Zoladex - instructions for use, reviews, analogs and forms of release (injections in capsules for hypodermic injections 3.6 mg and 10.8 mg) of the drug for the treatment of endometriosis, fibroids and breast and prostate cancer in adults, children and in pregnancy

In this article, you can read the instructions for using the drug Zoladeks. There are reviews of visitors to the site - consumers of this medication, as well as opinions of doctors of specialists on the use of Zoladex in their practice. A big request is to actively add their feedback on the drug: the medicine helped or did not help get rid of the disease, which were observed complications and side effects, possibly not declared by the manufacturer in the annotation. Analogues of Zoladex in the presence of existing structural analogues. Use for the treatment of endometriosis, fibroids and breast and prostate cancer in adults, children, as well as in pregnancy and lactation.

Zoladeks - synthetic analogue of natural GnRH (gonadotropin releasing hormone). With continued use, Zoladex inhibits pituitary glandularization of luteinizing hormone (LH), which leads to a decrease in serum testosterone concentration in men and an estradiol concentration in serum in women. This effect is reversible after the abolition of therapy. At the initial stage, Zoladex, like other GnRH agonists, can cause a temporary increase in serum testosterone concentrations in men and an estradiol concentration in the serum in women. In the early stages of Zoladex therapy, some women may experience vaginal bleeding of varying duration and intensity.

In men, approximately 21 days after the administration of the first capsule, the concentration of testosterone is reduced to castration levels and continues to be reduced with constant treatment, conducted every 28 days. This decrease in testosterone concentration in most patients leads to regression of the prostate tumor and to symptomatic improvement.

In women, the concentration of serum estradiol is also reduced by about 21 days after the administration of the first capsule and,with regular administration of the drug every 28 days, remains reduced to a level comparable to that observed in women in menopause.

This decrease leads to a positive effect with hormone-dependent forms of breast cancer, endometriosis, uterine fibroids and suppression of ovarian follicular development. This also causes thinning of the endometrium and is the cause of amenorrhea in most patients.

It is shown that Zoladex in combination with iron preparations causes amenorrhea and an increase in the level of hemoglobin and the corresponding hematological parameters in women with uterine fibroids and concomitant anemia.

Against the background of taking GnRH analogues in women, menopause may occur.

Rarely, some women do not recover menstruation after the end of therapy.

Composition

Goserelin (in the form of acetate) + auxiliary substances.

Pharmacokinetics

The administration of the capsule every 4 weeks ensures maintenance of effective concentrations. Cumulation in the tissues does not occur. Binding to plasma proteins is low.

Indications

• prostate cancer;
• mammary cancer;
• endometriosis;
• uterine fibroid;
• for thinning of the endometrium with planned operations on the endometrium;
• with in vitro fertilization.

Forms of release

Capsules for subcutaneous administration of prolonged action 3.6 mg and 10.8 mg (injections).

Other dosage forms, whether capsules or tablets for oral administration, do not exist.

Instructions for use and how to use (how to stab the drug)

Capsules 3.6 mg

An adult capsule of Zoladex 3.6 mg is injected subcutaneously into the anterior abdominal wall every 28 days.

In malignant neoplasms, the drug is used for a long time, with benign gynecological diseases - no more than 6 months.

For endometrial thinning, 2 injections are done at 4-week intervals, with ablation of the uterus being recommended in the first 2 weeks after the second dose.

In Vitro Fertilization

Zoladex 3.6 mg is used to desensitize the pituitary gland. Desensitization is determined by the concentration of estradiol in the blood serum. Typically, the required level of estradiol, which corresponds to that in the early follicular phase of the cycle (approximately 150 mmol / L), is reached between 7 and 21 days.At the onset of desensitization, stimulation of superovulation (controlled stimulation of the ovaries) with the help of gonadotropin begins. The resulting desensitization of the pituitary gland with the depot of the GnRH agonist may be more resistant, which may lead to an increased need for gonadotropin. At the appropriate stage of the development of the follicle, the administration of gonadotropin is discontinued and human chorionic gonadotropin is then introduced to induce ovulation. Control over the treatment, oocyte extraction and fertilization procedures are carried out in accordance with the established practice of this medical institution.

Elderly patients, as well as patients with renal or hepatic insufficiency, dose adjustment is not required.

Capsules 10.8 mg

For adults, a capsule of Zoladex 10.8 mg is injected subcutaneously into the anterior abdominal wall every 3 months.

Adult women capsule preparation Zoladex 10.8 mg is injected subcutaneously into the anterior abdominal wall every 12 weeks.

Patients with renal or hepatic insufficiency, as well as patients of advanced age, do not need dose adjustment.

Side effect

• a pituitary tumor;
• degeneration of fibromatous nodes in women with uterine fibroid;
• hypersensitivity reactions;
• anaphylactic reactions;
• hemorrhage in the pituitary gland;
• violation of glucose tolerance;
• hypercalcemia (in women);
• decreased libido, associated with the pharmacological effect of the drug and, in rare cases, leading to its abolition;
• decreased mood;
• depression (in women);
• paresthesia;
• compression of the spinal cord (in men);
• headache (in women);
• psychotic disorder;
• tides associated with the pharmacological action of the drug and, in rare cases, leading to its cancellation;
• myocardial infarction (in men);
• heart failure (in men), the risk of which increases with the simultaneous appointment of antiandrogenic drugs;
• hypotension or hypertension;
• increased sweating;
• alopecia (in women), as a rule, slightly expressed (including in young patients with benign neoplasms);
• alopecia (in men), which manifested itself as hair loss throughout the body due to decreased levels of androgens;
• rash;
• arthralgia;
• pain in the bones (in men);
• erectile disfunction;
• dryness of the vaginal mucosa and increase in the size of the mammary glands;
• gynecomastia;
• tenderness of the mammary glands (in men);
• obstruction of ureters (in men);
• ovarian cyst;
• syndrome of ovarian hyperstimulation;
• vaginal bleeding;
• reaction at the injection site;
• a temporary increase in the symptoms of the disease in patients with breast cancer at the beginning of therapy;
• decrease in bone mineral density;
• increase in body weight.

Contraindications

• pregnancy;
• lactation;
• childhood;
• hypersensitivity to goserelin or other analogues of GnRH.

Application in pregnancy and lactation

The drug is contraindicated for use in pregnancy and lactation.

Use in children

Contraindicated in childhood.

special instructions

It should be carefully appointed Zoladex to men who are at particular risk of developing obstruction of the ureters or squeezing the spinal cord. This category of patients should be closely monitored during the first month of therapy. In the event that compression or development of spinal cord compression or renal failure due to obstruction of the ureters, a standard treatment for these complications should be prescribed.

When using Zoladex in women before the restoration of menstruation should be used non-hormonal methods of contraception.

As with other GnRH analogues, when Zoladex was used in combination with gonadotropin, there were reports of rare cases of the development of the ovarian hyperstimulation syndrome (CGSS). It is assumed that desensitization caused by the use of Zoladex can lead in some cases to an increase in the required dose of gonadotropin. It is necessary to carefully monitor cycle stimulation to identify patients at risk of developing CHD because the severity and frequency of the syndrome may depend on the dose regimen of the gonadotropin. The introduction of human chorionic gonadotropin should be discontinued if required.

The use of GnRH analogues in women can cause a decrease in bone mineral density. After the termination of treatment in the majority of women there is a restoration of mineral density of an osteal tissue. In patients treated with Zoladex for the treatment of endometriosis, the addition of hormone replacement therapy (estrogen and progestogen drugs daily) reduced the loss of bone mineral density and vasomotor symptoms.

The resumption of menstruation after the end of treatment with Zoladex in some patients may occur with a delay. In rare cases, some women during the treatment of GnRH analogs may have the onset of menopause without restoring menstruation after the end of therapy.

The use of Zoladex can lead to an increase in cervical resistance, care must be taken when dilating the cervix.

There is no data on the efficacy and safety of Zoladex therapy for benign gynecological diseases lasting more than 6 months.

The drug Zoladex should be used for in vitro fertilization only under the supervision of a specialist with experience in this field.

It is recommended to use with caution the drug Zoladex for in vitro fertilization in patients with polycystic ovary syndrome, tk. it is possible to stimulate a large number of follicles.

According to preliminary data, the use of bisphosphonate in combination with GnRH agonists in men helps to reduce the loss of bone mineral density.In connection with the possibility of developing a decrease in glucose tolerance against the acceptance of GnRH agonists in men, it is recommended to periodically monitor the glucose level in the blood.

Impact on the ability to drive vehicles and manage mechanisms

There is no evidence that Zoladeks impairs the ability to drive vehicles and work with machinery.

Drug Interactions

The drug interaction of Zoladex is not described.

Analogues of the drug Zoladex

Structural analogues for the active substance of the drug Zoladex does not. The drug has a unique active ingredient in its composition.

Analogues for the pharmacological group (antitumor hormonal drugs):

• Anabrez;
• Anandron;
• Anaster;
• Anastrozole;
• Andriol;
• Androblok;
• Androkur;
• Androkur Depot;
• Arimidex;
• Aromasine;
• Aromeston;
• Balutar;
• Bicalutamide;
• Bicutuler;
• Bikaprost;
• Biel;
• Bilumide;
• Buserelin;
• Genfastat;
• Hormoplex;
• Decapeptil;
• Depot Provera;
• Depostat;
• Derremiril;
• The Divigel;
• Diferelin;
• Zitazonium;
• Zytiga;
• Kalumid;
• Casodex;
• Climara;
• Lestrodex;
• Letroza;
• Letrozole;
• Letros;
• Letrotera;
• Lucrin Depot;
• Mammoth;
• Megeis;
• Nexazole;
• Novofen;
• Nolvadex;
• Octreotide;
• Octretex;
• Octrid;
• Omnadren 250;
• Organometr;
• Auret;
• Orimeten;
• Prajisan;
• Premarin;
• Provera;
• Progesterone;
• Projest;
• The prostate;
• Sandostatin;
• Selana;
• Sinestrol;
• Suprefact;
• Sustanon 250;
• Tamoxen;
• Tamoxifen;
• Fazlodex;
• Fareston;
• Femara;
• Firmagon;
• Flutakan;
• Flutamide;
• Flutaplex;
• Flucin;
• Egistrazole;
• Exemestane;
• Extrase;
• Eligard;
• Estarizol;
• Estradurine;
• Estimax;
• Estrogele;
• Etrusil.

Similar medicines:

Other medicines: