Goserelin

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

  1. benign prostatic hyperplasia (BPH)
  2. breast cancer
  3. dysfunctional uterine bleeding
  4. endometriosis
  5. prostate cancer
  6. uterine leiomyomata

For the treatment of breast cancer

Side Effects

  1. abdominal pain
  2. acne vulgaris
  3. alopecia
  4. amblyopia
  5. anaphylactoid reactions
  6. anemia
  7. angina
  8. anorexia
  9. antibody formation
  10. anxiety
  11. appetite stimulation
  12. arthralgia
  13. asthenia
  14. back pain
  15. bleeding
  16. bone fractures
  17. bone pain
  18. breast enlargement
  19. chest pain (unspecified)
  20. chills
  21. constipation
  22. cough
  23. cystitis
  24. depression
  25. diabetes mellitus
  26. diaphoresis
  27. diarrhea
  28. dizziness
  29. drowsiness
  30. dysmenorrhea
  31. dyspareunia
  32. dyspepsia
  33. dyspnea
  34. ecchymosis
  35. edema
  36. elevated hepatic enzymes
  37. emotional lability
  38. epistaxis
  39. fatigue
  40. fever
  41. flatulence
  42. gout
  43. gynecomastia
  44. headache
  45. heart failure
  46. hematemesis
  47. hematoma
  48. hematuria
  49. hirsutism
  50. hot flashes
  51. hypercalcemia
  52. hyperglycemia
  53. hyperlipidemia
  54. hypertension
  55. hypertonia
  56. hypotension
  57. impotence (erectile dysfunction)
  58. increased urinary frequency
  59. infection
  60. influenza
  61. injection site reaction
  62. insomnia
  63. irritability
  64. lethargy
  65. libido decrease
  66. malaise
  67. mastalgia
  68. menorrhagia
  69. migraine
  70. muscle cramps
  71. myalgia
  72. myocardial infarction
  73. nausea
  74. new primary malignancy
  75. osteopenia
  76. osteoporosis
  77. ovarian hyperstimulation syndrome (OHSS)
  78. palpitations
  79. paresthesias
  80. pelvic pain
  81. peptic ulcer
  82. peripheral edema
  83. peripheral vasodilation
  84. pharyngitis
  85. pituitary apoplexy
  86. proctitis
  87. pruritus
  88. psychosis
  89. pulmonary embolism
  90. QT prolongation
  91. rash
  92. renal failure (unspecified)
  93. rhinitis
  94. seborrhea
  95. seizures
  96. sinus tachycardia
  97. sinusitis
  98. skin discoloration
  99. spinal cord compression
  100. stroke
  101. thrombosis
  102. tumor flare
  103. urinary incontinence
  104. urinary retention
  105. vaginal bleeding
  106. vaginitis
  107. visual impairment
  108. vomiting
  109. weight gain
  110. xerophthalmia
  111. xerosis
  112. 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