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Medication Safety Issues
Sound-alike/look-alike issues:
Gonadorelin may be confused with gonadotropin, guanadrel
Factrel® may be confused with Sectral®
Gonadotropin may be confused with gonadorelin
Pronunciation
(goe nad oh RELL in)
U.S. Brand Names
Index Terms
Generic Available
No
Canadian Brand Names
Pharmacologic Category
Use: Labeled Indications
Evaluation of functional capacity and response of gonadotrophic hormones; evaluate abnormal gonadotropin regulation as in precocious puberty and delayed puberty.
Orphan drug: Lutrepulse®: Induction of ovulation in females with hypothalamic amenorrhea
Pregnancy Risk Factor
B
Lactation
Excretion in breast milk unknown
Contraindications
Hypersensitivity to gonadorelin or any component of the formulation; women with any condition that could be exacerbated by pregnancy; patients who have ovarian cysts or causes of anovulation other than those of hypothalamic origin; any condition that may worsened by reproductive hormones
Warnings/Precautions
Concerns related to adverse effects:
• Hypersensitivity/anaphylactic reactions: Hypersensitivity and anaphylactic reactions have occurred following multiple-dose administration.
Disease-related concerns:
• Pituitary prolactinemia: Use with caution in women in whom pregnancy could worsen pre-existing conditions (eg, pituitary prolactinemia).
Other warnings/precautions:
• Multiple pregnancy: Alert patients that multiple pregnancy is a possibility.
Adverse Reactions
1% to 10%: Local: Pain at injection site
<1%: Abdominal discomfort, flushing, headache, lightheadedness, nausea, rash
Drug Interactions
There are no known significant interactions.
Storage
Factrel®: After reconstitution, store at room temperature and use within 1 day. Discard unused portion.
Lutrepulse®: Store at room temperature.
Reconstitution
Factrel®: Prepare immediately prior to use.
Lutrepulse®: Reconstitute with diluent immediately prior to use and transfer to plastic reservoir. The solution will supply 90-minute pulsatile doses for 7 consecutive days (Lutrepulse® pump).
Mechanism of Action
Stimulates the release of luteinizing hormone (LH) from the anterior pituitary gland
Pharmacodynamics/Kinetics
Onset of action: Peak effect: Maximal LH release: ~20 minutes
Duration: 3-5 hours
Half-life elimination: 4 minutes
Dosage
Diagnostic test: Children >12 years and Female Adults: I.V., SubQ hydrochloride salt: 100 mcg administered in women during early phase of menstrual cycle (day 1-7)
Primary hypothalamic amenorrhea: Female Adults: Acetate: I.V.: 5 mcg every 90 minutes via Lutrepulse® pump kit at treatment intervals of 21 days (pump will pulsate every 90 minutes for 7 days)
Administration: I.V.
Factrel®: Give I.V. push over 30 seconds.
Lutrepulse®: A presterilized reservoir bag with the infusion catheter set supplied with the kit should be filled with the reconstituted solution and administered I.V. using the Lutrepulse® pump. Set the pump to deliver 25-50 mL of solution, based upon the dose, over a pulse period of 1 minute and at a pulse frequency of 90 minutes.
Administration: I.V. Detail
Factrel®: Dilute in 3 mL of normal saline.
Monitoring Parameters
LH, FSH
Patient Education
If receiving this drug via pulsating pump, check all procedures with prescriber, and use exactly as prescribed. Report any rash, pain, or inflammation at injection site, and any change in respiratory status. Breast-feeding precaution: Consult prescriber if breast-feeding.
Dental Health: Effects on Dental Treatment
No significant effects or complications reported
Dental Health: Vasoconstrictor/Local Anesthetic Precautions
No information available to require special precautions
Mental Health: Effects on Mental Status
None reported
Mental Health: Effects on Psychiatric Treatment
Antipsychotics may decrease the effects of gonadorelin
Nursing: Physical Assessment/Monitoring
Assess other medications patient may be taking for effectiveness and interactions. When used for induction of ovulation, assess results of laboratory tests and therapeutic effectiveness. Assess knowledge/teach patient appropriate use (use of pulsating pump if applicable), interventions to reduce side effects, and adverse symptoms to report.
Dosage Forms
Excipient information presented when available (limited, particularly for generics); consult specific product labeling.
Injection, powder for reconstitution, as hydrochloride: 100 mcg [diluent contains benzyl alcohol]
References
Pescovitz OH, Comite F, Hench K, et al, “The NIH Experience With Precocious Puberty: Diagnostic Subgroups and Response to Short-Term Luteinizing Hormone-Releasing Hormone Analogue Therapy,” J Pediatr, 1986, 108(1):47-54.
International Brand Names
Lexi-Comp.com
Last full review/revision July 2009
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