Cetrotide (cetrorelix) dosing, indications, interactions, adverse effects, and more

Sections

Sections cetrorelix
Dosing & Uses
Adverse Effects
Warnings
Pregnancy
Pharmacology
Images
Patient Handout
Formulary

Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

injectable solution

0.25mg
3mg

Infertility Treatment

Single dose regimen: 3 mg SC when serum estradiol levels show appropriate stimulation response (range days 5-9) usually day 7; if hCG not administered within 4 days, continue dose at 0.25 mg/day until hCG administered

Multiple dose regimen: 0.25 mg SC morning or evening of stimulation day 5 or morning of stimulation day 6; continue until hCG administered

Renal Impairment

Mild-to-moderate impairment: Dose adjustment not described by manufacturer

Severe renal impairment: Contraindicated

Hepatic Impairment

Dose adjustment not described by manufacturer

Not recommended

1-10%

Ovarian hyperstimulation syndrome (4%)

Nausea (1%)

Hepatic enzyme elevation (1-2%)

Headache (1%)

<1%

Erythema at injection site

Itching

Pruritus

Swelling

Redness

Hypotension

Rash

Cough

Contraindications

Pregnancy

Hypersensitivity

Breastfeeding

Cautions

May cause elevations of hepatic enzymes: ALT, AST, GGT, AP

Exclude pregnancy before initiating therapy

Monitor closely for hypersensitivity following first injection

Pregnancy & Lactation

Pregnancy Category: X

Lactation: Excretion in milk unknown/contraindicated

Pregnancy Categories

A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

NA: Information not available.

Mechanism of Action

Gonadotropin releasing-hormone (luteinizing hormone-releasing hormone) antagonist; delays luteinizing hormone surge, which in turn prevents ovulation until follicles are of adequate size

Pharmacokinetics

Half-Life: 20-63 hr

Onset: within 12 hr

Peak Plasma Time: 1 hr (0.25mg dose); 1.5 hr (3 mg dose)

Bioavailability: 85% (SC)

Protein Bound: 86%

Duration: 4 days (3 mg dose)

Absorption: Rapid

Vd: 1.2 L/kg

Excretion: Feces; urine

BRAND	FORM.	UNIT PRICE	PILL IMAGE
cetrorelix subcutaneous -	0.25 mg kit
Cetrotide subcutaneous -	0.25 mg kit

Patient Handout

CETRORELIX - INJECTION

(SE-troe-REL-ix)

COMMON BRAND NAME(S): Cetrotide

USES: This medication is used by women having certain fertility treatments (controlled ovarian stimulation). Cetrorelix is usually used in combination with other hormones (FSH and hCG). It works by blocking the release of a certain hormone (luteinizing hormone). Cetrorelix stops eggs from being released too early and gives the eggs time to grow properly.

HOW TO USE: Read the Patient Information Leaflet if available from your pharmacist before you start using cetrorelix and each time you get a refill. If you have any questions, ask your doctor or pharmacist.Learn all preparation and usage instructions from your health care professional and the product package. Follow the instructions for adding the mixing liquid to the medication. Gently shake the vial to mix. Once mixed, use the liquid right away.Before using, check this product visually for particles or discoloration. If either is present, do not use the liquid.Inject this medication under the skin as directed by your doctor, usually once a day for several days. It should be injected in the stomach area, at least one inch away from the belly button. Carefully follow your doctor's instructions on when to start and stop this medication.Before injecting each dose, clean the injection site with rubbing alcohol. Change the injection site each time to lessen injury under the skin.Use this medication exactly as directed by your doctor to get the most benefit from it. Do not increase your dose or use this drug more often or for longer than prescribed.Learn how to store and discard medical supplies safely.

SIDE EFFECTS: Nausea, headache, or pain/bruising/redness/swelling/itching at the injection site may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.This medication may cause a condition known as ovarian hyperstimulation syndrome (OHSS). This condition may occur during or after treatment. Rarely, serious OHSS causes fluid to suddenly build up in the stomach, chest, and heart area. Get medical help right away if you develop the following side effects: severe pain or swelling in the lower abdominal (pelvic) area, severe nausea/vomiting, sudden/rapid weight gain, or decreased urination.A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, such as: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice any other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

PRECAUTIONS: Before using cetrorelix, tell your doctor or pharmacist if you are allergic to it; or to other products containing gonadotropin releasing hormone (GnRH); or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: history of severe allergic reactions, kidney disease.Before having surgery, tell your doctor or dentist about all the products you use (such as prescription drugs, nonprescription drugs, and herbal products).Stop using this medication when you become pregnant. This medication must not be used during pregnancy. If you think you may be pregnant, tell your doctor right away.It is unknown if this drug passes into breast milk. Because of the possible risk to the infant, breastfeeding is not recommended while using this drug. Consult your doctor before breastfeeding.

DRUG INTERACTIONS: Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (such as prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.

OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center.

NOTES: Do not share this medication with others.Lab and/or medical tests (such as vaginal ultrasound, hormone levels) may be done while you are using this medication. Keep all medical and lab appointments. Consult your doctor for more details.

MISSED DOSE: It is important to get each dose of this medication as scheduled. If you miss a dose, ask your doctor or pharmacist right away for a new dosing schedule. Do not double the dose to catch up.

STORAGE: Different brands of this medication have different storage needs. Check the product package for instructions on how to store your brand, or ask your pharmacist. Keep all medications away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

Formulary

FormularyPatient Discounts

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The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

View explanations for tiers and restrictions

Tier	Description
1	This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
2	This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
3	This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
4	This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
5	This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
6	This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
NC	NOT COVERED – Drugs that are not covered by the plan.

Code	Definition
PA	Prior Authorization Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
QL	Quantity Limits Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
ST	Step Therapy Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
OR	Other Restrictions Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.

Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.

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