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ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS › ENDOCRINE THERAPY › HORMONES AND RELATED AGENTS › Gonadotropin releasing hormone analogues
goserelin
L02AE03
Forms & Strengths
- Subcutaneous implant: 3.6 mg
- Subcutaneous implant: 10.8 mg
Adult Dosing
- Prostate cancer: 3.6 mg SC every 28 days or 10.8 mg SC every 12 weeks
- Breast cancer / Endometriosis: 3.6 mg SC every 28 days
Pediatric Dosing
- Central precocious puberty: Not officially indicated; use GnRH analogs like leuprolide preferred
Indications
- Palliative treatment of advanced prostate cancer
- Palliative treatment of advanced breast cancer in pre- and perimenopausal women
- Endometriosis (pain management and reduction of lesions)
- Endometrial thinning prior to endometrial ablation
Mechanism of Action
- Synthetic decapeptide analogue of luteinizing hormone-releasing hormone (LHRH / GnRH)
- Initially causes a transient surge in serum testosterone and estradiol (flare effect)
- Continuous administration leads to down-regulation of pituitary GnRH receptors
- Results in castration-level suppression of testosterone in men and marked suppression of estradiol in women
Contraindications
- Hypersensitivity to goserelin or other GnRH analogues
- Pregnancy and lactation (Category X)
Adverse Reactions
- Hot flashes and vasomotor symptoms
- Decreased libido and sexual dysfunction
- Bone mineral density loss / osteoporosis risk
- Tumor flare phenomenon upon initiation
- Injection site reactions, pain, or hemorrhage
- Mood changes, depression, and fatigue
Drug Interactions
- Drugs that prolong the QT interval (concurrent use may increase risk of Torsades de Pointes)
- Androgen or estrogen receptor modulators (may counteract pharmacodynamic efficacy)
Curated Content: Needs Vetting Before Put to Clinical Use