Ganirelix
Indications
Ganirelix is used for:
Ovarian stimulation, Assisted reproduction
Adult Dose
Subcutaneous
Female Infertility
250 mcg SC qDay during mid-to-late follicular phase after initiating follicle-stimulating hormone on day 2 and 3 of the cycle, continue therapy until day of hCG administration
Hepatic impairment: Moderate to severe: Contraindicated.
Child Dose
Renal Dose
Renal impairment: Moderate to severe: Contraindicated.
Administration
Contra Indications
Hypersensitivity, pregnancy, lactation, moderate to severe renal or hepatic impairment.
Precautions
Women with active allergic conditions or a history of allergies.
Lactation: Excretion unknown; not recommended
Pregnancy-Lactation
Pregnancy
Contraindicated in pregnant women
Animal data
When administered from Day 7 to near term to pregnant rats and rabbits at doses up to 10 and 30 mcg/day (~0.4 to 3.2 times the human dose based on body surface area), ganirelix acetate increased the incidence of litter resorption
There was no increase in fetal abnormalities
No treatment-related changes in fertility, physical, or behavioral characteristics were observed in the offspring of female rats treated with ganirelix acetate during pregnancy and lactation
Lactation
Should not be used by lactating women
Unknown whether drug is excreted in human milk
Consider the developmental and health benefits of breastfeeding along with the mother’s clinical need for the drug, and any potential adverse effects on the breastfed infant from the drug or from the underlying maternal condition
Interactions
May require dose adjustment of exogenous gonadotropins when concomitantly used during controlled ovarian hyperstimulation.
Side Effects
Side effects of Ganirelix :
1-10%
Abdominal pain (1%), Headache (3%), Injection site recation (1%), Nausea (1%), Ovarian hyperstimulation syndrome (2%), Vaginal bleeding (2%), Pelvic pain (5%)
<1%
Anaphylactoid reactions
Mode of Action
Ganirelix is a gonadorelin (gonadotrophin-releasing hormone) antagonist. It competitively blocks the gonadotropin-release hormone receptors on the pituitary gonadotroph and transduction pathway. This suppresses gonadotropin secretion and luteinising hormone secretion thus preventing ovulation until the follicles are of adequate size.