Goserelin Disease Interactions

The use of GnRH agonists in women may cause a reduction in bone mineral density. In women, current available data suggest that recovery of bone loss occurs on cessation of therapy in the majority of patients. Postmarketing data has also shown osteoporosis, decreased bone mineral density and bone fracture in men. Therapy with goserelin should be administered cautiously in patients with major risk factors for decreased bone mineral content, such as chronic alcohol and/or tobacco use, a strong family history of osteoporosis, or chronic use of drugs that can reduce bone mass (e.g., anticonvulsants, corticosteroids).

Increased risk of developing myocardial infarction, sudden cardiac death and stroke has been reported in association with use of GnRH agonists such as goserelin in men. The risk appears low based on the reported odds ratios, and should be evaluated carefully along with cardiovascular risk factors when determining a treatment for patients with prostate cancer.

Hyperglycemia and an increased risk of developing diabetes have been reported in men receiving GnRH agonists such as goserelin. Hyperglycemia may represent development of diabetes mellitus or worsening of glycemic control in patients with diabetes. Monitor blood glucose and/or glycosylated hemoglobin (HbA1c) periodically in patients receiving goserelin and manage with current practice for treatment of hyperglycemia or diabetes.

Androgen deprivation therapy may prolong the QT/QTc interval. Health care providers should consider whether the benefits of androgen deprivation therapy outweigh the potential risks in patients with congenital long QT syndrome, congestive heart failure, frequent electrolyte abnormalities, and in patients taking drugs known to prolong the QT interval. Electrolyte abnormalities should be corrected. Consider periodic monitoring of electrocardiograms and electrolytes.