goserelin

Goserelin is a synthetic gonadotropin-releasing hormone (GnRH) agonist used to suppress gonadal function in several hormone-dependent conditions. It is administered as a subcutaneous implant that releases the active drug over a defined period.

Goserelin acts as a GnRH agonist. It initially stimulates the pituitary, then downregulates GnRH receptors, leading to decreased secretion of luteinizing hormone and follicle-stimulating hormone and reduced estrogen or testosterone production.

It is used for advanced prostate cancer; hormone-sensitive breast cancer in premenopausal women as part of ovarian suppression; treatment of endometriosis and uterine fibroids; central precocious puberty; and to prevent premature ovulation in assisted reproduction.

The implant is placed under the skin of the abdomen by a clinician. Common regimens include 3.6 mg every 28 days or 10.8 mg every 12 weeks, though dosing varies by region and indication.

Common adverse effects include hot flashes, sweating, decreased libido, vaginal dryness, mood changes, and implant-site irritation. Long-term hypoestrogenism can cause bone mineral density loss; rare hypersensitivity or flare at initiation may occur.

Goserelin should not be used in pregnancy; lactation is contraindicated. Caution is advised in osteoporosis, cardiovascular risk, or hepatic impairment, and patients should be monitored for bone health and sexual function during treatment.

Goserelin was developed in the 1980s and is marketed under the brand Zoladex and in generic forms.