Indications

• Female infertility

- Used to initiate an LH surge and ovulation induction with gonadotropins

Dosing

• 2.5 μg/pulse IV or SQ every 120 minutes

Indications

• Male infertility

- For infertility in men with hypothalamic hypogonadotropic hypogonadism

Dosing

• Portable pump infuses IV every 90 minutes

Adverse effects

• Headache, lightheadedness, nausea, flushing

• Local swelling a SQ injection sites, generalized

hypersensitivity dermatitis (long-term SQ administration)

Adverse effects

• Sudden pituitary apoplexy and blindness with patients that have gonadotropin-secreting tumors

• Substitution of amino acids at the 6 position or replacement of the C-terminal glycine-amide produces synthetic agonists

• More potent and longer-lasting

Synthetic GnRH analogs

• IV and SQ

Synthetic GnRH analogs

• Intranasal

Synthetic GNRH analogs

• SQ or IM monthly or every 3 months

Indications

• Controlled Ovarian Stimulation

Indications

• Controlled Ovarian Stimulation

- Daily SQ injections with 0.1 mg daily for 10 days or until menstrual bleeding occurs

- Dose is then reduced to 0.5 mg daily until hCG is administered

Indications

• Controlled Ovarian Stimulation

- Daily nasal application initiated with 400 μg twice daily

- Decreased to 200 μg when menstrual bleeding

occurs

Indications

• Endometriosis

Indications

• Uterine Leiomyomata

Indications

• Prostate Cancer

Indications

- Precipitate pain in patients with bone metastases

- Precipitate tumor growth and neurologic symptoms in patients with vertebral metastases

Indications

- Temporarily worsen symptoms of urinary obstruction

Indications

• Central Precocious Puberty

- Treatment is generally continued to age 11 in females and age 12 in males

Adverse effects

• In women: typical symptoms of menopause

• Reduced bone density and osteoporosis in prolonged use

• In men:

- Hot flushes and sweats

- Edema

- Gynecomastia

- Decreased libido

- Decreased hematocrit

- Reduced bone density

- Asthenia

- Injection site reactions

Adverse effects

• May cause or aggravate sinusitis

Indications

• Approved for use in ovarian stimulation procedures

• Well tolerated when used for controlled ovarian stimulation

• Absorbed rapidly after subcutaneous (SQ) injection

Adverse effects

• Nausea

• Headache

Indications

• Approved for men with advanced prostate cancer

Indications

• Approved for men with advanced prostate cancer

- Initiated with 240mg administered 2 SQ injections

- Maintenance dosing: 80mg SQ injection every 28 days

Indications

• Approved for men with advanced prostate cancer

- Initiated with 100mg IM every 2 weeks for 3 doses and every 4 weeks thereafter

Adverse effects

• Continuous use lead to signs and symptoms of androgen deprivation such as hot flushes and weight gain

Adverse effects

• Caused injection site reactions and increases liver enzymes during treatment of men with prostate cancer