• Palliative treatment of advanced prostate cancer.
• Locally confined stage T2b–T4 (stage B2–C) prostate cancer (in combination with flutamide).
• Palliative treatment of advanced breast cancer in peri menopausal and postmenopausal women.
• Endometriosis.
• Produces thinning of the endometrium before endometrial ablation for dysfunctional uterine bleeding.

Contraindicated in:

• Hypersensitivity
• Undiagnosed vaginal bleeding
• OB: Pregnancy
• Lactation: Lactation.

Use Cautiously in:

• Congenital long QT syndrome, HF, hypokalemia, or hypomagnesemia
• Concurrent use of other drugs known to prolong the QTc interval
• Low BMI (↑ risk of bleeding complications)
• Concurrent use of anticoagulant therapy (↑ risk of bleeding complications)
• Pedi: Safety and effectiveness not established in children.

CV: vasodilation, MI, QT interval prolongation, chest pain, hypertension, palpitations, peripheral edema.

Derm: hot flushing, sweating, acne, rash.

Endo: ↓ libido, erectile dysfunction, breast swelling, breast tenderness, infertility, ovarian cysts, ovarian hyperstimulation syndrome (with gonadotropins).

GI: anorexia, constipation, diarrhea, nausea, ulcer, vomiting.

GU: renal insufficiency, urinary obstruction.

Hemat: anemia.

Local: injection site/vascular injury.

Metab: ↑ weight, gout, hyperglycemia, hyperlipidemia.

MS: ↑ bone pain, ↓ bone density, arthralgia.

Neuro: headache, anxiety, depression (women), dizziness, fatigue, insomnia, mood swings, SEIZURES, STROKE, SUICIDAL IDEATION/BEHAVIOR (WOMEN), weakness.

Resp: dyspnea.

Misc: chills, fever.

Drug-Drug:

• None reported.

• Implant: 3.6 mg; 10.8 mg;

• SC (Adults): 3.6 mg every 4 wk or 10.8 mg every 12 wk. Endometrial thinning: 1 or 2 depots given 4 wk apart; if 1 depot used, surgery is performed at 4 wk; if 2 depots used, surgery is performed 2–4 wk after 2nd depot.

Zoladex

• Acts as a synthetic form of luteinizing hormone–releasing hormone (LHRH, GnRH). Inhibits the production of gonadotropins by the pituitary gland. Initially, levels of luteinizing hormone (LH), follicle-stimulating hormone (FSH), and testosterone increase. Continued administration leads to decreased production of testosterone and estradiol.

• Decreased spread of cancer of the prostate or breast.
• Regression of endometriosis with decreased pain.
• Thinning of the endometrium.

Therapeutic Classification: antineoplastics, hormones

Pharmacologic Classification: gonadotropin releasing hormones

Absorption: Well absorbed from SUBQ implant. Absorption is slower in first 8 days, then is faster and continuous for remainder of 28-day dosing cycle.

Distribution: Unknown.

Metabolism/Excretion: Some metabolism by the liver (<10%), some excretion by kidneys (>90%, only 20% as unchanged drug).

Half-life: 4.2 hr.

Zoladex LA

(↓ in serum testosterone levels)

• Explain purpose of goserelin to patient. Emphasize importance of adhering to the schedule of monthly or every-3-mo administration.
• Advise patient that bone pain may increase at initiation of therapy. This will resolve with time. Patient should discuss use of analgesics to control pain with health care professional.
• Advise female patients to notify health care professional if regular menstruation persists.
• Inform diabetic patients of potential for hyperglycemia. Encourage close monitoring of serum glucose.
• Advise patient that medication may cause hot flashes. Notify health care professional if these become bothersome. Hormone replacement therapy may be added to decrease vasomotor symptoms and vaginal dryness without compromising beneficial effect.
• Instruct patient to notify health care professional promptly if difficulty urinating or if symptoms of myocardial infarction or stroke (chest pain, difficulty breathing, weakness, loss of consciousness) occur.
• Rep: May cause fetal harm. Advise premenopausal women to notify health care professional if pregnancy is planned or suspected and to avoid breastfeeding. Effective nonhormonal contraception should be used during and for 12 wk after treatment ends.

GOE-se-rel-lin

NDC Code^*

• 0310- AstraZeneca Pharmaceuticals LP
  • 0310-0950- ZOLADEX
    • 0310-0950-36- 1 POUCH in 1 CARTON (0310-0950-36) > 1 SYRINGE in 1 POUCH > 1 IMPLANT in 1 SYRINGE

• 0310- AstraZeneca Pharmaceuticals LP
  • 0310-0951- ZOLADEX
    • 0310-0951-30- 1 POUCH in 1 CARTON (0310-0951-30) > 1 SYRINGE in 1 POUCH > 1 IMPLANT in 1 SYRINGE

• 50090- A-S Medication Solutions
  • 50090-2027- ZOLADEX
    • 50090-2027-0- 1 POUCH in 1 CARTON (50090-2027-0) > 1 IMPLANT in 1 POUCH

• 50090- A-S Medication Solutions
  • 50090-3466- ZOLADEX
    • 50090-3466-0- 1 POUCH in 1 CARTON (50090-3466-0) > 1 IMPLANT in 1 POUCH

• 70720- TerSera Therapeutics LLC
  • 70720-950- ZOLADEX
    • 70720-950-36- 1 POUCH in 1 CARTON (70720-950-36) > 1 SYRINGE in 1 POUCH > 1 IMPLANT in 1 SYRINGE

• 70720- TerSera Therapeutics LLC
  • 70720-951- ZOLADEX
    • 70720-951-30- 1 POUCH in 1 CARTON (70720-951-30) > 1 SYRINGE in 1 POUCH > 1 IMPLANT in 1 SYRINGE