Type of Drug:

Synthetic hormone.

How the Drug Works:

Nafarelin is similar to natural gonadotropin releasing hormone. It stimulates the release of the pituitary hormones, luteinizing hormone (LH), and follicle stimulating hormone (FSH). These hormones stimulate the ovaries to produce estrogen and progestogen. Stimulation of the pituitary gland decreases over time.

Tissues and organs dependent on secretion of gonads hormones (estrogen and progestogen) to function, including the uterine lining (endothelium), will become less active after about 4 weeks of twice daily therapy. This causes a decrease in the symptoms of endometriosis (eg, pelvic pain, menstrual cramps, painful intercourse).

Uses:

For the management of endometriosis in women 18 years of age and older for a period not to exceed 6 consecutive months of therapy.

Also used for the treatment of central precocious puberty (CPP) in children of both sexes.

Precautions:

Do not use in the following situations: allergy to the drug, any of its ingredients, or to gonadotropin releasing hormone type drugs breastfeeding hormone.

Use with caution in the following situations: alcohol or tobacco use, chronic menstruation drug therapy that can reduce osteoporosis, family history of bone mass (eg, anticonvulsant, polycystic ovarian disease corticosteroid), current runny nose, chronic hypoestrogenism

Pregnancy: Do not use during pregnancy. The risk of use in a pregnant woman clearly outweighs any possible benefit.

Breastfeeding: It is not known if nafarelin acetate appears in breast milk. Use in nursing mothers is not recommended.

Drug Interactions:

Tell your doctor or pharmacist if you are taking or planning to take any over­the-counter or prescription medications or dietary supplements while taking this drug. Drug doses may need to be modified or a different drug prescribed. Topical nasal decongestants (eg, Afrin) interact with this drug.

Guidelines for Use:

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  Dosage is individualized. Use exactly as prescribed.
  
  



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  Do not stop taking or change the dose, unless instructed by your doctor.
  
  



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  Avoid sneezing during or immediately following administration.
  
  



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  Tilt head back slightly while administering this medicine.
  
  



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  If using more than I spray in each nostril, wait 30 seconds between sprays.
  
  



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  If the use of a topical nasal decongestant is necessary during treatment with nafarelin, do not use the decongestant until at least 2 hours after taking nafarelin.
  
  



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  If a dose is missed, inhale it as soon as possible. If several hours have passed or it is nearing time for the next dose, do not double the dose to catch up, unless instructed by your doctor. If more than one dose is missed or it is necessary to establish a new dosage schedule, contact your doctor or pharmacist.
  
  



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  Store upright at room temperature (68° to 77°F). Protect from light.
  
  



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  For endometriosis - Treatment should begin between the 2nd and 4th day of the menstrual period. Usual dose is I spray (about 200 mcg) into one nostril in the morning and I spray into the other nostril in the evening. When used regularly at the recommended dose, nafarelin usually inhibits ovulation and stops menstruation. However, use of the drug should not be considered a reliable form of contraception. Non hormonal contraceptive measures (eg, condom, diaphragm) should be used during therapy. Do not use if pregnancy is suspected, if you are breastfeeding, or if you are experiencing undiagnosed vaginal bleeding. May cause break through bleeding if doses are missed. However, if regular menstruation persists, notify your doctor.
  
  



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  The usual course of therapy is 6 months. Retreatment is not recommended.
  
  



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  For CCP- Usual dose is 2 sprays (about 400 mcg) into each nostril in the morning (4 sprays total) and 2 sprays into each nostril in the evening (4 sprays total). During the first month of treatment, some signs of puberty may occur. If this does not resolve within the first 2 months of treatment, contact your doctor.