osteoporosis) or family history of osteoporosis, polycystic ovarian disease, high cholesterol/triglyceride levels.

       

      • Should not be used during pregnancy as it may harm an unborn baby. If you are planning to be pregnant or think you may be pregnant, discuss the risks and benefits of use with your doctor.

       

      • It is not known if this drug passes into breast milk. Before breast-feeding, consult your physician.

       

      Interactions:

       

      Taking multiple drugs may affect how medications work and/or cause unwanted side effects. List down all the medications you are taking and inform your physician and pharmacist. Do not take, discontinue, or alter any dose of medications without prior approval of your physician.

       

      • Products that may interact with this medication include:
        • estrogens, birth control pills, medications that can cause bone loss (e.g., corticosteroids such as prednisone)
      • Labratory tests that may be affected:
        • tests for pituitary gonadotropic and gonadal functions)
    • Overdose: If overdose is suspected, contact a poison control center or emergency room immediately.

       

      Missed Dose

      If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose and As soon as you remember, take a regular dose or if the time of the next dose is near, wait for it before taking another dose and resume your usual schedule. Do not increase the dose to compensate for the missed dose.

       

      Storage

      • Room temperature at 77 degrees F (25 degrees C)
      • Do not store at temperatures above 86 degrees F (30 degrees C)
      • Do not freeze
      • Do not expose to light and moisture
      • Do not store in the bathroom

      Keep all medications away from pets and children

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