NAFARELIN

Brand & Generic Names

Synarel

Basic Information

• Habit forming? No
• Prescription needed? Yes
• Available as generic? No
• Drug class: Gonadotropin inhibitor

Uses

• Treatment of endometriosis to relieve pain and reduce scattered implants of endometrial tissue.
• Treatment for central precocious puberty.

Dosage & Usage Information

How to take:
Nasal spray: Follow instructions on package insert provided with your medicine.

When to take:
As directed by your doctor. Usually two times a day.

If you forget a dose:
Take as soon as you remember. Don't double this dose.

What drug does:
Reduces estrogen production from ovaries.

Time lapse before drug works:
May require 6 months for full effect.

Don't take with:
Birth control pills.
Nasal sprays to decongest the membranes in the nose.
Any other medicine without consulting your doctor or pharmacist.

Overdose

SYMPTOMS:
None expected.

WHAT TO DO:

Overdose unlikely to threaten life. If person takes much larger amount than prescribed, call doctor, poison-control center or hospital emergency room for instructions.

Possible Adverse Reactions or Side Effects

Life-threatening:

None expected.

Common:

Hot flashes.

Infrequent:

Decreased sexual desire, vaginal dryness, headache, acne, swelling of hands and feet, reduction of breast size, weight gain, itchy scalp with flaking, muscle ache, nasal irritation.

Rare:

Insomnia, depression, weight loss.

Warnings & Precautions

Don't take if:

• You become pregnant.
• You have breast cancer.
• You are allergic to any of the ingredients in nafarelin.
• You have undiagnosed abnormal vaginal bleeding.

Before you start, consult your doctor:

• If you take birth control pills.
• If you have diabetes.
• If you have heart disease.
• If you have epilepsy.
• If you have kidney disease.
• If you have liver disease.
• If you have migraine headaches.
• If you need to use topical nasal decongestants.

Over age 60:
Adverse reactions and side effects may be more frequent and severe than in younger persons.

Pregnancy:
Risk to unborn child outweighs drug benefits. Don't use. Stop if you get pregnant.

Breast-feeding:
Unknown whether medicine filters into milk. Consult doctor.

Infants & children:
Not recommended.

Prolonged use:

• Full effect requires prolonged use. Don't discontinue without consulting doctor.
• Talk to your doctor about the need for mammogram, follow-up medical examinations or laboratory studies to check liver function.

Skin & sunlight:
No special problems expected.

Driving, piloting or hazardous work:
No special problems expected.

Discontinuing:
Don't discontinue without consulting doctor. Menstrual periods may be absent for 2 to 3 months after discontinuation.

Others:

• May alter blood sugar levels in diabetic persons.
• Interferes with accuracy of laboratory tests to study pituitary gonadotropic and gonadal functions.
• Experience with nafarelin has been limited to women 18 years of age and older.
• Bone density decreases during treatment phase, but recovers following treatment.

Possible Interaction with Other Drugs

GENERIC NAME OR	COMBINED EFFECT
-------------------------	-----------------------
Decongestant nasal	Decreased absorption of nafarelin.

Possible Interaction with Other Substances

INTERACTS WITH	COMBINED EFFECT
---------------	---------------
Alcohol:	Excessive nervous system depression.
	Avoid.
Caffeine drinks.	Rapid, irregular heartbeat.
	Avoid.
Cocaine:	May interfere with expected
	action of nafarelin.
	Avoid.
Foods:	None expected.
Marijuana:	May interfere with expected action
	of nafarelin. Avoid.
Tobacco:	Rapid, irregular heartbeat;
	increased leg cramps.
	Avoid.