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Zoladex  (Goserelin)

 

Brand name: Zoladex ®  

 

Generic name:Goserelin  

Other names: Goserelin acetate 

Therapeutic Class: lutenizing hormone releasing hormone (LHRH) agonist [also known as a gonadotropin releasing hormone (GnRH) agonist analogue]
 

Manufacturer / Distributor: AstraZeneca 

FDA Approval: Zoladex (Goserelin) was approved by the U.S. Food and Drug Administration in 1989 for treatment of Prostate cancer; other indications were subsequently approved.  

Availability: Zoladex is available by prescription only  

Indication: Zoladex is used to treat:

  • Prostate cancer  
  • breast cancer in premenopausal and perimenopausal (the phase before menopause) women
  • Endometriosis, a non-cancerous but painful overgrowth in the inner membrane (endometrium) inside or outside the uterus.

Zoladex is also used to thin the lining of the uterus before surgery of the uterus. In addition, Zoladex is recommended for other medical conditions such as stopping or reducing production of testosterone and estradiol. Talk to your pharmacist or physician to have more information on ZOLADEX.  

Dosage form:  Zoladex is given by injection under the skin in the stomach area.  

Dosage: to recommend you the dosage of Zoladex most capable of fighting the cancer, your oncologist will base on your age, whether or not you are taking other medications, and body surface area (BSA). You can start feeling better days or weeks after you begin to take Zoladex; however, you should not neglect or stop taking the medication. If in the other hand, you develop severe adverse reactions, consult your physician before taking any decision.  

Usually, if you are taking Zoladex for long term, 10.8 mg of the drug will be injected under the skin of your abdomen every 12 or 13 weeks. It is necessary that the Injection is made by a physician or a health professional with experience in chemotherapy medications. During treatment with Zoladex, certain activities such as cigarette smoking and alcohol consumption are strictly prohibited; using them can aggravate side effects of Zoladex.  

Overdose: Zoladex should be taken exactly according to the indications on the label. In fact, not only Zoladex, but taking any medication in the right dose is the first step to better treatment. No fatal case of Zoladex overdose has been reported so far; however, as is the case with any drug, an overdose of Zoladex can cause serious health problems. If you feel that you have been given an overdose, contact your doctor immediately.  

Missing dose: a delayed or missed dose of zoladex can cause serious health problems such as vaginal bleeding in women . Avoiding missing dose and taking the medication at right time are keys to get good results from any drug including Zoladex. Therefore, keep all appointment with your doctor and lab technicians. If for some reasons you cannot be present at the hospital for the treatment, contact your health care provider before the date schedule for the injection.  

Contraindications : Zoladex is contraindicated or should be used with precautions in the following conditions: 

  • breastfeeding  
  • infants or children 
  • diabetes (unless under strict medical supervision)  
  • severe hypertension (unless under strict medical supervision) 
  • having undiagnosed abnormal vaginal bleeding  
  • being female over 50 years (unless under strict medical supervision)  
  • having undergone orchiectomy or pulpectomy (removing the testicles or their content) 
  • pregnancy - if you use contraceptives to avoid pregnancy during treatment, take a no- hormonal contraceptives 
  • Allergy to Zoladex or to one of its constituents. In addition, tell your doctor if you are allergic to the following medications: 

a)      histrelin (Supprelin) 

b)      leuprolide (Lupron)  

c)      gonadorelin (Factrel, Lutrepulse) 

d)      menotropins (Humegon, Pergonal, Repronex).  

Note : smoking cigarette and alcohol consumption are strictly prohibited during treatment with zoladex. 

Mechanism of action (MOA): The hypothalamus uses LHRH (luteinizing hormone-releasing hormone ) to transmit messages to the hypophysis (also called pituitary gland), another gland in the brain. Having received the message, the hypophysis command, by impulsion, to the ovaries in women and testes in men to produce the sex hormones estrogen (female hormone) and testosterone (male hormone). Some forms of cancer cells need these hormones to survive and multiply. Zoladex works by stopping the production of these hormones.   

 Interactions:  if you are taking zoladex, tell your doctor before taking vitamins, nutritional supplements or St. John's wort. Some medications can alter the effects of Zoladex, or increase the risk of side effects. Tell your doctor or pharmacist if you are taking any of these medications:  

  • testosterone or androgens (men)
  • estrogen-containing birth control (women)
  • Medications that promote loss of bone density, such as prednisone.   

Side effects: In addition to attacking cancer cells, Zoladex also affects healthy cells that multiply rapidly; this often cause adverse effects in most patients. most common Zoladex side effects include: 

  • vision changes
  • constipation
  • hot flashes
  • decreased sexual desire
  • weight gain
  • headaches
  • bone pain
  • trouble sleeping
  • nausea or vomiting
  • pelvic pain (women)
  • cessation of menstruation (women)
  • reduced volume of testes (male)
  • Swelling and tenderness of the breasts.  

If the side effects above persist for weeks, contact your oncologist. In addition, contact your doctor if you experience any of these symptoms: 

  •   fainting 
  •   vaginal dryness 
  •   emotionality 
  •   increased amount of body hair 
  •   chest pain 
  •   difficulty breathing 
  •   fever 
  •   chills 
  •   rapid heartbeat 
  •   painful urination 

Note : Zoladex can cause infertility in men and women  

References: 

 

1 - FDA Approval for Zoladex 3.6 mg  

2-  http://en.wikipedia.org/wiki/Goserelin 

3 - http://www.pharmacyescrow.com/s6-fr-801-s-ZOLADEX.aspx

 

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