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Goserelin (Zoladex ®)

Warning: Goserelin should not be given to a pregnant woman as it can cause fetal harm. The medication is also associated with hypoestrogenism (reduced level of estrogen) symptoms such as hot flashes (flushes), headaches, vaginal dryness, erectile dysfunction or change in libido, depression, sweating and change in breast size. Although very rare, Goserelin can increase the risk for a stroke or heart attack in patients with heart problems.  

The drug should be used cautiously in patient having risk factors for osteoporosis, chronic tobacco or alcohol use and patients receiving drugs that affect bone density.   

Indication: Goserelin is used mainly to treat prostate cancer in men. It is also used in women for breast cancer and certain uterine disorders (endometriosis). It is also used to thin the walls of the uterus to prepare it for a procedure that will stop abnormal uterine bleeding.

This treatment is comparable to a hormone that is naturally produced in the body (luteinizing hormone releasing hormone). It is effective because it lowers the estrogen in women and the testosterone in men. Women should not take the 10.8 milligram syringe.

Dosage: Goserelin is implanted in your body by a medical professional. It slowly releases hormones into your body over weeks and months. It is usually inserted into the abdomen, below the navel. There is no need to remove this implant because it is entirely absorbed over a few weeks or months.

Your doctor may prescribe you different methods of receiving this medication. The 3.6 milligram syringe may be prescribed to inject once every four weeks. There is also a 10.8 milligram syringe that is injected once every 12 weeks.

During the first couple of weeks of starting this treatment you may experience an increase in hormones and testosterone. You may also feel the side effects more, such as increased pain and size in tumor. Women usually stop having a period altogether after receiving Goserelin. If you are still experiencing a period after 2 months, consult your doctor.  

Your body will usually absorb all of the medicine, however, if you are experiencing side effects that are uncomfortable and not getting any relief your doctor may want to take it out. Consult your doctor if you are experiencing side effects. 

Overdose: To prevent serious complications, the medication should be taken exactly according to the indications on the label. In fact, not only Goserelin, but taking any medication in the right dose is the first step to better treatment. No fatal case of Goserelin overdose has been reported so far; however, as is the case with any drug, an overdose of Goserelin can cause serious health problems. If you feel that you have been given an overdose, contact your doctor immediately.  

Missing dose: Avoiding missing dose and taking the medication at right time are keys to get good results from any drug including Goserelin. Therefore, keep all appointment with your doctor and lab technicians. If for some reasons you cannot be present at the hospital for the treatment, contact your health care provider before the date schedule for the injection.  

Before taking this medication or any tell your doctor of all of your medical history as well as your family’s history of: long-term alcohol use, smoking, osteoporosis, heart problems, stroke, high cholesterol, urinary blockage (men), spinal cord problems (men), and unusual abnormal vaginal bleeding (women).  

Goserelin may also affect heart health of some patients. It can cause a rapid heartbeat, as well as make you feel dizzy and faint. Tell your doctor of all heart problems you have experienced in the past, as this may not be the medication for you.

Pregnant women should not take this medication as it may cause harm to an unborn baby.   

smoking cigarette and drinking alcohol are strongly prohibited when being treated with Goserelin . 

Mechanism of action (MOA): The hypothalamus uses LHRH (luteinizing hormone-releasing hormone ) to transmit messages to the hypophysis (also called pituitary gland), another gland in the brain. Having received the message, the hypophysis command, by impulsion, to the ovaries in women and testes in men to produce the sex hormones estrogen (female hormone) and testosterone (male hormone). Some forms of cancer cells need these hormones to survive and multiply. Goserelin works by stopping the production of these hormones.   

Interactions: Your doctor and pharmacist should know all of the medication you are taking to avoid any possible interactions. Keep a list of all medications you are taking. Some birth control methods (pill and patch) and medications that cause bone loss are known to interact with Goserelin.  

Tell your oncologist if you are taking or planing to take vitamin supplements or St. John's wort. Some medications can alter the effects of Goserelin, or increase the risk of side effects. Tell your doctor or pharmacist if you are taking any of these medications:  

  • testosterone or androgens (men)
  • estrogen-containing birth control (women)
  • Medications that promote loss of bone density, such as prednisone. 

Side effects: In addition to attacking cancer cells, Goserelin also affects healthy cells that multiply rapidly; this often cause adverse effects in most patients. Most common Goserelin side effects include: 

  • vision changes
  • constipation
  • hot flashes
  • decreased sexual desire
  • weight gain
  • headaches
  • bone pain
  • trouble sleeping
  • nausea or vomiting
  • pelvic pain (women)
  • cessation of menstruation (women)
  • reduced volume of testes (male)
  • Swelling and tenderness of the breasts 

You should see your health care immediately if you experience any of these symptoms: 

  • fainting
  • vaginal dryness
  • emotionality
  • increased amount of body hair
  • chest pain
  • infertility (men and women)

 

 

References: 

 

1 - FDA Approval for Goserelin  3.6 mg  

2-  http://en.wikipedia.org/wiki/Goserelin 

3 - http://www.pharmacyescrow.com/s6-fr-801-s-GOSERELIN .aspx