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Goserelin

(go-seh-rel-in)

Trade/other name(s): Zoladex, Zoladex 3-month

Why would this drug be used?

Goserelin is used to treat advanced prostate and breast cancers, and is sometimes used for other conditions.

How does this drug work?

Goserelin is a member of the general group of drugs known as hormones or hormone antagonists. It is a man-made version of the body's luteinizing-hormone-releasing hormone (LHRH). It blocks the release of testosterone in men and estrogen in women. It stops the growth of cancer cells that depend on these hormones. If the medicine is stopped, hormone levels are expected to return to normal.

Before taking this medicine

Tell your doctor…

  • If you are allergic to anything, including medicines, dyes, additives, or foods.
  • If you have any medical conditions such as kidney disease, liver disease (including hepatitis), congestive heart failure, gout, or infections. These conditions may require that your medicine dose, regimen, or timing be changed.
  • If you have ever had diabetes, heart disease, high blood pressure, high cholesterol, heart attack, or stroke. Also tell your doctor if you have ever smoked. Your doctor may watch you more closely for heart and blood vessel problems while you take this drug.
  • If you or others in your family have weakened bones (osteoporosis), if you have ever been a heavy user of alcohol, or if you have taken steroids or medicines to prevent seizures, which can cause bone loss. Goserelin can speed up loss of bone minerals and your doctor may need to watch for this.
  • If you are pregnant, trying to get pregnant, or if there is any chance of pregnancy. This drug may harm the baby or cause birth defects if either the male or female is taking it at the time of conception or during pregnancy. Men and women who are taking this drug need to use some kind of birth control. It is important to check with your doctor about what kinds of birth control can be used with this medicine.
  • If you are breast-feeding. It is not known whether this drug passes into breast milk. If it does, it could harm the baby.
  • If you think you might want to have children in the future. This drug may reduce fertility. Talk with your doctor about the possible risk with this drug and the options that may preserve your ability to have children.
  • About any other prescription or over-the-counter medicines you are taking, including vitamins and herbs. In fact, keeping a written list of each of these medicines (including the doses of each and when you take them) with you in case of emergency may help prevent complications if you get sick.

Interactions with other drugs

Birth control pills (and other forms of birth control that involve hormones) should not be used with this drug. Check with your doctor, nurse, or pharmacist about other medicines, vitamins, herbs, and supplements, and whether alcohol can cause problems with this medicine.

Interactions with foods

No serious interactions with food are known at this time. Check with your doctor, nurse, or pharmacist about whether foods may be a problem.

Tell all the doctors, dentists, nurses, and pharmacists you visit that you are taking this drug.

How is this drug taken or given?

Goserelin is injected under the skin once a month. The medicine is slowly released over 1 month. There is also a dose that lasts for about 12 weeks, which is injected once every 3 months.

Precautions

Goserelin may briefly increase testosterone in men when the drug is first started. This causes the symptoms of prostate cancer to get worse for about a week and is called a disease flare. These symptoms usually improve after a week or two, but sometimes extra treatment is needed.

  • The prostate gland may enlarge, and you may have blood in your urine, painful urination, or trouble passing urine. Call your doctor if you have these symptoms.
  • Bone pain may also worsen. Call your doctor or nurse right away if your pain medicine is not stopping the pain during this time. Your doctor should help you get the right dose or drug for the time that the pain has increased.
  • If prostate cancer has spread to the bones of the spine, leg weakness may also occur. To prevent this, most doctors give drugs that block testosterone for the first week of treatment. Call your doctor right away if you develop numbness or tingling of the fingers/hands, toes/feet, weakness in the legs, and/or trouble urinating or moving your bowels.
  • Tell your doctor if you have any of the above flare symptoms that last longer than 2 weeks.

If you are a woman taking goserelin, you may have vaginal bleeding at first. This is due to the drop in estrogen level. Menstrual periods usually stop after this. If you are having any menstrual bleeding after the first 2 months on goserelin, call your doctor.

People have had problems with their blood sugar going up while on goserelin, even if they have not had diabetes in the past. Your doctor may want to check your blood sugar while you are on this drug. Those who have diabetes should watch blood sugars carefully and contact their doctors with any problems.

Your doctor may also watch you for signs of cardiovascular disease (which can result in heart attack or stroke) while you take this medicine.

Call your doctor right away if you develop skin welts, itching, swelling in the face, mouth, or throat, or other signs of an allergic reaction.

Tell your doctor or nurse right away if you get pain in your chest, shortness of breath, or leg pain.

Get help right away if you have sudden headache, vomiting, changes in vision, confusion, or collapse. Rarely, the drug can affect the pituitary, and cause emergencies due to effects like those caused by tumors of the pituitary gland.

Rarely, goserelin can cause the calcium level in the blood to increase in women who have advanced breast cancer. Call your doctor for treatment if you notice nausea, vomiting, thirst, weakness, and confusion.

It is important to keep taking this drug, even if you feel well. If you have side effects, talk to your doctor or nurse to be sure the problems are not serious, and find out how you can lessen them.

Possible side effects

You will probably not have most of the following side effects, but if you have any talk to your doctor or nurse. They can help you understand the side effects and cope with them.

Common

  • hot flashes
  • decrease in sexual desire
  • vaginal bleeding in first month or two*
  • menstrual periods usually stop after the first month or so (may return after the drug is stopped)*
  • vaginal dryness
  • swelling of breasts in men
  • decreased ability to have erections
  • prostate cancer "flare" in the first week or so of treatment*
  • bone thinning

Less common

  • breast tenderness in men

Rare

  • irregular heartbeat
  • increased blood pressure
  • chest pain
  • depression
  • chills
  • fever
  • anxiety
  • vomiting
  • increased weight
  • constipation
  • diarrhea
  • stroke
  • heart attack*
  • headache
  • increased blood sugar*
  • urinary tract infection
  • high calcium level in the blood (in women with advanced breast cancer)*
  • kidney damage
  • decreased blood flow in arms and legs
  • higher cholesterol
  • diabetes*
  • blood vessel disease (heart disease or stroke)*
  • pressure or bleeding in the pituitary gland, causing vomiting, headache, and other serious symptoms*

*See "Precautions" section for more detailed information.

There are some other side effects not listed above that can also occur in some patients. Tell your doctor or nurse if you develop these or any other problems.

FDA approval

Yes – first approved in 1989.

Disclaimer: This information does not cover all possible uses, actions, precautions, side effects, or interactions. It is not intended as medical advice, and should not be relied upon as a substitute for talking with your doctor, who is familiar with your medical needs.

Last Medical Review: 09/16/2009
Last Revised: 10/22/2010