Goserelin Brand Name– Zoladex
What is Goserelin
Goserelin is a synthetic gonadotropin-releasing hormone (GnRH) agonist administered as a subcutaneous depot.
It is used for the palliative treatment of advanced prostate cancer or breast cancer, for the management of endometriosis, dysfunctional uterine bleeding, and the adjunct medical management of uterine myomas (fibroids).
In males, after an initial increase in serum testosterone levels, treatment with goserelin leads to suppression of serum testosterone to castration levels approximately 2 to 4 weeks after initiation of therapy.
In females, a similar down-regulation of the pituitary gland leads to decreases in serum estradiol to levels consistent with the postmenopausal state within 3 weeks of the first dose.
Transient worsening of tumor symptoms may occur during the first few weeks of treatment, which may include ureteral obstruction and spinal cord compression; monitor patients at risk for complications of tumor flare.
Indications
- benign prostatic hyperplasia (BPH)
- breast cancer
- dysfunctional uterine bleeding
- endometriosis
- prostate cancer
- uterine leiomyomata
For the treatment of breast cancer
Side Effects
- abdominal pain
- acne vulgaris
- alopecia
- amblyopia
- anaphylactoid reactions
- anemia
- angina
- anorexia
- antibody formation
- anxiety
- appetite stimulation
- arthralgia
- asthenia
- back pain
- bleeding
- bone fractures
- bone pain
- breast enlargement
- chest pain (unspecified)
- chills
- constipation
- cough
- cystitis
- depression
- diabetes mellitus
- diaphoresis
- diarrhea
- dizziness
- drowsiness
- dysmenorrhea
- dyspareunia
- dyspepsia
- dyspnea
- ecchymosis
- edema
- elevated hepatic enzymes
- emotional lability
- epistaxis
- fatigue
- fever
- flatulence
- gout
- gynecomastia
- headache
- heart failure
- hematemesis
- hematoma
- hematuria
- hirsutism
- hot flashes
- hypercalcemia
- hyperglycemia
- hyperlipidemia
- hypertension
- hypertonia
- hypotension
- impotence (erectile dysfunction)
- increased urinary frequency
- infection
- influenza
- injection site reaction
- insomnia
- irritability
- lethargy
- libido decrease
- malaise
- mastalgia
- menorrhagia
- migraine
- muscle cramps
- myalgia
- myocardial infarction
- nausea
- new primary malignancy
- osteopenia
- osteoporosis
- ovarian hyperstimulation syndrome (OHSS)
- palpitations
- paresthesias
- pelvic pain
- peptic ulcer
- peripheral edema
- peripheral vasodilation
- pharyngitis
- pituitary apoplexy
- proctitis
- pruritus
- psychosis
- pulmonary embolism
- QT prolongation
- rash
- renal failure (unspecified)
- rhinitis
- seborrhea
- seizures
- sinus tachycardia
- sinusitis
- skin discoloration
- spinal cord compression
- stroke
- thrombosis
- tumor flare
- urinary incontinence
- urinary retention
- vaginal bleeding
- vaginitis
- visual impairment
- vomiting
- weight gain
- xerophthalmia
- xerosis
- xerostomia
Monitoring Parameters
- blood glucose
- glycosylated hemoglobin A1c (HbA1c)
- pregnancy testing
Contraindications
- anticoagulant therapy
- apheresis
- AV block
- bradycardia
- breast-feeding
- cardiomyopathy
- celiac disease
- children
- contraception requirements
- diabetes mellitus
- females
- fever
- geriatric
- Gonadotropin-Releasing Hormone (GnRH) analogs hypersensitivity
- heart failure
- human immunodeficiency virus (HIV) infection
- hyperglycemia
- hyperparathyroidism
- hypocalcemia
- hypokalemia
- hypomagnesemia
- hypothermia
- hypothyroidism
- infants
- infertility
- laboratory test interference
- long QT syndrome
- myocardial infarction
- neonates
- obesity
- pheochromocytoma
- pituitary insufficiency
- pregnancy
- pregnancy testing
- QT prolongation
- reproductive risk
- rheumatoid arthritis
- sickle cell disease
- sleep deprivation
- spinal cord compression
- stroke
- systemic lupus erythematosus (SLE)
- urinary tract obstruction
Goserelin is contraindicated in patients with hypersensitivity to goserelin, GnRH, or with Gonadotropin-Releasing Hormone (GnRH) Analogs hypersensitivity; anaphylactic reactions to synthetic GnRH or GnRH agonist analogs have been reported
Interactions
- Aclidinium; Formoterol
- Albuterol
- Albuterol; Ipratropium
- Alfuzosin
- Amiodarone
- Amitriptyline
- Amitriptyline; Chlordiazepoxide
- Amoxapine
- Amoxicillin; Clarithromycin; Lansoprazole
- Amoxicillin; Clarithromycin; Omeprazole
- Anagrelide
- Androgens
- Apomorphine
- Arformoterol
- Aripiprazole
- Arsenic Trioxide
- Artemether; Lumefantrine
- Asenapine
- Atomoxetine
- Azithromycin
- Bedaquiline
- Bismuth Subcitrate Potassium; Metronidazole; Tetracycline
- Bismuth Subsalicylate; Metronidazole; Tetracycline
- Brexpiprazole
- Budesonide; Formoterol
- Buprenorphine
- Buprenorphine; Naloxone
- Cariprazine
- Ceritinib
- Chloroquine
- Chlorpromazine
- Ciprofloxacin
- Cisapride
- Citalopram
- Clarithromycin
- Clofazimine
- Clomipramine
- Clozapine
- Codeine; Phenylephrine; Promethazine
- Codeine; Promethazine
- Crizotinib
- Danazol
- Dasatinib
- Desipramine
- Deutetrabenazine
- Dextromethorphan; Promethazine
- Dextromethorphan; Quinidine
- Disopyramide
- Dofetilide
- Dolasetron
- Dolutegravir; Rilpivirine
- Donepezil
- Donepezil; Memantine
- Doxepin
- Dronedarone
- Droperidol
- Efavirenz
- Efavirenz; Emtricitabine; Tenofovir
- Efavirenz; Lamivudine; Tenofovir Disoproxil Fumarate
- Eliglustat
- Emtricitabine; Rilpivirine; Tenofovir alafenamide
- Emtricitabine; Rilpivirine; Tenofovir disoproxil fumarate
- Encorafenib
- Entrectinib
- Eribulin
- Erythromycin
- Erythromycin; Sulfisoxazole
- Escitalopram
- Esterified Estrogens; Methyltestosterone
- Ezogabine
- Fingolimod
- Flecainide
- Fluconazole
- Fluoxetine
- Fluoxetine; Olanzapine
- Fluoxymesterone
- Fluphenazine
- Fluticasone; Salmeterol
- Fluticasone; Umeclidinium; Vilanterol
- Fluticasone; Vilanterol
- Fluvoxamine
- Formoterol
- Formoterol; Mometasone
- Foscarnet
- Gemifloxacin
- Gemtuzumab Ozogamicin
- Gilteritinib
- Glasdegib
- Glycopyrrolate; Formoterol
- Granisetron
- Halogenated Anesthetics
- Haloperidol
- Hydrochlorothiazide, HCTZ; Methyldopa
- Hydroxychloroquine
- Hydroxyzine
- Ibutilide
- Iloperidone
- Imipramine
- Indacaterol
- Indacaterol; Glycopyrrolate
- Inotuzumab Ozogamicin
- Itraconazole
- Ivosidenib
- Ketoconazole
- Lapatinib
- Lefamulin
- Lenvatinib
- Levalbuterol
- Levofloxacin
- Lithium
- Lofexidine
- Long-acting beta-agonists
- Loperamide
- Loperamide; Simethicone
- Lopinavir; Ritonavir
- Lorcaserin
- Loxapine
- Macimorelin
- Maprotiline
- Mefloquine
- Meperidine; Promethazine
- Mesoridazine
- Metaproterenol
- Methadone
- Methyldopa
- Methyltestosterone
- Metoclopramide
- Metronidazole
- Midostaurin
- Mifepristone
- Mirtazapine
- Molindone
- Moxifloxacin
- Nandrolone Decanoate
- Nilotinib
- Nortriptyline
- Octreotide
- Ofloxacin
- Olanzapine
- Olodaterol
- Ondansetron
- Osilodrostat
- Osimertinib
- Oxaliplatin
- Oxandrolone
- Oxymetholone
- Ozanimod
- Paliperidone
- Panobinostat
- Pasireotide
- Pazopanib
- Pentamidine
- Perphenazine
- Perphenazine; Amitriptyline
- Phenylephrine; Promethazine
- Pimavanserin
- Pimozide
- Pirbuterol
- Pitolisant
- Posaconazole
- Prasterone, Dehydroepiandrosterone, DHEA (Dietary Supplements)
- Prasterone, Dehydroepiandrosterone, DHEA (FDA-approved)
- Primaquine
- Procainamide
- Prochlorperazine
- Promethazine
- Propafenone
- Protriptyline
- Quetiapine
- Quinidine
- Quinine
- Ramelteon
- Ranolazine
- Reserpine
- Ribociclib
- Ribociclib; Letrozole
- Rilpivirine
- Risperidone
- Romidepsin
- Salmeterol
- Saquinavir
- Selpercatinib
- Sertraline
- Short-acting beta-agonists
- Siponimod
- Solifenacin
- Sorafenib
- Sotalol
- Sunitinib
- Tacrolimus
- Tamoxifen
- Telavancin
- Telithromycin
- Terbutaline
- Testolactone
- Testosterone
- Tetrabenazine
- Thiethylperazine
- Thioridazine
- Thiothixene
- Tiotropium; Olodaterol
- Tolterodine
- Toremifene
- Trandolapril; Verapamil
- Trazodone
- Triclabendazole
- Trifluoperazine
- Trimipramine
- Umeclidinium; Vilanterol
- Valbenazine
- Vandetanib
- Vardenafil
- Vemurafenib
- Venlafaxine
- Verapamil
- Voriconazole
- Vorinostat
- Ziprasidone
