GOSERELIN (Systemic)
Some commonly used brand names are:
In the U.S.?
In Canada?
Category
- Gonadotropin-releasing hormone analog
- Antiendometriotic agent
- Antineoplastic
- Gonadotropin inhibitor
Description
Goserelin (GOE-se-rel-in) is a hormone similarto the one normally released from the hypothalamus gland in the brain. Itis used to treat a number of medical problems. These include:
- Cancer of the prostate in men
- Cancer of the breast in women if it develops before or around thetime of menopause
- Endometriosis, a painful condition caused by extra tissue growinginside or outside of the uterus and
- Thinning of the lining of the uterus before surgery on the uterus
When given regularly as an implant, goserelin works every day to decreasethe amount of estrogen and testosterone in the blood.
Reducing the amount of estrogen in the body is one way of treating endometriosisand cancer of the breast, and can help thin the uterus lining before surgery.Goserelin prevents the growth of tissue associated with endometriosis in adultwomen during treatment and for up to 6 months after treatment is discontinued.
Reducing the amount of testosterone in the body is one way of treatingcancer of the prostate.
Suppressing estrogen can thin the bones or slow their growth. This is aproblem for adult women whose bones are no longer growing like the bones ofchildren. This is why goserelin is used only for up to 6 months in adult womentreated for endometriosis.
Goserelin is to be given only by or under the supervision of your doctor.It is injected under the skin and is available in the following dosage form:
Parenteral- Implants (U.S. and Canada)
Before Using This Medicine
In deciding to use a medicine,the risks of taking the medicine must be weighed against the good it willdo. This is a decision you and your doctor will make. For goserelin, the followingshould be considered:
Allergies?Tell your doctor if you have ever had any unusual orallergic reaction to goserelin, buserelin, gonadorelin, histrelin, leuprolide,or nafarelin.
Pregnancy?Goserelin is not recommended for use during pregnancy.This medicine may cause birth defects if taken by a woman during pregnancyor may cause a miscarriage to occur. Use of a nonhormonalcontraceptive is recommended for women who are taking goserelin. Althoughthe chance of becoming pregnant is decreased while you are taking this medicine,a pregnancy can still occur. Tell your doctor immediately if you think youhave become pregnant.
Breast-feeding?It is not known whether goserelin passes into breastmilk. However, use of goserelin is not recommended during breast-feeding becauseit may cause unwanted effects in nursing babies.
Children?Studies of this medicine have been done only in adultpatients, and there is no specific information comparing use of goserelinin children younger than 18 years of age with use in other age groups. Endometriosisis not likely to occur before puberty.
Older adults?Many medicines have not been tested in older people.Therefore, it may not be known whether they work exactly the same way theydo in younger adults. Although there is no specific information comparinguse of goserelin in the elderly to use in other age groups, it has been usedmostly in elderly patients and is not expected to cause different side effectsor problems in older people than it does in younger adults.
Other medicines?Although certain medicines should not be usedtogether at all, in other cases two medicines may be used together even ifan interaction might occur. In these cases, your doctor may want to changethe dose, or other precautions may be necessary. Tell your doctor and pharmacistif you are taking any other prescription or nonprescription (over-the-counter[OTC]) medicine.
Other medical problems?The presence of other medicalproblems may affect the use of goserelin. Make sure you tell your doctor ifyou have any other medical problems, especially:
- Changes in vaginal bleeding from an unknown cause?Gonadorelinmay delay diagnosis or worsen condition. The reason for the bleeding shouldbe determined before goserelin is used
- Conditions that increase the chances of developing thinning bonesor
- Osteoporosis (brittle bones), history of, or family history of?Itis important that your doctor know if you already have an increased risk ofosteoporosis. Some things that can increase your risk for having osteoporosisinclude cigarette smoking, alcohol abuse, and a family history of osteoporosisor easily broken bones. Some medicines, such as corticosteroids (cortisone-likemedicines) or anticonvulsants (seizure medicine), can also cause thinningof the bones when used for a long time
- Nerve problems caused by bone lesions in the spine (in treatmentof cancer of the prostate) or
- Problems in passing urine (in treatment of cancer of the prostate)?Conditionsmay get worse for a short time after goserelin treatment is started
Proper Use of This Medicine
Goserelinsometimes causes unwanted effects such as hot flashes or decreased sexualability. However, it is very important that you continue to receive the medicine,even after you begin to feel better. Do not stop treatmentwith this medicine without first checking with your doctor.
Dosing?The dose of goserelin will be different fordifferent patients. Goserelin implants are usually given by a doctor in theoffice or hospital. The following information includes only the average doseof goserelin:
- For implants dosage form:
- For treating cancer of the breast:
- Adults?3.6 milligrams (mg) (one implant) injected under theskin of the upper abdomen every twenty-eight days.
- Children up to 18 years of age?Use and dose must be determinedby the doctor.
- For treating cancer of the prostate:
- Adults?3.6 milligrams (mg) (one implant) injected under theskin of the upper abdomen every twenty-eight days or 10.8 mg (one implant)injected under the skin of the upper abdomen every twelve weeks.
- Children up to 18 years of age?Use and dose must be determinedby the doctor.
- For treating endometriosis:
- Adults?3.6 milligrams (mg) (one implant) injected under theskin of the upper abdomen every twenty-eight days for six months.
- Children up to 18 years of age?Use must be determined by thedoctor.
- For thinning the uterus before surgery of the uterus:
- Adults?3.6 milligrams (mg) (one implant) injected under theskin of the upper abdomen every twenty-eight days for two doses.
- Children up to 18 years of age?Use and dose must be determinedby the doctor.
Missed dose?If you miss getting a dose of this medicine, receiveit as soon as possible.
Precautions While Using This Medicine
It isvery important that your doctor check your progress at regular visitsto make sure that this medicine is working properly and to check for unwantedeffects.
For women?
- During the time you are receiving goserelin, your menstrual periodmay not be regular or you may not have a menstrual period at all. This isto be expected when being treated with this medicine. If regular menstrualperiods continue during treatment or do not begin within 2 to 3 months afteryou stop using this medicine, check with your health care professional.
- To prevent pregnancy if you are sexually active and able to becomepregnant, you should use birth control methods that do not contain hormones,such as vaginal spermicides with condoms, a diaphragm, or a cervical cap.If you have any questions about this, check with your health care professional.
- If you suspect you are pregnant, check with yourdoctor immediately. There is a chance goserelin could cause problemsto the unborn baby if taken during a pregnancy.
During use of goserelin, and usually for a short time after discontinuingit, the medicine decreases fertility in men by reducing sperm counts and inmany women by suppressing egg development. Be sure you have discussed thiswith your doctor before receiving the medicine.
Side Effects of This Medicine
Along with its needed effects, a medicine may cause some unwanted effects.Although not all of these side effects may occur, if they do occur they mayneed medical attention.
Get emergency help immediately if any of the following side effects occur:
For adults
Rare
Bone, muscle, or joint pain; changesin skin color of face; fainting; fast or irregular breathing; numbness or tinglingof hands or feet; puffiness or swelling of the eyelidsor around the eyes; shortness of breath; skin rash, hives, and/or itching; sudden,severe decrease in blood pressure and collapse; tightness in chest or wheezing; troubled breathing
Check with your doctor assoon as possible if any of the following side effects occur:
Other side effects may occur that usually do not need medicalattention. These side effects may go away during treatment as your body adjuststo the medicine. However, check with your doctor if any of the following sideeffects continue or are bothersome:
For females and males
Less common
Blurred vision; burning, itching, redness,or swelling at place of injection; decreased interestin sexual intercourse; dizziness; headache; nausea or vomiting; swelling and increased tenderness of breasts; swellingof feet or lower legs; trouble in sleeping; weight gain
Other side effects not listed above may also occur insome patients. If you notice any other effects, check with your doctor.
Revised: 06/09/2000
