Drug reference
Administration of gonadorelin analogues produces an initial phase of stimulation; continued administration is followed by down-regulation of gonadotrophin-releasing hormone receptors, thereby reducing the release of gonadotrophins (follicle stimulating hormone and luteinising hormone) which in turn leads to inhibition of androgen and oestrogen production.
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Endometriosis ▶BY INTRANASAL ADMINISTRATION ▶Adult: 300 micrograms 3 times a day maximum duration of treatment 6 months (do not repeat), to be started on days 1 or 2 of menstruation; administer one 150 microgram spray into each nostril Pituitary desensitisation before induction of ovulation by gonadotrophins for in vitro fertilisation (under expert supervision) ▶BY SUBCUTANEOUS INJECTION ▶Adult: 200–500 micrograms once daily, increased if necessary up to 500 micrograms twice daily, starting in early follicular phase (day 1) or, after exclusion of pregnancy, in midluteal phase (day 21) and continued until down-regulation achieved (usually 1–3 weeks) then maintained during gonadotrophin administration (stopping gonadotrophin and buserelin on administration of chorionic gonadotrophin at appropriate stage of follicular development) ▶BY INTRANASAL ADMINISTRATION ▶Adult: 150–300 micrograms 4 times a day, (150 micrograms equivalent to one spray), to be administered during waking hours. Start in early follicular phase (day 1) or, after exclusion of pregnancy, in the midluteal phase (day 21) and continued until down-regulation achieved (usually about 2–3 weeks) then maintained during gonadotrophin administration (stopping gonadotrophin and buserelin on administration of chorionic gonadotrophin at appropriate stage of follicular development) Advanced prostate cancer ▶INITIALLY BY SUBCUTANEOUS INJECTION ▶Adult: 500 micrograms every 8 hours for 7 days, then (by intranasal administration) 200 micrograms 6 times a day, (a single 100 microgram spray to be administered into each nostril)
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▶When used for endometriosis Undiagnosed vaginal bleeding. use longer than 6 months (do not repeat) ▶When used for pituitary desensitisation Undiagnosed vaginal bleeding
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Depression. diabetes. hypertension. patients with metabolic bone disease (decrease in bone mineral density can occur). polycystic ovarian disease
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GENERAL SIDE-EFFECTS ▶Common or very common Depression. mood altered ▶Rare or very rare Auditory disorder. hypotension. leucopenia. pituitary tumour benign. thrombocytopenia. tinnitus ▶Frequency not known Alopecia. anxiety. appetite change. breast abnormalities. broken nails. concentration impaired. constipation. diarrhoea. dizziness. drowsiness. dry eye. dysuria. embolism and thrombosis. fatigue. feeling of pressure behind the eyes. follicle recruitment increased. galactorrhoea. gastrointestinal discomfort. gynaecomastia. hair changes. headache. hot flush. hydronephrosis. hyperhidrosis. increased risk of fracture. lymphostasis. memory loss. menopausal symptoms. menstrual cycle irregularities. muscle weakness in legs. musculoskeletal discomfort. nausea. oedema. osteoporosis. ovarian and fallopian tube disorders. pain. painful sexual intercourse. palpitations. paraesthesia. QT interval prolongation. sexual dysfunction. shock. skin reactions. sleep disorder. testicular atrophy. thirst. tumour activation temporary. uterine leiomyoma degeneration. vision disorders. vomiting. vulvovaginal disorders. weight changes SPECIFIC SIDE-EFFECTS ▶With intranasal use Altered smell sensation. epistaxis. hoarseness. nasal irritation. taste altered SIDE-EFFECTS, FURTHER INFORMATION During the initial stage (1–2 weeks) increased production of testosterone may be associated with progression of prostate cancer. In susceptible patients this tumour ‘flare’ may cause spinal cord compression, ureteric obstruction or increased bone pain.
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Non-hormonal, barrier methods of contraception should be used during entire treatment period. Pregnancy should be excluded before treatment, the first injection should be given during menstruation or shortly afterwards or use barrier contraception for 1 month beforehand.
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Avoid.
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Avoid.
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▶With intranasal use Avoid use of nasal decongestants before and for at least 30 minutes after treatment. ▶With subcutaneous use Rotate injection site to prevent atrophy and nodule formation.
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There can be variation in the licensing of different medicines containing the same drug. Solution for injection ▶Suprecur (Sanofi) Buserelin (as Buserelin acetate) 1 mg per 1 ml Suprecur 5.5mg/5.5ml solution for injection vials | 2 vial P £33.02 ▶Suprefact (Sanofi) Buserelin (as Buserelin acetate) 1 mg per 1 ml Suprefact 5.5mg/5.5ml solution for injection vials | 2 vial P £34.37 Spray ▶Suprecur (Sanofi) Buserelin (as Buserelin acetate) 150 microgram per 1 dose Suprecur 150micrograms/dose nasal spray | 168 dose P £105.16 DT = £105.16 ▶Suprefact (Sanofi) Buserelin (as Buserelin acetate) 100 microgram per 1 dose Suprefact 100micrograms/dose nasal spray | 336 dose P £122.24 DT = £122.24
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Patients or carers should be given advice on how to administer buserelin nasal spray.
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300 micrograms 3 times a day maximum
First-line fragment. Read the complete Indications and Dose section above.
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200–500 micrograms once daily, increased if
First-line fragment. Read the complete Indications and Dose section above.
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150–300 micrograms 4 times a day,
First-line fragment. Read the complete Indications and Dose section above.
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500 micrograms every 8 hours for 7 days, then
First-line fragment. Read the complete Indications and Dose section above.
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