rubbish nafarelin (Nasal route) naf-a-REL-in Overview Side Effects Dosage Professional Pregnancy More User Reviews Support Group Q & A Commonly used brand name(s) In the U.S. Synarel Available Dosage Forms: Spray Therapeutic Class: Endocrine-Metabolic Agent Pharmacologic Class: Luteinizing Hormone Releasing Hormone Agonist Slideshow Endometriosis: A Healthcare Professional's Guide Uses For nafarelin Nafarelin nasal spray is a synthetic (man-made) hormone that is similar to a natural hormone that is produced in the brain. It is used for the treatment of: Central precocious puberty (CPP), a condition which causes early puberty in boys (before 9 years of age) and in girls (before 8 years of age), or Endometriosis, a painful condition caused by extra tissue growing inside or outside of the uterus (womb). When given regularly to boys and girls experiencing early puberty, nafarelin slows down the development of genital areas in both sexes. It will also slow breast development in girls. nafarelin will delay puberty as long as the child continues to use it. When given regularly to women, nafarelin decreases estrogen levels which helps treat endometriosis. It prevents the growth of tissue caused by endometriosis in adult women during treatment and for 6 months after treatment is discontinued. Suppressing estrogen can cause thinning of the bones or slowing of growth. This is a problem for adult women whose bones are no longer growing. Slowing the growth of bones is a positive effect for girls and boys whose bones grow too fast when puberty begins too early. Boys and girls may benefit by adding inches to their adult height when nafarelin causes their bones to grow at the proper and expected rate for children. nafarelin is available only with your doctor's prescription. Before Using nafarelin In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For nafarelin, the following should be considered: Allergies Tell your doctor if you have ever had any unusual or allergic reaction to nafarelin or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully. Pediatric Appropriate studies performed to date have not demonstrated pediatric-specific problems that would limit the usefulness of nafarelin nasal spray in children. Nafarelin will stop having an effect on a child treated for central precocious puberty soon after the child stops using it, and puberty will advance normally. Appropriate studies have not been performed on the relationship of age to the effects of nafarelin nasal spray for the treatment of endometriosis in the pediatric population. Safety and efficacy have not been established. Geriatric No information is available on the relationship of age to the effects of nafarelin nasal spray in geriatric patients. Pregnancy Pregnancy Category Explanation All Trimesters X Studies in animals or pregnant women have demonstrated positive evidence of fetal abnormalities. This drug should not be used in women who are or may become pregnant because the risk clearly outweighs any possible benefit. Breast Feeding Studies in women breastfeeding have demonstrated harmful infant effects. An alternative to this medication should be prescribed or you should stop breastfeeding while using nafarelin. Interactions with Medicines Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking nafarelin, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive. Using nafarelin with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take. Amifampridine Amisulpride Bepridil Cisapride Dronedarone Mesoridazine Pimozide Piperaquine Saquinavir Sparfloxacin Terfenadine Thioridazine Ziprasidone Using nafarelin with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines. Alfuzosin Amiodarone Amitriptyline Anagrelide Apomorphine Aripiprazole Aripiprazole Lauroxil Arsenic Trioxide Asenapine Astemizole Atazanavir Azithromycin Bedaquiline Chloroquine Chlorpromazine Ciprofloxacin Citalopram Clarithromycin Clomipramine Clozapine Crizotinib Cyclobenzaprine Dabrafenib Dasatinib Delamanid Desipramine Deutetrabenazine Disopyramide Dofetilide Dolasetron Domperidone Donepezil Doxepin Droperidol Ebastine Efavirenz Eribulin Erythromycin Escitalopram Famotidine Felbamate Fingolimod Flecainide Fluconazole Fluoxetine Formoterol Foscarnet Fosphenytoin Galantamine Gatifloxacin Gemifloxacin Granisetron Halofantrine Haloperidol Hydroquinidine Hydroxychloroquine Hydroxyzine Ibutilide Iloperidone Imipramine Itraconazole Ivabradine Ketoconazole Lapatinib Levofloxacin Lumefantrine Mefloquine Methadone Metronidazole Mifepristone Mizolastine Moxifloxacin Nelfinavir Nilotinib Norfloxacin Octreotide Ofloxacin Olanzapine Ondansetron Paliperidone Panobinostat Paroxetine Pasireotide Pazopanib Pentamidine Perphenazine Pimavanserin Pipamperone Pitolisant Posaconazole Probucol Procainamide Prochlorperazine Promethazine Propafenone Protriptyline Quetiapine Quinidine Quinine Ranolazine Ribociclib Rilpivirine Risperidone Ritonavir Sertindole Sevoflurane Sodium Phosphate Sodium Phosphate, Dibasic Sodium Phosphate, Monobasic Solifenacin Sorafenib Sotalol Sulpiride Sunitinib Tacrolimus Tamoxifen Telaprevir Telavancin Telithromycin Tetrabenazine Tizanidine Tolterodine Toremifene Trazodone Trimipramine Vandetanib Vardenafil Vemurafenib Venlafaxine Vilanterol Vinflunine Voriconazole Vorinostat Zuclopenthixol Interactions with Food/Tobacco/Alcohol Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco. Other Medical Problems The presence of other medical problems may affect the use of nafarelin. Make sure you tell your doctor if you have any other medical problems, especially: Abnormal or unusual vaginal bleeding Should not be used in patients with this condition. Alcohol abuse or Cigarette smoking or Conditions that increase the chances of developing thinning bones or Osteoporosis (brittle bones), or history of Increases your risk of developing osteoporosis. Brain tumors, history of or Seizures or epilepsy, history of or Use with caution. May increase risk for seizures. Depression, history of or Mental problems, history of or Polycystic ovarian disease (PCOD) or Pituitary gland problem or Rhinitis (swelling or irritation of the nose) Use with caution. May make these conditions worse. Proper Use of nafarelin Use nafarelin only as directed by your doctor . Do not use more of it, do not use it more often, and do not use it for a longer time than your doctor ordered. Do not change your dose or stop using nafarelin without checking first with your doctor. nafarelin comes with patient instructions. Read and follow these instructions carefully and make sure you understand: How to prepare the nasal spray. How to use the spray. How long the spray can be stored. nafarelin is only used in the nose . Do not get it in your eyes or on your skin. If it does get on these areas, rinse them with water right away and call your doctor. To use nafarelin spray: Before you use each new bottle of nafarelin, the spray pump needs to be primed first. To do this, point the bottle away from you and pump the bottle firmly about 7 times until a fine mist spray appears. This only needs to be done once for each new bottle of nafarelin. Be careful not to breathe in this spray. You could inhale extra doses of nafarelin, since the medicine is dissolved in the spray. Before you use nafarelin spray, blow your or your child's nose gently to clear the nostrils. You can also use a bulb syringe to clean your child's nose. For central precocious puberty: Tilt your child's head back slightly. Put the tip of the bottle into your child's nostril. Close the other nostril with your finger. At the same time, let your child sniff in the spray as you pump the bottle once. Allow 30 seconds between sprays in the same nostril. Keep your child's head tilted back for a few seconds after spraying nafarelin to let the spray get onto the back of the nose. For endometriosis: Lean your head forward. Put the spray tip into one nostril. Aim the tip toward the back and outside of your nostril. You do not need to put the tip too far into your nose. Close your other nostril with your finger. At the same time, sniff in the spray as you pump the bottle once. Do not spray nafarelin in your other nostril unless your doctor tells you to. Tilt your head backwards for a few seconds after spraying nafarelin to let the spray get onto the back of your nose. Repeat these steps for each dose of the medicine. Each time you use the spray bottle, wipe off the tip with a clean tissue or cloth. Keep the white safety clip and plastic cap on the bottle when you are not using it. Be sure to clean the tip of the spray bottle before and after every use. To do this, hold the bottle sideways. Rinse the tip with warm water, while wiping the tip with your finger or a soft cloth for about 15 seconds. Dry the tip with a soft cloth or tissue. Replace the cap right after use. Be careful not to get water into the bottle, since this could dilute the medicine. Do not try to make the tiny hole in the spray tip larger. Doing so, may deliver a wrong dose of the medicine. If you are also using a nasal decongestant, do not use it at the same time you are using nafarelin. Wait at least 2 hours after using nafarelin spray before using the nasal decongestant. Avoid sneezing when spraying and immediately after using the medicine. If you sneeze, the medicine may not be absorbed as well. Many boys and girls who have central precocious puberty will not feel sick or will not understand the importance of taking nafarelin regularly. Nafarelin must be given on a regular schedule. Women with endometriosis should start using nafarelin between the 2nd and 4th day of their menstrual period, unless instructed otherwise by your doctor. nafarelin is used for six months. Dosing The dose of nafarelin will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of nafarelin. If your dose is different, do not change it unless your doctor tells you to do so. The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine. For nasal dosage form (spray): For treatment of central precocious puberty: Children Two sprays in each nostril two times a day, taken in the morning and in the evening. This provides a total dose of 8 sprays a day. Some patients may need a larger dose by using 3 sprays in alternating nostrils three times a day to provide a total of 9 sprays per day. For treatment of endometriosis: Adults One spray in one nostril in the morning and one spray into the other nostril in the evening, taken for 6 months. Begin your treatment on Day 2, 3, or 4 of your menstrual period. Children Use and dose must be determined by your doctor. Missed Dose If you miss a dose of nafarelin, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses. Storage Keep out of the reach of children. Do not keep outdated medicine or medicine no longer needed. Ask your healthcare professional how you should dispose of any medicine you do not use. Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing. Keep the bottle upright. Do not freeze. After you prime the bottle, there will only be 60 doses or sprays. Keep track of the number of sprays you use. Throw the bottle away after you use 60 sprays (for 30 days) even if some liquid remains. Precautions While Using nafarelin It is very important that your doctor check the progress of you or your child at regular visits to make sure that nafarelin is working properly. Blood tests may be needed to check for unwanted effects. Be sure to keep all appointments. For female patients : You should not use nafarelin if you are pregnant or may become pregnant. Using nafarelin while you are pregnant can harm your unborn baby. Use an effective form of birth control to keep from getting pregnant during treatment with nafarelin. If you think you have become pregnant while using the medicine, tell your doctor right away. For children using nafarelin spray for central precocious puberty (CPP) : nafarelin can cause a brief increase in blood levels of some hormones. During this time, you may notice more signs of puberty in your child, including light vaginal bleeding and breast enlargement in girls. If your child's symptoms do not improve within 4 weeks, or if they get worse, call your doctor. For adult women using nafarelin spray for endometriosis : For the first few days of treatment, the symptoms of your condition may get worse. This is normal. Do not stop using nafarelin. Talk with your doctor if you have concerns about this. During the time you are using nafarelin, your menstrual period may not be regular or you may not have a menstrual period at all. This is to be expected when being treated with nafarelin. If regular menstruation does not begin within 2 to 3 months after you stop using nafarelin, check with your doctor. During the time you are using nafarelin spray, you should use birth control methods that do not contain hormones, such as condoms, IUD, a diaphragm or a cervical cap with a spermicide. If you have any questions about this, check with your doctor. Use a water-based vaginal lubricant product if dryness of the vagina causes problems, such as pain during sexual intercourse. Make sure the lubricant you choose can be used with a latex birth control device if you are using one. Some lubricants contain oils, which can break down the latex rubber of condoms, a cervical cap, or a diaphragm, and cause them to rip or tear. nafarelin can cause your bone mineral density to decrease, which may lead to osteoporosis or weakened bones. Talk with your doctor about how this risk will affect you. If you suspect you may have become pregnant, stop using nafarelin and check with your doctor right away. There is a chance that continued use of nafarelin during pregnancy could cause birth defects or a miscarriage. nafarelin may cause some people to be agitated, irritable, or display other abnormal behaviors. Make sure the doctor knows if you have trouble sleeping, get upset easily, have a big increase in energy, or start to act reckless. Also tell the doctor if you have sudden or strong feelings, such as feeling nervous, angry, restless, violent, or scared. If you or your caregiver notice any of these side effects, tell your doctor right away. Using nafarelin may increase your risk of having seizures. Check with your doctor right away if you start to have convulsions, muscle spasm or jerking of all extremities, sudden loss of consciousness, or loss of bladder control. Nafarelin spray can increase your risk of having cysts in the ovaries. Talk to your doctor about this risk. Before you have any medical tests, tell the medical doctor in charge that you are using nafarelin. The results of some tests may be affected by nafarelin. Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements. nafarelin Side Effects Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention. Check with your doctor immediately if any of the following side effects occur: More common For adults (female) Breast enlargement light vaginal bleeding between regular menstrual periods, called spotting longer or heavier menstrual periods vaginal bleeding between regular menstrual periods, called breakthrough bleeding For children (male) Body odor growth of pubic hair For children (female) Body odor breast enlargement growth of pubic hair light vaginal bleeding between regular menstrual periods, called spotting longer or heavier menstrual periods vaginal bleeding between regular menstrual periods, called breakthrough bleeding Less common Chest pain rash, hives or welts, itching redness of the skin Less common or rare For adults (female) Fast or irregular heartbeat numbness or tingling of the hands or feet pain in the eyes or joints patchy brown or dark brown discoloration of the skin pelvic bloating or tenderness unexpected or excess milk flow from the breasts unusual tiredness or weakness Incidence not known For adults (female) Cough difficulty with speaking dizziness or lightheadedness double vision fainting fast heartbeat inability to move the arms, legs, or facial muscles inability to speak nausea pain or discomfort in the arms, jaw, back, or neck pain, redness, or swelling in the arm or leg slow speech sweating troubled breathing vomiting yellow eyes or skin Incidence not known Anxiety or mental depression changes in vision cold, clammy, or pale skin confusion convulsions headache irregular heartbeats nightmares or unusually vivid dreams slow heart rate vomiting weakness Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them: More common For adults (female) Acne dandruff hot flashes increase or decrease in sexual desire increased hair growth, often abnormally distributed mood swings muscle pain oily skin pain during sexual intercourse rapid weight gain reduced breast size stopping of menstrual periods swelling of the feet or lower legs vaginal dryness For children (male) Acne dandruff mood swings oily skin For children (female) Acne dandruff hot flashes mood swings oily skin Less common or rare For adults (female) Breast pain headache (mild and transient) irritated or runny nose mental depression (mild and transient) For children (male) Irritated or runny nose For children (female) Irritated or runny nose white or brownish vaginal discharge Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional. Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088. Side Effects (complete list) The information contained in the Truven Health Micromedex products as delivered by Drugs.com is intended as an educational aid only. It is not intended as medical advice for individual conditions or treatment. It is not a substitute for a medical exam, nor does it replace the need for services provided by medical professionals. Talk to your doctor, nurse or pharmacist before taking any prescription or over the counter drugs (including any herbal medicines or supplements) or following any treatment or regimen. Only your doctor, nurse, or pharmacist can provide you with advice on what is safe and effective for you. The use of the Truven Health products is at your sole risk. 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Next Side Effects Print this page Add to My Med List More about nafarelin Side Effects During Pregnancy Dosage Information Support Group En Español 2 Reviews Add your own review/rating Drug class: gonadotropin releasing hormones Consumer resources Nafarelin nasal Nafarelin Other brands: Synarel Professional resources Nafarelin Acetate (AHFS Monograph) Nafarelin (Wolters Kluwer) Related treatment guides Endometriosis Precocious Puberty} Drug Status Rx Availability Prescription only X Pregnancy Category Not for use in pregnancy N/A CSA Schedule Not a controlled drug Drug Class Gonadotropin releasing hormones Related Drugs Endometriosis medroxyprogesterone , leuprolide , Provera , Depo-Provera , Lupron Depot , norethindrone , Sprintec , Zoladex , Ortho Tri-Cyclen , danazol , TriNessa , Mononessa , More... Precocious Puberty tamoxifen , Lupron , leuprolide , Nolvadex , triptorelin , histrelin , Vantas , Triptodur , More... Nafarelin Rating 2 User Reviews 6.3 /10 2 User Reviews 6.3 Rate it! Help and Support Looking for answers? Ask a question or go join the nafarelin support group to connect with others who have similar interests.} } guidelines
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