Nafarelin Acetate(naf’ a re lin)
Synarel
PREGNANCY CATEGORY X
Drug class
Gonadotropin-releasing hormone (GnRH)
Therapeutic Actions
A potent agonistic analogue of GnRH, which is released from the hypothalamus to stimulate LH and FSH release from the pituitary; these hormones are responsible for regulating reproductive status. Repeated dosing abolishes the stimulatory effect on the pituitary gland, leading to decreased secretion of gonadal steroids by about 4 wk; consequently, tissues and functions that depend on gonadal steroids for their maintenance become quiescent.
Indications
Treatment of endometriosis, including pain relief and reduction of endometriotic lesions
Treatment of central precocious puberty in children of both genders
Contraindications and Cautions
Contraindicated with known sensitivity to GnRH, GnRH-agonist analogues, excipients in the product; undiagnosed abnormal vaginal bleeding; pregnancy; lactation (potential androgenic effects on the fetus).
Use cautiously with rhinitis.
Available Forms
Nasal solution—2 mg/mL (200 mcg/spray)
Dosages
Adults
Endometriosis: 400 mcg/day. One spray (200 mcg) into one nostril in the morning and 1 spray into the other nostril in the evening. Start treatment between days 2 and 4 of the menstrual cycle. 800-mcg dose may be administered as 1 spray into each nostril in the morning (a total of 2 sprays) and again in the evening for patients with persistent regular menstruation after 2 months of treatment. Treatment for 6 mo is recommended. Retreatment is not recommended because safety has not been established.
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