Monograph Details
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Ob/Gyn
> Endometriosis
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SYNAREL |
| Manufacturer |
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Pfizer Labs |
| Legal Classification |
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Rx
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| Pharmacological Class |
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GnRH analogue. |
| Generic Name |
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Nafarelin (as acetate) 200micrograms/spray; intranasal soln. |
| Indications |
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Endometriosis. |
| Children |
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Not applicable. |
| Adults |
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≥18yrs: Start between days 2 and 4 of menstrual cycle. 400micrograms daily as 1 spray in one nostril in AM and repeat in other nostril in PM. If menstruation continues after 2 months of therapy, increase to 800micrograms daily as 1 spray each nostril AM and PM. Max therapy 6 months. |
| Contraindications |
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Undiagnosed abnormal vaginal bleeding. Pregnancy (Cat.X). Nursing mothers. |
| Precautions |
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Exclude pregnancy before treatment. Use nonhormonal contraception during therapy. Discontinue immediately if pregnancy occurs. Patients should adhere to regimen carefully. Missing successive doses may lead to breakthrough bleeding or ovulation. Risk factors for decreased bone mineral density (e.g., chronic alcohol or tobacco abuse, family history of osteoporosis, chronic corticosteroids or anticonvulsants). Avoid sneezing during or immediately after dosing. |
| Interactions |
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Avoid nasal decongestants until at least 2 hrs after dosing. |
| Adverse Reactions |
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Hypoestrogenic: hot flashes, decreased libido, vaginal dryness, headache, emotional lability, insomnia, bone density loss. Androgenic: acne, myalgia, breast size reduction, edema, seborrhea, weight gain, hirsutism, increased libido. Ovarian cysts. Nasal irritation. |
| How Supplied |
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Nasal spray—8mL (60 sprays) |
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