Dosing & Uses
Dosage Forms & Strengths
implant
- 3.6mg
- 10.8mg
Prostate Cancer
Monthly implant: 3.6 mg SC q28days
3-months implant: 10.8 mg SC q12week
Treat long-term
Place in upper abdominal wall
Breast Cancer
3.6 mg implant SC q28days
Treat long-term
Place in upper abdominal wall
Endometriosis
3.6 mg implant SC q28days
Treat for 6 months
Place in upper abdominal wall
Endometrial Thinning
3.8 mg SC q28days for 1 or 2 doses
Renal Impairment
Dose adjustment not necessary
Hepatic Impairment
Dose adjustment not necessary
Safety and efficacy not established
Interactions
Interaction Checker
No Results
Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor
Contraindicated (30)
- amiodarone
goserelin increases toxicity of amiodarone by QTc interval. Contraindicated. Increases risk of torsades de pointes.
- anagrelide
goserelin increases toxicity of anagrelide by QTc interval. Contraindicated. Increases risk of torsades de pointes.
- arsenic trioxide
goserelin increases toxicity of arsenic trioxide by QTc interval. Contraindicated. Increases risk of torsades de pointes.
- artemether
goserelin increases toxicity of artemether by QTc interval. Contraindicated. Increases risk of torsades de pointes.
- artemether/lumefantrine
goserelin increases toxicity of artemether/lumefantrine by QTc interval. Contraindicated.
- citalopram
goserelin increases toxicity of citalopram by QTc interval. Contraindicated. Increases risk of torsades de pointes.
- disopyramide
goserelin increases toxicity of disopyramide by QTc interval. Contraindicated. Increases risk of torsades de pointes.
- dofetilide
goserelin increases toxicity of dofetilide by QTc interval. Contraindicated. Increases risk of torsades de pointes.
- dronedarone
goserelin increases toxicity of dronedarone by QTc interval. Contraindicated. Increases risk of torsades de pointes.
- eliglustat
goserelin increases toxicity of eliglustat by QTc interval. Contraindicated. Increases risk of torsades de pointes.
- escitalopram
goserelin increases toxicity of escitalopram by QTc interval. Contraindicated. Increases risk of torsades de pointes.
- fluoxetine
goserelin increases toxicity of fluoxetine by QTc interval. Contraindicated. Increases risk of torsades de pointes.
- ibutilide
goserelin increases toxicity of ibutilide by QTc interval. Contraindicated. Increases risk of torsades de pointes.
- iloperidone
goserelin increases toxicity of iloperidone by QTc interval. Contraindicated. Increases risk of torsades de pointes.
- lopinavir
goserelin increases toxicity of lopinavir by QTc interval. Contraindicated. Increases risk of torsades de pointes.
- lumefantrine
goserelin increases toxicity of lumefantrine by QTc interval. Contraindicated. Increases risk of torsades de pointes.
- mifepristone
goserelin increases toxicity of mifepristone by QTc interval. Contraindicated. Increases risk of torsades de pointes.
- nilotinib
goserelin increases toxicity of nilotinib by QTc interval. Contraindicated. Increases risk of torsades de pointes.
- paliperidone
goserelin increases toxicity of paliperidone by QTc interval. Contraindicated. Increases risk of torsades de pointes.
- pimozide
goserelin increases toxicity of pimozide by QTc interval. Contraindicated. Increases risk of torsades de pointes.
- procainamide
goserelin increases toxicity of procainamide by QTc interval. Contraindicated. Increases risk of torsades de pointes.
- quetiapine
goserelin increases toxicity of quetiapine by QTc interval. Contraindicated. Increases risk of torsades de pointes.
- quinidine
goserelin increases toxicity of quinidine by QTc interval. Contraindicated. Increases risk of torsades de pointes.
- sotalol
goserelin increases toxicity of sotalol by QTc interval. Contraindicated. Increases risk of torsades de pointes.
- tetrabenazine
goserelin increases toxicity of tetrabenazine by QTc interval. Contraindicated. Increases risk of torsades de pointes.
- thioridazine
goserelin increases toxicity of thioridazine by QTc interval. Contraindicated. Increases risk of torsades de pointes.
- toremifene
goserelin increases toxicity of toremifene by QTc interval. Contraindicated. Increases risk of torsades de pointes.
- vandetanib
goserelin increases toxicity of vandetanib by QTc interval. Contraindicated. Increases risk of torsades de pointes.
- vemurafenib
goserelin increases toxicity of vemurafenib by QTc interval. Contraindicated. Increases risk of torsades de pointes.
- ziprasidone
goserelin increases toxicity of ziprasidone by QTc interval. Contraindicated. Increases risk of torsades de pointes.
Serious - Use Alternative (23)
- amisulpride
amisulpride and goserelin both increase QTc interval. Avoid or Use Alternate Drug. ECG monitoring is recommended if coadministered.
- asenapine
asenapine and goserelin both increase QTc interval. Avoid or Use Alternate Drug.
- asenapine transdermal
asenapine transdermal and goserelin both increase QTc interval. Avoid or Use Alternate Drug.
- buprenorphine
buprenorphine and goserelin both increase QTc interval. Avoid or Use Alternate Drug.
- buprenorphine buccal
buprenorphine buccal and goserelin both increase QTc interval. Avoid or Use Alternate Drug.
- buprenorphine subdermal implant
buprenorphine subdermal implant and goserelin both increase QTc interval. Avoid or Use Alternate Drug.
- buprenorphine transdermal
buprenorphine transdermal and goserelin both increase QTc interval. Avoid or Use Alternate Drug.
- buprenorphine, long-acting injection
buprenorphine, long-acting injection and goserelin both increase QTc interval. Avoid or Use Alternate Drug.
- desflurane
desflurane and goserelin both increase QTc interval. Avoid or Use Alternate Drug.
- encorafenib
encorafenib and goserelin both increase QTc interval. Avoid or Use Alternate Drug.
- entrectinib
goserelin and entrectinib both increase QTc interval. Avoid or Use Alternate Drug.
- fexinidazole
fexinidazole and goserelin both increase QTc interval. Avoid or Use Alternate Drug. Avoid coadministration of fexinidazole with drugs known to block potassium channels or prolong QT interval.
- glasdegib
goserelin and glasdegib both increase QTc interval. Avoid or Use Alternate Drug. If coadministration unavoidable, monitor for increased risk of QTc interval prolongation.
- inotuzumab
inotuzumab and goserelin both increase QTc interval. Avoid or Use Alternate Drug. If unable to avoid concomitant use, obtain ECGs and electrolytes before and after initiation of any drug known to prolong QTc, and periodically monitor as clinically indicated during treatment.
- isoflurane
isoflurane and goserelin both increase QTc interval. Avoid or Use Alternate Drug.
- lefamulin
lefamulin and goserelin both increase QTc interval. Avoid or Use Alternate Drug.
- lithium
lithium and goserelin both increase QTc interval. Avoid or Use Alternate Drug.
- olanzapine
olanzapine and goserelin both increase QTc interval. Avoid or Use Alternate Drug.
- oxaliplatin
oxaliplatin and goserelin both increase QTc interval. Avoid or Use Alternate Drug.
- panobinostat
goserelin and panobinostat both increase QTc interval. Avoid or Use Alternate Drug. Panobinostat is known to significantly prolong QT interval. Panobinostat prescribing information states use with drugs known to prolong QTc is not recommended.
- pitolisant
goserelin and pitolisant both increase QTc interval. Avoid or Use Alternate Drug.
- sevoflurane
sevoflurane and goserelin both increase QTc interval. Avoid or Use Alternate Drug.
- siponimod
siponimod and goserelin both increase QTc interval. Avoid or Use Alternate Drug.
Monitor Closely (80)
- albuterol
albuterol and goserelin both increase QTc interval. Use Caution/Monitor.
- alfuzosin
goserelin and alfuzosin both increase QTc interval. Use Caution/Monitor.
- apomorphine
goserelin increases toxicity of apomorphine by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.
- arformoterol
goserelin increases toxicity of arformoterol by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.
- aripiprazole
aripiprazole and goserelin both increase QTc interval. Use Caution/Monitor.
- atomoxetine
atomoxetine and goserelin both increase QTc interval. Use Caution/Monitor.
- azithromycin
goserelin increases toxicity of azithromycin by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.
- bedaquiline
goserelin increases toxicity of bedaquiline by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.
- bosutinib
bosutinib and goserelin both increase QTc interval. Use Caution/Monitor.
- capecitabine
capecitabine and goserelin both increase QTc interval. Use Caution/Monitor.
- ceritinib
goserelin increases toxicity of ceritinib by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.
- chloroquine
goserelin increases toxicity of chloroquine by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.
- chlorpromazine
goserelin increases toxicity of chlorpromazine by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.
- cholera vaccine
goserelin decreases effects of cholera vaccine by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Immunosuppressive therapies, including irradiation, antimetabolites, alkylating agents, cytotoxic drugs and corticosteroids (used in greater than physiologic doses), may reduce the immune response to cholera vaccine.
- ciprofloxacin
goserelin increases toxicity of ciprofloxacin by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.
- clarithromycin
goserelin increases toxicity of clarithromycin by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.
- clozapine
goserelin increases toxicity of clozapine by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.
- crizotinib
goserelin increases toxicity of crizotinib by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.
- dasatinib
dasatinib and goserelin both increase QTc interval. Use Caution/Monitor.
- degarelix
goserelin increases toxicity of degarelix by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.
- dengue vaccine
goserelin decreases effects of dengue vaccine by immunosuppressive effects; risk of infection. Use Caution/Monitor. Immunosuppressive therapies (eg, irradiation, antimetabolites, alkylating agents, cytotoxic drugs, corticosteroids [greater than physiologic doses]) may reduce immune response to dengue vaccine.
- desipramine
desipramine and goserelin both increase QTc interval. Use Caution/Monitor.
- deutetrabenazine
deutetrabenazine and goserelin both increase QTc interval. Use Caution/Monitor. At the maximum recommended dose, deutetrabenazine does not prolong QT interval to a clinically relevant extent. Certain circumstances may increase risk of torsade de pointes and/or sudden death in association with drugs that prolong the QTc interval (eg, bradycardia, hypokalemia or hypomagnesemia, coadministration with other drugs that prolong QTc interval, presence of congenital QT prolongation).
- dolasetron
goserelin increases toxicity of dolasetron by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.
- donepezil
donepezil and goserelin both increase QTc interval. Use Caution/Monitor.
- doxepin
doxepin and goserelin both increase QTc interval. Use Caution/Monitor.
- droperidol
goserelin increases toxicity of droperidol by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.
- efavirenz
efavirenz and goserelin both increase QTc interval. Use Caution/Monitor.
- eribulin
goserelin increases toxicity of eribulin by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.
- erythromycin base
goserelin increases toxicity of erythromycin base by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.
- erythromycin ethylsuccinate
goserelin increases toxicity of erythromycin ethylsuccinate by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.
- erythromycin lactobionate
goserelin increases levels of erythromycin lactobionate by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.
- erythromycin stearate
goserelin increases toxicity of erythromycin stearate by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.
- ezogabine
goserelin increases levels of ezogabine by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.
- fingolimod
goserelin increases toxicity of fingolimod by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.
- flecainide
goserelin increases toxicity of flecainide by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.
- fluconazole
goserelin increases toxicity of fluconazole by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.
- formoterol
goserelin increases toxicity of formoterol by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.
- fostemsavir
goserelin and fostemsavir both increase QTc interval. Use Caution/Monitor. QTc prolongation reported with higher than recommended doses of fostemsavir.
- gallium Ga 68 PSMA-11
goserelin will decrease the level or effect of gallium Ga 68 PSMA-11 by unspecified interaction mechanism. Modify Therapy/Monitor Closely. Androgen deprivation therapy and other therapies targeting the androgen pathway may result in changes in the uptake of gallium Ga 68 PSMA-11 in prostate cancer. The effect of ADT on the performance of gallium Ga 68 PSMA-11 is unknown.
- gemifloxacin
goserelin increases toxicity of gemifloxacin by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.
- gemtuzumab
goserelin and gemtuzumab both increase QTc interval. Use Caution/Monitor.
- gilteritinib
gilteritinib and goserelin both increase QTc interval. Use Caution/Monitor.
- granisetron
granisetron and goserelin both increase QTc interval. Use Caution/Monitor.
- haloperidol
goserelin increases toxicity of haloperidol by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.
- hydroxyzine
hydroxyzine and goserelin both increase QTc interval. Use Caution/Monitor.
- indacaterol, inhaled
goserelin increases toxicity of indacaterol, inhaled by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.
- itraconazole
itraconazole and goserelin both increase QTc interval. Use Caution/Monitor.
- lapatinib
goserelin increases levels of lapatinib by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.
- lenvatinib
goserelin and lenvatinib both increase QTc interval. Use Caution/Monitor. Lenvatinib prescribing information recommends monitoring ECG closely when coadministered with QT prolonging drugs.
- levofloxacin
goserelin increases toxicity of levofloxacin by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.
- metformin
goserelin decreases effects of metformin by pharmacodynamic antagonism. Use Caution/Monitor.
- methadone
goserelin increases toxicity of methadone by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.
- mirtazapine
mirtazapine and goserelin both increase QTc interval. Use Caution/Monitor.
- moxifloxacin
goserelin increases toxicity of moxifloxacin by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.
- ofloxacin
goserelin increases toxicity of ofloxacin by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.
- ondansetron
goserelin increases toxicity of ondansetron by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.
- osilodrostat
osilodrostat and goserelin both increase QTc interval. Use Caution/Monitor.
- osimertinib
goserelin increases toxicity of osimertinib by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.
- oxaliplatin
oxaliplatin will increase the level or effect of goserelin by Other (see comment). Use Caution/Monitor. Monitor for ECG changes if therapy is initiated in patients with drugs known to prolong QT interval.
- pasireotide
goserelin increases toxicity of pasireotide by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.
- pazopanib
goserelin increases toxicity of pazopanib by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.
- pentamidine
goserelin increases toxicity of pentamidine by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.
- perflutren
goserelin increases toxicity of perflutren by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.
- primaquine
primaquine and goserelin both increase QTc interval. Use Caution/Monitor.
- propafenone
goserelin increases toxicity of propafenone by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.
- ranolazine
goserelin increases toxicity of ranolazine by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.
- romidepsin
goserelin increases toxicity of romidepsin by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.
- saquinavir
goserelin increases toxicity of saquinavir by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.
- sertraline
sertraline and goserelin both increase QTc interval. Use Caution/Monitor.
- siponimod
siponimod and goserelin both increase immunosuppressive effects; risk of infection. Use Caution/Monitor. Caution if coadministered because of additive immunosuppressive effects during such therapy and in the weeks following administration. When switching from drugs with prolonged immune effects, consider the half-life and mode of action of these drugs to avoid unintended additive immunosuppressive effects.
- solifenacin
solifenacin and goserelin both increase QTc interval. Use Caution/Monitor.
- sorafenib
goserelin increases toxicity of sorafenib by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.
- sunitinib
goserelin increases toxicity of sunitinib by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.
- tacrolimus
tacrolimus and goserelin both increase QTc interval. Use Caution/Monitor.
- telavancin
goserelin increases toxicity of telavancin by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.
- trazodone
goserelin increases toxicity of trazodone by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.
- valbenazine
valbenazine and goserelin both increase QTc interval. Use Caution/Monitor.
- voriconazole
goserelin increases toxicity of voriconazole by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.
- vorinostat
vorinostat and goserelin both increase QTc interval. Use Caution/Monitor.
Minor (2)
- maitake
maitake increases effects of goserelin by pharmacodynamic synergism. Minor/Significance Unknown. Maitake mushroom has anti-tumor effects (animal/in vitro research).
- taurine
goserelin decreases levels of taurine by unspecified interaction mechanism. Minor/Significance Unknown.
Adverse Effects
>10%
Flushing (46-96%)
Vaginitis (5-75%)
Hot flashes (62%)
Reduced libido (47-61%)
Mood swings (60%)
Depression (women 54%)
Sweating (16-45%)
Acne (42%)
Diarrhea (40%)
Breast atrophy (33%)
Headache (women 32-75%)
Seborrhea (26%)
Tumor flare (23%)
Sexual dysfunction (21%)
Peripheral edema (21%)
Erectile dysfunction (18%)
Pain (8-17%)
UTI (13%)
1-10%
Nausea (9%)
Lethargy (8%)
Rash (6%)
Chronic obstructive pulmonary disease (5%)
Congestive heart failure(5%)
Cerebrovascular accident (1-5%)
Renal impairment (1-5%)
Headache (men 1-5%)
Depression (men 1-5%)
Immune hypersensitivity reaction (>1%)
Frequency Not Defined
Asthenia
Hypercalcemia
Cystitis
Dysmenorrhea
Hirsutism
Dyspareunia
Breast changes
Implant site reactions
Bone pain
Spinal cord compression (rare)
Postmarketing Reports
Bone mineral density: Osteoporosis, decreased bone mineral density, bony fracture in men
Cardiovascular: DVT, PE, MI, stroke, TIA observed in women treated with GnRH agonists
Ovarian cyst: Ovarian cyst formation and, in combination with gonadotropins, ovarian hyperstimulation syndrome
Changes in blood pressure: Hypotension and hypertension
Pituitary apoplexy and tumors: Pituitary apoplexy
Acne: Usually within 1 month of starting treatment
Other: Psychotic disorders, convulsions, mood swings
Warnings
Contraindications
Hypersensitivity to LHRH, LHRH-agonists, any component of product
Pregnancy (for endometriosis), lactation, undiagnosed abnormal vaginal bleeding
Cautions
Manifestations of disease may worsen at beginning of therapy
Increase in cervical resistance may occur; caution is recommended when dilating the cervix for endometrial ablation
Avoid pregnancy; premenopausal women should use nonhormonal contraception until >12 wk following end of treatment
Risk of reduced glucose tolerance in men
Males at risk of ureteral obstruction or spinal compression
Risk of pituitary apoplexy (rare)
Ongoing analysis found that men receiving GnRH agonists for prostate cancer were at a small increased risk for diabetes, heart attack, stroke, and sudden death
Do not exceed 1 year treatment duration with GnRH angonists in women except when treating breast cancer
Androgen deprivation therapy may prolong the QT interval; consider risks and benefits
Hypercalcemia has been reported in patients with bone metastases treated with goserelin; monitor and manage appropriately
Increased risk of myocardial infarction, sudden cardiac death and stroke reported in association with use of GnRH analogs in men; monitor for cardiovascular disease and manage according to current clinical practice
Hyperglycemia and an increased risk of developing diabetes have been reported in men receiving GnRH analogs. Monitor blood glucose level and manage according to current clinical practice
Pregnancy must be excluded for use in benign gynecological conditions
Transient worsening of tumor symptoms may occur during first few weeks of therapy, which may include ureteral obstruction and spinal cord compression; monitor patients at risk for complications of tumor flare
Injection site injury and vascular injury including pain, hematoma, hemorrhage and hemorrhagic shock, requiring blood transfusions and surgical intervention, reported; use extra care when administering to patients with low BMI and/or to patients receiving full dose anticoagulation
Pregnancy & Lactation
Pregnancy Category: D (advanced breast cancer); X (endometriosis, endometrial thinning)
Lactation: excretion in milk unknown; not recommended
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.Pharmacology
Mechanism of Action
Gonadotropin-releasing hormone (LHRH) analog; chronic stimulation of goserelin results in suppression of LH, FSH serum levels
Pharmacokinetics
Half-life: 2-4 hr
Protein bound: 27%
Time to peak: 12-15 days (male); 8-22 days (female)
Vd: 44.1 L (Male); 20.3 L (female)
Excretion: Urine (90%)
Absorption
- 3.6 mg: absorbed slowly during first 8 days, then more rapid continuous release
- 10.8 mg: peak level within 24 hr, then decline until day 4, then concentrations stabilize
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Formulary
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