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Zoladex LA 10.8 SC injection
Zoladex is a synthetic gonadotropin-releasing hormone (GnRH) analog used in the treatment of various hormone-sensitive conditions, including cancers and gynecological disorders. Its mechanism involves suppressing the secretion of pituitary gonadotropins, leading to a reduction in sex hormones (testosterone in men and estrogen in women).
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✅ Description:
Prostate Cancer:
- Stage B2-C (T2b-T4): Combined with flutamide, Zoladex is used for locally confined carcinoma, starting 8 weeks before and continuing during radiation therapy.
- Advanced Prostate Cancer: Palliative treatment for advanced stages.
Breast Cancer:
- Palliative treatment of advanced breast cancer in pre-and perimenopausal women, particularly in hormone receptor-positive cases.
Endometriosis:
- Management of pain and reduction of endometriotic lesions during treatment, limited to 6 months.
Endometrial Thinning:
- Pre-treatment for endometrial ablation in cases of dysfunctional uterine bleeding.
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✔️ Pharmacology
- Mechanism of Action: Goserelin suppresses gonadotropin secretion, leading to decreased levels of testosterone in men and estrogen in women.
- Effects: Regression of hormone-sensitive tumors and reduction in hormonally driven symptoms (e.g., endometriosis pain).
✔️ Dosage & Administration
Goserelin 3.6 mg Depot:
- Administered subcutaneously every 28 days into the anterior abdominal wall.
- For Stage B2-C Prostate Cancer: Start 8 weeks before radiotherapy.
- For Endometriosis and Endometrial Thinning: Limited to 6 months of treatment.
- For Breast Cancer: Long-term administration as required.
Goserelin 10.8 mg Depot:
- Administered subcutaneously every 12 weeks for prostate cancer.
- Not recommended for women due to insufficient data.
Special Populations:
- No dosage adjustment is needed for renal or hepatic impairment.
✔️ Side Effects
Common Adverse Reactions (>10%):
- Men: Hot flashes, sexual dysfunction, reduced erections, lower urinary tract symptoms.
- Women: Hot flashes, sweating, headache, acne, emotional lability, decreased libido, vaginal dryness, and peripheral edema.
Serious Reactions:
- Tumor flare (worsening symptoms during initial treatment).
- Injection site injury or vascular damage.
- QT/QTc prolongation.
- Depression (especially in women).
✔️ Contraindications
- Known hypersensitivity to goserelin, GnRH analogs, or any component of the formulation.
- Pregnancy: Contraindicated unless used for palliative breast cancer treatment. Can cause fetal harm.
✔️ Special Precautions
- Women of Childbearing Age: Exclude pregnancy before initiating therapy.
- Tumor Flare Phenomenon: Monitor for ureteral obstruction or spinal cord compression in at-risk patients.
- Hyperglycemia and Cardiovascular Risks: Monitor glucose and cardiovascular health in men receiving androgen deprivation therapy.
- Hypercalcemia: Monitor in patients with bone metastases.
- Depression: Assess mental health status regularly.
- Cervical Resistance: Caution during procedures requiring cervical dilation.
✔️ Pregnancy & Lactation
- Pregnancy: Can harm the fetus; use is contraindicated except in advanced breast cancer.
- Lactation: Unknown if excreted in human milk; discontinue breastfeeding or the drug.
✔️ Storage
- Store away from light, moisture, and heat.
- Keep out of reach of children.
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