ganirelix acetate

ganirelix acetate Warning - Hazardous drug!

Pharmacologic class: Gonadotropin-releasing hormone (GnRH) antagonist

Therapeutic class: Sex hormone

Pregnancy risk category X

Action

Competitively blocks GnRH receptors on pituitary gonadotroph, suppressing secretion of gonadotropin and luteinizing hormone (LH) and thereby preventing ovulation

Availability

Prefilled syringe: 250 mcg/0.5 ml

⊘Indications and dosages

➣ To inhibit premature LH surges during controlled ovarian hyperstimulation

Adult women: 250 mcg subcutaneously daily during early to mid-follicular phase

Contraindications

• Hypersensitivity to drug, its components, GnRH, or GnRH analogs
• Known or suspected pregnancy

Precautions

Use cautiously in:
• GnRH sensitivity
• latex sensitivity (packaging contains natural rubber latex)
• breastfeeding patients.

Administration

☞ Know that pregnancy must be excluded before therapy begins.
• Inject into abdomen (around navel) or upper thigh.
• Be aware that drug is given with follicle-stimulating hormone (FSH). After starting FSH on day 2 or 3 of menstrual cycle, patient receives ganirelix on morning of day 7 or 8 and continues this drug until adequate follicular response occurs. Then human chorionic gonadotropin is given and FSH and ganirelix are discontinued.

Route	Onset	Peak	Duration
Subcut.	Unknown	Unknown	Unknown

Adverse reactions

CNS: headache

GI: nausea, abdominal pain of GI tract origin

GU: abdominal pain of gynecologic origin, vaginal bleeding, ovarian hyperstimulation syndrome

Other: injection site reaction, fetal death

Interactions

Drug-diagnostic tests. Hematocrit, total bilirubin: decreased values

Neutrophils: altered count (8.3/mm³ or greater)

Patient monitoring

☞ Monitor patient for adverse effects, especially ovarian hyperstimulation.
• Monitor total bilirubin level and CBC with white cell differential.

Patient teaching

• Inform patient about possible adverse reactions.
• Teach patient about duration of treatment and required monitoring procedures.
☞ Urge patient to tell prescriber if she is pregnant before starting drug.
• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the tests mentioned above.