Goserelin
Indications
Goserelin is used for:
Palliative treatment of prostatic carcinoma, Pituitary desensitisation before ovulation induction with gonadotrophins, Breast Carcinoma
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
Interactions
Adverse Effects
Side effects of Goserelin :
Vaginal bleeding and dryness, arthralgia, paraesthesias, increase in menstrual bleeding, hot flushes, sexual dysfunction. Headache, emotional lability, depression, insomnia, diaphoresis, dizziness, breast swelling/tenderness, Inj site reactions. Anaphylaxis.
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.