Zoladex

How does it work?

Goserelin acetate is a type of medicine known as a gonadorelin (LHRH) analogue. It acts on the pituitary gland in the brain. The pituitary gland produces and stores various hormones, including the sex hormones, luteinising hormone (LH) and follicle-stimulating hormone (FSH). In the male, LH released from the pituitary gland causes the testes to produce testosterone. FSH and testosterone cause the production of sperm by the testes. In the female, FSH and LH cause the production of oestrogen by the ovaries and help control the menstrual cycle. The amount of LH and FSH released from the pituitary gland is controlled by another hormone, called gonaderelin (LHRH), which acts on LHRH receptors in the pituitary gland. Goserelin acetate is a synthetic form of gonaderelin. It acts on the LHRH receptors in the pituitary gland, in the same way as natural gonadorelin. Initially, goserelin causes an increase in the amount of FSH and LH released from the pituitary gland. However, chronic administration of goserelin desensitises the pituitary gland. This means that it produces less and less FSH and LH, which in turn stops the production of oestrogens in the female and androgens in the male. This reduction in the levels of sex hormone can be exploited to treat disorders that are linked to levels of oestrogen or testosterone. The growth of some breast cancers is stimulated by oestrogen, and that of some prostate cancers by testosterone. Because these cancers are sensitive to the sex hormones, goserelin can be used in their treatment. Reducing the body's levels of these hormones causes the tumours to shrink. This treatment does not provide a cure, but rather improves quality of life and increases life expectancy. Similarly, goserelin is used to treat endometriosis in women, a condition where tissue resembling the womb or uterus lining (endometrium) is found in other sites in the body. The growth of this tissue is stimulated by oestrogen, so decreasing oestrogen levels will stop the growth. Administration of goserelin in women results in decreased oestrogen levels. This thins the lining of the womb (endometrium) and most women's periods will stop during treatment. This effect is used to thin the endometrium prior to endometrial surgery, and also to treat women with fibroids who have become anaemic. Goserelin is also used to desensitise the pituitary gland and stop the natural production of FSH and LH, in women with infertility caused by ovulation problems. Synthetic FSH and LH are then administered to stimulate ovulation.

What is it used for?

Breast cancer

Endometriosis

Fibroids of the uterus

Preparing the pituitary gland prior to infertility treatment

Preparing the uterus lining (endometrium) prior to surgery

Prostate cancer

Warning!

This medicine should be used with caution in men at particular risk of developing a blockage of the kidney tubes (ureteric obstruction) or spinal cord compression.

This medicine may cause a loss of bone mineral density. In women treated for endometriosis, bone mineral loss can be reduced if hormone replacement therapy (HRT) is also prescribed.

Women should use a non-hormonal method of contraception during treatment with this medicine.

Use with caution in

Polycystic ovary syndrome

Women with metabolic bone disease, eg osteoporosis

Not to be used in

Allergy to other LHRH analogues, eg buserelin

Children

Pregnancy

This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy. If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.

Pregnancy and Breastfeeding

Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.

This medicine should not be used during pregnancy. A non-hormonal method of contraception, eg condoms, should be used by women who could get pregnant. Seek medical advice from your doctor.

The use of this medicine during breastfeeding is not recommended. Seek medical advice from your doctor.

Side effects

Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.

Headache

Abnormal enlargement of breasts in men (gynaecomastia)

Bruising or pain at injection site

Pins and needles (paraesthesia)

Hot flushes

Pain in the joints (arthralgia)

Decrease in the density of bone

Changes in blood pressure

Development of fluid filled sacks (cysts) in the ovaries

Vaginal dryness

Decreased sex drive

Damage to the pituitary gland due to haemorrhage or decreased blood supply (pituitary apoplexy) following initial administration

The side effects listed above may not include all of the side effects reported by the drug's manufacturer. For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.

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