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Zoladex (Goserelin)  

Zoladex (Goserelin) contains a potent synthetic decapeptide analogue of luteinizing hormone-releasing hormone which is shown to be useful in the treatment of prostate cancer. Goserelin is an off-white powder with a molecular weight of 1269 free base. 

 

Indications: Zoladex comes in tablets form. The medication is often indicated in the treatment of prostate cancer in men and for breast cancer in women. It is also indicated in endometriosis (uterus disorder). Goserelin is a similar natural hormone which works by decreasing the testosterone hormones in men and oestrogen hormones in women. Testosterones are the male hormones that help cancerous cells in their growth. Zoladex reduces the growth of these hormones, consecutively inhibiting proliferation of the malignancy.  

 

Dosage: Zoladex is usually given as an injection in the dosage of 3.6 milligram for 4 weeks or 10.8 milligram for 12 weeks. The dosage schedule of this drug has to be followed strictly in order to achieve desired results. Hormone levels tend to increase usually during the first few weeks of the treatment. This is a normal indication because hormone levels start decreasing during the consequent course of this drug. The 10.8 milligram dosage should not be used in women and it is prescribed only for men. Zoladex is also supplied as a sterile, biodegradable product consisting of Goserelin acetate, equivalent to a 3.6 mg of Goserelin to be administered every 28 days. 

 

Contraindications: Zoladex (Goserelin) may face contraindications in following cases:  

  • This drug should not be taken if the patient is suffering from diabetes as the drug decreases the control of blood sugar levels. In such cases monitoring of sugar levels becomes important.  
  • If the patient is having a family history of osteoporosis (bone loss) 
  • Spinal cord problems or urinary blockage in men 
  • Long term usage of alcohol, etc 
  • If the patient is allergic to the drug, or any of its components, its intake must be ceased. 

Therefore, before the commencement of the treatment, the doctor should be informed about the complete medical history of the patient.

 

Mechanism of Action (MOA): Zoladex being an analogue of natural event LHRH, with its incessant administration results in a major turn down in testosterone production by the testicles. This reduces testosterone’s encouragement to development or proliferation of prostate cancer. In women, it reduces the growth of oestrogen hormones and prevents them from associated problems. 

 

Interactions: The use of vitamins or herbal products, minerals, and the prescriptions given by other doctors may interact with this drug.  

 

Side Effects: Zoladex may cause some of the following common side effects that may cease after patient’s body gets accustomed to this drug:  

  • Pain in bones and joints 
  • Eruption of symptomatic signs of prostatic cancer, known as the tumour flare effect, due to the amplification in the production of luteinizing hormone 
  • Hot flushes, rashes, hives and eruptions on skin 
  • Headache, lethargy, stomach ache, acidity, and depression 
  • Sudden gain in weight gain and tenderness of breasts 
  • Poor libido and painful erection 

If any of these side effects are persistent even after ceasing the intake of Zoladex, doctor must be consulted at earliest to prevent complications that can worsen the cancer.