GnRH analogues Previous Next A number of different GnRH analogues exist, including: goserelin acetate leuprorelin acetate nafarelin Administration: SC injection (daily, monthly, or 3-monthly) intranasally intravaginally. They produce a prolonged activation of the GnRH receptor, resulting in an initial ↑ in FSH and LH secretion: this may cause a worsening of symptoms (‘initial flare’). Continued activation of the receptor leads to ↓ LH/FSH secretion: serum oestradiol levels are suppressed by approximately 21 days remain at similar levels to postmenopausal women with continued dosing. Indications and adverse effects are shown in Boxes 18.1 and 18.2. Adequate barrier contraception should be used during treatment as there is a theoretical risk of teratogenicity and miscarriage. Bone mineral density (BMD) Up to 6% BMD may be lost after the first 6mths treatment. If treatment is to be continued for longer than 3mths, the use of ‘addback’ HRT is recommended: combined GnRH agonist and HRT add-back has been shown to be safe for a period of up to 5–10yrs. Resumption of menstruation and return of fertility occur soon after stopping treatment. Previous Next
Posted on: Fri, 04 Jul 2014 12:33:22 +0000
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