Nasal Adjunct to induce ovulation with gonadotrophins in the treatment of infertility
Adult: 400 mcg bid, given as 1 spray to each nostril in the morning and 1 spray to each nostril in the evening, starting either on the early follicular phase (day 2) or midluteal phase (day 21) of menstrual cycle, continued until down-regulation is achieved. Max treatment duration: 12 wk.
Adult: 200 mcg bid, given as 1 spray (200 mcg) in 1 nostril in the morning and 1 spray in the other nostril in the evening, starting on days 2-4 of menstrual cycle. Dose may be doubled after 2 mth if symptoms persist. Max treatment duration: 6 mth.
Nasal Central precocious puberty
Child: 800 mcg bid, given as 2 sprays (400 mcg) into each nostril in the morning and 2 sprays into each nostril in the evening. Dose may be increased up to 600 mcg tid, if necessary depending on response.
Undiagnosed abnormal vag bleeding. Pregnancy and lactation.
Patient w/ pituitary adenoma, polycystic ovarian disease, psychiatric comorbidities, risk factors for BMD, intercurrent rhinitis; history of seizures, cerebrovascular disorders, CNS anomalies or tumours. Childn.
Monitor BMD (prior to therapy and before retreatment), FSH and LH blood levels, bone age measurement, development or worsening of psychiatric symptoms, menstruation, vag bleeding/spotting.
May enhance the effect of corifollitropin alfa.
May give misleading result in the diagnostic test for pituitary gonadotropic and gonadal functions up to 4-8 wk after treatment discontinuation.
Description: Nafarelin is a gonadorelin analogue. It produces an initial phase of stimulation followed by down-regulation of gonadotrophin-releasing hormone receptors, thus reducing the release of FSH and LH, leading to inhibition of androgen and oestrogen production. Pharmacokinetics: Absorption: Rapidly absorbed intranasally. Bioavailability: Approx 3%. Time to peak plasma concentration: W/in 20 min. Distribution: Plasma protein binding: Approx 80%, mainly to albumin. Metabolism: Metabolised by peptidases to form metabolites. Excretion: Via urine (44-55%, approx 3% as unchanged drug); faeces (19-44%). Elimination half-life: Approx 3 hr.
Store below 25°C. Protect from light. Do not freeze.
H01CA02 - nafarelin ; Belongs to the class of gonadotropin-releasing hormones. Used in hypothalamic hormone preparations.
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