GnRH Analogues

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GnRH Analogues


Use

Mechanism of Action

  • (initially stimulates release of FSH/LH)
  • after 2 weeks down regulates this response
  • decreases pituitary stimulation of male and female gonads → medical orchidectomy/ovariectomy

Adverse effects

  • Menopausal
    • hot flushes
    • increased sweating
    • vaginal dryness
    • decreased bone density
    • headaches
  • skin reactions
  • asthma
  • amenorrhoea (70%)
  • 2-4% reversible bone loss over 6 months (3%)

Drugs in class

  • goserelin (Zoladex)
    • injected every 28 days
  • leuprorelin
    • injected every 28 days
  • buserelin
    • nasal spray TDS
  • nafarelin
    • nasal spray BD
  • triptorelin
    • injection every 28 days

Pharmacokinetics

  • peptides so parenteral administration
  • cleared by hepatic and renal excretion
  • plasma half-life 80 mins to 4-5 hours
 

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