Goserelin

Indications

Goserelin is used for: Palliative treatment of prostatic carcinoma, Pituitary desensitisation before ovulation induction with gonadotrophins, Breast Cancer, Endometriosis

Adult Dose

Subcutaneous Palliative treatment of prostatic carcinoma Adult: 3.6 mg injected into the anterior abdominal wall every 28 days or 10.8 mg every 12 wk. An anti-androgen is given several days before beginning of the treatment and continued for at least 3 wk to prevent disease flare. Pituitary desensitisation before ovulation induction with gonadotrophins Adult: 3.6 mg as a depot inj. Monitor serum-oestradiol concentrations until they decline to levels similar to those in the early follicular phase which takes about 7-21 days.

Child Dose

Renal Dose

Administration

Contra Indications

Hypersensitivity; pregnancy, lactation.

Precautions

Urinary tract obstruction or spinal cord compression (when used for prostate cancer); decreased bone density in women. Contraceptive measures should be taken to protect against pregnancy. Monitor men at risk from tumour flare during the 1st mth of therapy. Safety and efficacy on the usage of the 10.8 mg implant in women is not established. Lactation: excretion in milk unknown; not recommended

Pregnancy-Lactation

Pregnancy Category: D (advanced breast cancer); X (endometriosis, endometrial thinning) Lactation: excretion in milk unknown; not recommended

Interactions

Adverse Effects

Side effects of Goserelin : >10% Flushing (46-96%), Vaginitis (5-75%), Hot flashes (62%), Reduced libido (47-61%), Mood swings (60%), Depression (women 54%), Sweating (16-45%), Acne (42%), Diarrhea (40%), Breast atrophy (33%), Headache (women 32-75%), Seborrhea (26%), Tumor flare (23%), Sexual dysfunction (21%), Peripheral edema (21%), Erectile dysfunction (18%), Pain (8-17%), UTI (13%) 1-10% Nausea (9%), Lethargy (8%), Rash (6%), Chronic obstructive pulmonary disease (5%), Congestive heart failure(5%), Cerebrovascular accident (1-5%), Renal impairment (1-5%), Headache (men 1-5%), Depression (men 1-5%), Immune hypersensitivity reaction (>1%) Frequency Not Defined Asthenia, Hypercalcemia, Cystitis, Dysmenorrhea, Hirsutism, Dyspareunia, Breast changes, Implant site reactions, Bone pain, Spinal cord compression (rare)

Mechanism of Action

Goserelin is a potent inhibitor of pituitary gonadotrophin secretion. Initially, it causes an increase in the serum levels of FSH and LH but chronic admin will lead to sustained suppression of the pituitary gonadotrophin release causing regression of the sex organs.