gonadorelin hydrochloride: clinical use

Prescribing considerations

• Use within clinical and biochemical assessment; the test cannot independently establish the cause of a subnormal response or quantify pituitary reserve.
• Review medicines that alter pituitary gonadotrophin secretion and plan any interruption before testing.
• Consider menstrual-cycle timing and possible premature ovulation.
• Safety and efficacy have not been established in children younger than one year.

Contraindications and cautions

• Hypersensitivity to gonadorelin hydrochloride or an excipient, including lactose monohydrate.
• Known or suspected pregnancy.
• Avoid during breastfeeding.
• Not recommended with a pituitary adenoma because pituitary apoplexy may occur.

Monitoring

• Obtain and interpret serial luteinising hormone measurements using laboratory-specific reference standards and assay performance.
• Observe carefully during re-administration, particularly intravenously, because rare hypersensitivity reactions have occurred.
• Review menstrual effects and suspected adverse reactions. Serious suspected reactions can be reported through the MHRA Yellow Card Scheme.

Clinical pharmacology

Gonadorelin stimulates synthesis and release of luteinising hormone and follicle-stimulating hormone from the anterior pituitary. It is rapidly hydrolysed in plasma and excreted in urine.

Formulation and product differences

• The UK product is a powder for solution for injection containing lactose monohydrate.
• It requires reconstitution with sterile water and may be given subcutaneously or intravenously.
• Do not mix it with other substances. Discard unused reconstituted solution according to the product instructions.

Injection

Route: Parenteral

Strengths: 100 micrograms