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Zoladex (Goserelin)

Warnings: You may be allergic to one or more of the ingredients in Zoladex, so be sure to warn your doctor if you know of any allergies and watch for any warning signs. You should not take Zoladex while pregnant or if you are planning to become pregnant. It is normal in the first few weeks of treatment for your condition to worsen slightly or your tumor to grow just a little. While this reaction is normal within the first few weeks of treatment, if the growth is severe or continues for more than a few weeks, let your doctor know immediately. There are many side effects associated with Zoladex, some of which may be very serious, or even life threatening. Talk about the possible complications with your doctor before you begin treatments.

Indication: Zoladex can be used in combination with radiation therapy and sometimes with other medications in order to treat prostate cancer, or it can also be used on its own.  It can also be used to treat breast cancer and certain uterine problems in women, or prepare a woman for a surgery involving her uterus.

Zoladex is a hormonal treatment, and works by mimicking a hormone that occurs naturally in the body. When the levels of this hormone increase, testosterone will decrease in men and estrogen will decrease in women. This will help to slow the growth of cancer cells which depend on these hormones to thrive, namely those cancers which start in the sex organs.

The medication is also used to treat Endometriosis, a non-cancerous but painful overgrowth in the inner membrane (endometrium) inside or outside the uterus. Zoladex is also used to thin the lining of the uterus before surgery of the uterus. In addition, Zoladex is recommended for other medical conditions such as stopping or reducing production of testosterone and estradiol.  

Dosage:  Zoladex is an insert which is placed into the body through an injection. Depending on whether you are taking the 3.6-milligram injections or the 10.8-milligram injections, you will need to have an appointment once every 4 or 12 weeks to have another insert put in. The hormones will be slowly released from the insert and then eventually, over a period of months to years, the insert itself will be absorbed into the body.

Interactions: As a hormonal medication, Zoladex will not react with many medications but may change how your medications work. Some of these include dexamethasone, methylprednisolone, and prednisone, or any medication which may cause bone loss. Any type of hormonal medication, including birth control, may also become ineffective while you are on Zoladex.

Contraindications: Talk to your doctor about any tobacco or alcohol use, family history of osteoporosis, diabetes, a compressed spinal cord, urinary obstruction, unusual vaginal bleeding, or a history of heart or liver disease, as taking Zoladex may cause additional complications, some of which may be life threatening.

The medication is contraindicated or should be used with precautions in the following conditions: 

  • breastfeeding   
  • infants or children  
  • diabetes (unless under strict medical supervision)   
  • severe high blood pressure (unless under strict medical supervision)  
  • having undiagnosed abnormal vaginal bleeding   
  • being female over 50 years (unless under strict medical supervision)   
  • having undergone orchiectomy or pulpectomy (removing the testicles or their content)  
  • pregnancy - if you use contraceptives to avoid pregnancy during treatment, take a no- hormonal contraceptives  
  • Allergy to Zoladex or to one of its constituents.

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. Zoladex works by stopping the production of these hormones.  

 

Side effects:  Zoladex also affects healthy cells that multiply rapidly; this often cause adverse effects in most patients. most common Zoladex 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 

If  the side effects above persist for weeks, contact your oncologist. In addition, contact your doctor if you experience any of these symptoms: 

  • fainting
  • vaginal dryness
  • emotionality
  • increased amount of body hair
  • chest pain
  • fever
  • breathing problem 
  • chills
  • rapid heartbeat
  • painful urination  

Zoladex can cause infertility in men and women  

References: 

 

1 - FDA Approval for Zoladex 3.6 mg  

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

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