Nafarelin (Systemic)

Brand Names : Synarel

Proper Use of This Medicine

You will be given a fact sheet with your prescription for nafarelin that explains how to use the pump spray bottle. If you have any questions about using the pump spray, ask your health care professional.

To use nafarelin spray :

• Before you use each new bottle of nafarelin, the spray pump needs to be started. To do this, point the bottle away from you and pump the bottle firmly about seven times. A spray should come out by the seventh time you pump the spray bottle. This only needs to be done once for each new bottle of nafarelin . Be careful not to breathe in this spray. You could inhale extra doses of nafarelin, since the medicine is dissolved in the spray.
• Before you take your daily doses of nafarelin, blow your nose gently. Hold your head forward a little. Put the spray tip into one nostril. Aim the tip toward the back and outside of your nostril. You do not need to put the tip too far into your nose.
• Close your other nostril off by pressing on the outside of your nose with a finger. Then, sniff in the spray as you pump the bottle once.
• Take the spray bottle out of your nose. Tilt your head back for 30 seconds, to let the spray get onto the back of your nose.
• Repeat these steps for each dose of medicine.
• Each time you use the spray bottle, wipe off the tip with a clean tissue or cloth. Keep the blue safety clip and plastic cap on the bottle when you are not using it.
• Every 3 or 4 days you should clean the tip of the spray bottle. To do this, hold the bottle sideways. Rinse the tip with warm water, while wiping the tip with your finger or a soft cloth for about 15 seconds. Dry the tip with a soft cloth or tissue. Replace the cap right after use. Be careful not to get water into the bottle, since this could dilute the medicine.

It is important to avoid sneezing when spraying and immediately after using the medicine. If you sneeze, the medicine may not be absorbed as well.

Use this medicine only as directed by your doctor. Do not use more or less of it, and do not use it more often than your doctor ordered. The exact amount of medicine you need has been carefully worked out. Using too much may increase the chance of side effects, while using too little may not improve your condition.

Many boys and girls who have central precocious puberty will not feel sick or will not understand the importance of taking the medicine regularly. It is very important that the medicine is used exactly as directed and that the proper amount is used at the proper time. It works best when there is a constant amount in the blood. To help keep the amount constant, nafarelin must be given on a regular schedule.

Dosing - The dose of nafarelin will be different for different patients. Follow your doctor's orders or the directions on the label . The following information includes only the average dose of nafarelin. If your dose is different, do not change it unless your doctor tells you to do so.

• For nasal solution dosage form:
  • For treating central precocious puberty:
    • Children - 800 micrograms (mcg) (two sprays into each nostril) two times a day, once in the morning and once in the evening. This provides a total daily dose of eight sprays or 1600 mcg a day. Sometimes a larger dose may be needed. 1800 mcg a day is provided by using three sprays in alternating nostrils three times a day to provide a total of nine sprays a day.
  • For treating endometriosis:
    • Adults - 200 mcg (one spray) inhaled into one nostril in the morning and one spray inhaled into the other nostril in the evening, for six months. Begin your treatment on Day 2, 3, or 4 of your menstrual period.

Missed dose - If you miss a dose of this medicine, take it as soon as possible. However, if you do not remember until the next day, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage - To store this medicine:

• Keep out of the reach of children.
• The bottle should be stored standing upright, with the tip up.
• Store away from heat and direct light.
• Keep the medicine from freezing. Do not refrigerate.
• Do not keep outdated medicine or medicine no longer needed. Be sure that any discarded medicine is out of the reach of children.