Generic Name: nafarelin (NAF-a-REL-in)
Brand Name: Synarel
Synarel is used for:
Treating endometriosis, including relieving pain and reducing lesions. It is also used to treat early puberty (central precocious puberty [CPP]) in children of both sexes. It may also be used for other conditions as determined by your doctor.
Synarel is a gonadotropin-releasing hormone (GnRH) agonist. It works by decreasing production of certain steroids in the body, which decreases the symptoms of endometriosis or early puberty.
Do NOT use Synarel if:
- you are allergic to any ingredient in Synarel, GnRH, or another GnRH agonist (eg, histrelin)
- you are pregnant, may become pregnant, or are breast-feeding
- you have undiagnosed abnormal vaginal bleeding
Contact your doctor or health care provider right away if any of these apply to you.
Before using Synarel:
Some medical conditions may interact with Synarel. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:
- you are planning to become pregnant
- if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
- if you have allergies to medicines, foods, or other substances
- if you have a runny or stuffy nose, osteoporosis (weak bones), or a family history of osteoporosis
- if you regularly use alcohol or tobacco
- if the patient is a child with endometriosis
- if you are taking medicines that can weaken the bones, such as anticonvulsants (eg, phenytoin) or corticosteroids (eg, prednisone)
Some MEDICINES MAY INTERACT with Synarel. However, no specific interactions with Synarel are known at this time.
Ask your health care provider if Synarel may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.
How to use Synarel:
Use Synarel as directed by your doctor. Check the label on the medicine for exact dosing instructions.
- An extra patient leaflet is available with Synarel. Talk to your pharmacist if you have questions about this information.
- The pump must be primed before the first use. To prime the pump, hold it upright, pointed away from yourself and others. Pump 7 to 10 times, until you see a fine spray. Do this only before the first use of a new bottle. Do not do this before each dose.
- Gently blow your nose before using Synarel.
- This nasal spray is used differently in children than in adults. Be sure you know how to use Synarel. Ask your doctor or pharmacist if you have any questions about how to use it.
- When you insert the spray tip into the nose, be sure to point it toward the back and outer side of the nose.
- If you are using more than 1 spray in the same nostril, wait at least 30 seconds between sprays.
- Clean the spray tip before and after each use. To do this, rinse the tip of the spray unit in warm water for 15 seconds while wiping the tip with a finger or a soft cloth. Dry with a clean tissue or soft cloth. Do NOT try to clean it with a pointed object or take apart the pump.
- If you are also using a decongestant nasal spray, do not use it within 2 hours after using Synarel. Check with your doctor if you have questions about using Synarel along with your other medicines.
- It may take 4 to 8 weeks for Synarel to work. Continue to use Synarel even if you feel well. Do not miss any doses.
- If you miss a dose of Synarel, use it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.
- If you miss more than 1 dose of Synarel, contact your doctor.
Ask your health care provider any questions you may have about how to use Synarel.
Important safety information:
- Avoid sneezing during or immediately after using Synarel, if possible, because Synarel's effectiveness may be decreased.
- Do NOT take more than the recommended dose or use for longer than prescribed without checking with your doctor.
- If you are using Synarel for CPP, you may experience some signs of puberty (eg, vaginal bleeding, breast enlargement, increased pubic hair) or temporary body odor during the first month of treatment. This is normal. If these side effects persist or are severe, contact your doctor.
- If you are using Synarel for endometriosis, you may experience irregular or unusual vaginal bleeding during the first 2 months you use Synarel. This is normal. If you experience severe or persistent vaginal bleeding or if you have unusual vaginal bleeding that lasts longer than 2 months after you start Synarel, contact your doctor.
- Your menstrual period should stop while you use Synarel. Contact your doctor if your regular menstrual period continues while you are using Synarel.
- Women who may become pregnant must have a negative pregnancy test before beginning treatment with Synarel.
- Women of childbearing age should avoid becoming pregnant while using Synarel. To prevent pregnancy, use a nonhormonal form of birth control (eg, condoms) while using Synarel. Do not use birth control pills while you use Synarel.
- Women who miss more than 1 dose of Synarel in a row may experience breakthrough vaginal bleeding and ovulation, with the possibility of pregnancy. Contact your doctor if you miss more than 1 dose of Synarel.
- Synarel may cause your bones to weaken or become more prone to fractures, especially if you use Synarel for long periods of time. Contact your doctor if you experience bone pain or if you have concerns regarding changes in bone density. Discuss any questions or concerns with your doctor.
- Tell your doctor or dentist that you take Synarel before you receive any medical or dental care, emergency care, or surgery.
- Rarely, a serious pituitary gland problem (pituitary apoplexy) has been reported with the use of GnRH agonists. This serious problem usually occurs shortly after beginning treatment. Contact your doctor immediately if you experience a sudden headache, vomiting, fainting, eye weakness, inability to move your eyes, mental status changes, or vision changes.
- Synarel may interfere with certain lab tests, including diagnostic tests of pituitary gonadotropic and gonadal function. Be sure your doctor and lab personnel know you are using Synarel.
- Lab tests, including gonadal sex steroid levels, bone density, and growth rate, may be performed while you use Synarel. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.
- Synarel should be used with extreme caution in CHILDREN younger than 18 years old who have endometriosis; safety and effectiveness in these children have not been confirmed.
- PREGNANCY and BREAST-FEEDING: Do not use Synarel if you are pregnant. It may cause harm to the fetus. Avoid becoming pregnant while you are taking it. If you think you may be pregnant, contact your doctor right away. It is not known if Synarel is found in breast milk. Do not breast-feed while taking Synarel.
Possible side effects of Synarel:
All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:
Seek medical attention right away if any of these SEVERE side effects occur:
Acne; dandruff; decreased sexual desire; headache; hot flashes; mood swings; muscle pain; nasal irritation; runny nose; temporary increase or decrease in breast size; trouble sleeping; vaginal dryness; weight change.
Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); chest pain; continued menstrual periods; depression; irregular heartbeat; mental or mood changes; seizures; severe, persistent, or unusual vaginal bleeding; shortness of breath; stomach pain; sudden headache or vomiting; swelling of the hands or feet; vision changes; whitish or brownish vaginal discharge; yellowing of the eyes or skin.
This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.
If OVERDOSE is suspected:
Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately.Proper storage of Synarel:
Store Synarel upright at 77 degrees F (25 degrees C). Brief storage at temperatures between 59 and 86 degrees F (15 and 30 degrees C) is permitted. Do not freeze. Store away from heat, moisture, and light. Keep Synarel out of the reach of children and away from pets.
- If you have any questions about Synarel, please talk with your doctor, pharmacist, or other health care provider.
- Synarel is to be used only by the patient for whom it is prescribed. Do not share it with other people.
- If your symptoms do not improve or if they become worse, check with your doctor.
- Check with your pharmacist about how to dispose of unused medicine.
This information should not be used to decide whether or not to take Synarel or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about Synarel. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to Synarel. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using Synarel.
Disclaimer: This information should not be used to decide whether or not to take this medicine or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this medicine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using this medicine.