Ganirelix

Indications

Ganirelix is used for: Ovarian stimulation, Assisted reproduction

Adult Dose

Subcutaneous Female Infertility 250 mcg SC qDay during mid-to-late follicular phase after initiating follicle-stimulating hormone on day 2 and 3 of the cycle, continue therapy until day of hCG administration Hepatic impairment: Moderate to severe: Contraindicated.

Child Dose

Renal Dose

Renal impairment: Moderate to severe: Contraindicated.

Administration

Contra Indications

Hypersensitivity, pregnancy, lactation, moderate to severe renal or hepatic impairment.

Precautions

Women with active allergic conditions or a history of allergies. Lactation: Excretion unknown; not recommended

Pregnancy-Lactation

Pregnancy Contraindicated in pregnant women Animal data When administered from Day 7 to near term to pregnant rats and rabbits at doses up to 10 and 30 mcg/day (~0.4 to 3.2 times the human dose based on body surface area), ganirelix acetate increased the incidence of litter resorption There was no increase in fetal abnormalities No treatment-related changes in fertility, physical, or behavioral characteristics were observed in the offspring of female rats treated with ganirelix acetate during pregnancy and lactation Lactation Should not be used by lactating women Unknown whether drug is excreted in human milk Consider the developmental and health benefits of breastfeeding along with the mother’s clinical need for the drug, and any potential adverse effects on the breastfed infant from the drug or from the underlying maternal condition

Interactions

May require dose adjustment of exogenous gonadotropins when concomitantly used during controlled ovarian hyperstimulation.

Adverse Effects

Side effects of Ganirelix : 1-10% Abdominal pain (1%), Headache (3%), Injection site recation (1%), Nausea (1%), Ovarian hyperstimulation syndrome (2%), Vaginal bleeding (2%), Pelvic pain (5%) <1% Anaphylactoid reactions

Mechanism of Action

Ganirelix is a gonadorelin (gonadotrophin-releasing hormone) antagonist. It competitively blocks the gonadotropin-release hormone receptors on the pituitary gonadotroph and transduction pathway. This suppresses gonadotropin secretion and luteinising hormone secretion thus preventing ovulation until the follicles are of adequate size.