nafarelin, Synarel

  • Pharmacy Author:
    Omudhome Ogbru, PharmD

    Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.

  • Medical and Pharmacy Editor: Jay W. Marks, MD
    Jay W. Marks, MD

    Jay W. Marks, MD

    Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.

What is the dosage for nafarelin?

For treatment of endometriosis nafarelin is given as one spray (200 µg) into one nostril in the morning and one spray in the other nostril in the evening for 6 months. The first dose of nafarelin should be taken between the second and fourth day after menstrual bleeding begins. After the first two months of nafarelin treatment, most women can expect a decrease in menstrual flow, and menstruation may stop altogether. For women who continue to experience normal menstrual cycles after two months of treatment, the daily dose may be increased to 800 µg daily.

Central precocious puberty is treated with 1600-1800 µg daily administered as four sprays in alternating nostrils twice daily or three sprays in alternating nostrils three times daily. Thirty seconds should elapse between sprays.

For optimal effectiveness and safety, nafarelin has to be given continuously without interruption. Missing one or more doses can cause vaginal bleeding. Missing successive doses can cause release of an egg from the ovary (ovulation) and result in pregnancy, unless proper contraceptive measures have been followed. Since birth control pills cannot be used with nafarelin, it is important to use non-hormonal methods of contraception (such as a diaphragm with contraceptive jelly, IUD, or condoms) while taking nafarelin.

Absorption of nafarelin is not affected by a cold or runny nose. If nasal decongestant sprays are needed, they should be taken at least 2 hours before or after using nafarelin.

Which drugs or supplements interact with nafarelin?

Nasal decongestant sprays (for example, Afrin) may interfere with the absorption of nafarelin. If nasal decongestant sprays are needed, they should be used at least 2 hours before or after using nafarelin.

Quick GuideEndometriosis Symptoms, Stages, Treatment

Endometriosis Symptoms, Stages, Treatment
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