Formulary
Goserelin: Indications, Dosing, Side Effects and Interactions
Administration of gonadorelin analogues produces an initial phase of stimulation; continued administration is followed by down-regulation of...
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Goserelin: Indications, Dosing, Side Effects and Interactions
Administration of gonadorelin analogues produces an initial phase of stimulation; continued administration is followed by down-regulation of...
Drug action
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.
Indications and dose
**Locally advanced prostate cancer as an alternative to surgical castration,Adjuvant treatment to radiotherapy or radical prostatectomy in patients with high-risk localised or locally advanced prostate cancer,Neoadjuvant treatment prior to radiotherapy in patients with high-risk localised or locally advanced prostate cancer,Metastatic prostate cancer**
- **Adult** (By Subcutaneous Injection): 10.8 mg every 12 weeks, to be administered into the anterior abdominal wall.
**Locally advanced prostate cancer as an alternative to surgical castration,Adjuvant treatment to radiotherapy or radical prostatectomy in patients with high-risk localised or locally advanced prostate cancer,Neoadjuvant treatment prior to radiotherapy in patients with high-risk localised or locally advanced prostate cancer,Metastatic prostate cancer,Advanced breast cancer,Oestrogen-receptor-positive early breast cancer**
- **Adult** (By Subcutaneous Injection): 3.6 mg every 28 days, to be administered into the anterior abdominal wall.
**Endometriosis**
- **Adult** (By Subcutaneous Injection): 3.6 mg every 28 days maximum duration of treatment 6 months (do not repeat), to be administered into the anterior abdominal wall.
**Endometrial thinning before intra-uterine surgery**
- **Adult** (By Subcutaneous Injection): 3.6 mg, dose may be repeated after 28 days if uterus is large or to allow flexible surgical timing, to be administered into the anterior abdominal wall.
**Before surgery in women who have anaemia due to uterine fibroids**
- **Adult** (By Subcutaneous Injection): 3.6 mg every 28 days maximum duration of treatment 3 months, to be given with supplementary iron, to be administered into the anterior abdominal wall.
**Pituitary desensitisation before induction of ovulation by gonadotrophins**
- **Adult** (By Subcutaneous Injection): for in vitro fertilisation (after exclusion of pregnancy) (under expert supervision) 3.6 mg, dose given to achieve pituitary down-regulation (usually 1-3 weeks) then gonadotrophin is administered (stopping gonadotrophin on administration of chorionic gonadotrophin at appropriate stage of follicular development), to be administered into the anterior abdominal wall.
**Gonadotrophin-dependent precocious puberty for Zoladex LA**
- **Child** (By subcutaneous injection): 10.8 mg every 12 weeks, to be administered into the anterior abdominal wall, injections may be required more frequently in some cases.
**Gonadotrophin-dependent precocious puberty for Zoladex**
- **Child** (By subcutaneous injection): 3.6 mg every 28 days, to be administered into the anterior abdominal wall, injections may be required more frequently in some cases.
Cautions
Depression; diabetes; hypertension; patients with metabolic bone disease (decrease in bone mineral density can occur); polycystic ovarian disease; risk of spinal cord compression in men; risk of ureteric obstruction in men
Contraindications
Undiagnosed vaginal bleeding; use longer than 6 months in endometriosis (do not repeat)
Side effects
Common or very common Alopecia; arthralgia; bone pain; breast abnormalities; depression; glucose tolerance impaired; gynaecomastia; headache; heart failure; hot flush; hyperhidrosis; mood altered; myocardial infarction; neoplasm complications; paraesthesia; sexual dysfunction; skin reactions; spinal cord compression; vulvovaginal disorders; weight increased Uncommon Hypercalcaemia (in women); ureteral obstruction Rare or very rare Ovarian and fallopian tube disorders; pituitary haemorrhage; pituitary tumour; psychotic disorder Frequency not known Abdominal cramps; body hair change; constipation; diarrhoea; fatigue; hepatic function abnormal; interstitial pneumonia; muscle complaints; nausea; nervousness; peripheral oedema (when used for gynaecological conditions); premature menopause; pulmonary embolism; QT interval prolongation; sleep disorder; uterine leiomyoma degeneration; voice alteration; vomiting; vulvovaginal infection; withdrawal bleed Side-effects, further information Tumour flare can occur when androgen deprivation therapy is initiated.
Pregnancy
Pituitary desensitisation before induction of ovulation by gonadotrophins for in vitro fertilisation (after exclusion of pregnancy) (under expert supervision) for Zoladex By subcutaneous injection Adult 3.6 mg, dose given to achieve pituitary down-regulation (usually 1-3 weeks) then gonadotrophin is administered (stopping gonadotrophin on administration of chorionic gonadotrophin at appropriate stage of follicular development), to be administered into the anterior abdominal wall.
Breast feeding
Avoid.
Medicinal forms
Clinical governance
**Author:** MedNext Clinical Team. **Clinical reviewer:** Dr Shameer Deen, MBBS, MS, MRCS. **Sources:** BNF, Indian Pharmacopoeia, CIMS India. **Correction:** Report errors at support@mednext.academy.
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