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Goserelin Implant

(goe' se rel in)

Brand Name(s): Zoladex®

Other Name(s): Decapeptide I

WHY is this medicine prescribed?

Goserelin implant is used in combination with radiation therapy and other medications to treat localized prostate cancer and is used alone to treat the symptoms associated with advanced prostate cancer. It is also used to treat advanced breast cancer in certain women. It is also used to manage endometriosis (a condition in which the type of tissue that lines the uterus [womb] grows in other areas of the body and causes pain, heavy or irregular menstruation [periods], and other symptoms) and to help with the treatment of abnormal bleeding of the uterus. Goserelin implant is in a class of medications called gonadotropin-releasing hormone (GnRH) agonists. It works by decreasing the amount of certain hormones in the body.

Are there OTHER USES for this medicine?

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

HOW should this medicine be used?

Goserelin comes as an implant to be inserted with a syringe subcutaneously (under the skin) in your stomach area by a doctor or nurse in a medical office or clinic. An implant with 3.6 mg of goserelin is usually inserted every 4 weeks. An implant with 10.8 mg of goserelin is usually inserted every 12 weeks. The length of your treatment depends on the condition being treated and your response to the medication. Your doctor will determine how long you should use goserelin implant.

Goserelin may cause an increase in certain hormones in the first few weeks after insertion of the implant. Your doctor will monitor you carefully for any new or worsening symptoms during this time.

What SPECIAL PRECAUTIONS should I follow?

Before receiving goserelin implant,

  • tell your doctor and pharmacist if you are allergic to goserelin, histrelin (Supprelin LA, Vantas), leuprolide (Camcevi, Eligard, Fensolvi, Lupron, others), nafarelin (Synarel), triptorelin (Trelstar, Triptodur), any other medications, or any of the ingredients in goserelin implant. Ask your pharmacist for a list of the ingredients.

  • tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.

  • tell your doctor if you have a history of drinking alcohol or using tobacco products for a long period of time, or if you or anyone in your family has or has ever had osteoporosis (a condition in which the bones become thin and weak and break easily) or a prolonged QT interval (a rare heart problem that may cause irregular heartbeat, fainting, or sudden death) or if you have or have ever had a compressed spinal cord, diabetes, depression, unusual vaginal bleeding, urinary obstruction in men (blockage that causes difficulty urinating), an electrolyte imbalance in your blood, heart failure, or heart or liver disease.

  • tell your doctor if you are pregnant or plan to become pregnant. Goserelin implant should not be used in pregnant women, except for treatment of advanced breast cancer. Call your doctor right away if you think you have become pregnant during your treatment. Goserelin implant may harm the fetus.

    You should not plan to become pregnant while using goserelin implant or for 12 weeks after your treatment. Your doctor may perform a pregnancy test or tell you to begin your treatment during your menstrual period to be sure that you are not pregnant when you begin using goserelin implant. You will need to use a reliable nonhormonal method of birth control to prevent pregnancy while you are using goserelin implant and for 12 weeks after your treatment. Talk to your doctor about the types of birth control that are right for you, and continue to use birth control even though you should not have regular menstrual periods during your treatment.

    tell your doctor if you are breast-feeding. You should not breast-feed during your treatment with goserelin implant.

What SPECIAL DIETARY instructions should I follow?

Unless your doctor tells you otherwise, continue your normal diet.

What should I do IF I FORGET to take a dose?

If you miss an appointment to receive an implant of goserelin, you should call your healthcare provider right away to reschedule your appointment. The missed dose should be given within a few days.

What SIDE EFFECTS can this medicine cause?

Goserelin implant may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

  • headache
  • hot flashes (a sudden wave of mild or intense body heat)
  • sweating
  • sudden reddening of the face, neck, or upper chest
  • lack of energy
  • loss of appetite
  • breast pain or change in breast size in women
  • decreased sexual desire or ability
  • painful sexual intercourse
  • vaginal discharge, dryness, or itching
  • menstruation (periods)
  • swelling of the hands, feet, ankles, or lower legs
  • nervousness
  • unable to control emotions and frequent mood changes
  • difficulty falling asleep or staying asleep
  • pain, itching, swelling, or redness at the place where the implant was inserted

Some side effects can be serious. If you experience any of these symptoms, call your doctor immediately:

  • hives
  • rash
  • itching
  • difficulty breathing or swallowing
  • chest pain
  • pain in the arms, back, neck, or jaw
  • unusual weight gain
  • slow or difficult speech
  • dizziness or fainting
  • weakness or numbness of an arm or leg
  • bone pain
  • painful or difficult urination
  • frequent urination
  • extreme thirst
  • weakness
  • blurred vision
  • dry mouth
  • nausea
  • vomiting
  • breath that smells fruity
  • decreased consciousness
  • stomach pain
  • shortness of breath
  • vaginal bleeding
  • new or worsening depression

Goserelin implant may cause a decrease in the density of your bones which can increase the chance of broken bones and fractures. Talk to your doctor about the risks of using this medication and to find out what you can do to decrease these risks.

Goserelin implant may cause other side effects. Call your doctor if you have any unusual problems while using this medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).

What OTHER INFORMATION should I know?

Keep all appointments with your doctor.

Ask your pharmacist any questions you have about goserelin implant.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.