Brand Name Choices
No generic medication is available for Synarel (Nafarelin Acetate)
What Synarel is and what it is used for
Synarel works by reducing the normal response of your body to a hormone called GnRH (gonadotrophin releasing hormone). As a result, your ovaries produce less of another hormone called oestrogen. You will notice the reduced amount of oestrogen usually by your periods either stopping or being reduced in amount after about one month of taking Synarel. Synarel has to get into your blood stream before it can work. This cannot happen if it is taken by mouth, because your stomach acid will break it down and it will be digested. Therefore, nasal inhalation is a simple way to get this medicine into your blood stream. Synarel is used to treat endometriosis. It can also be prescribed with other medicines for women trying to become pregnant as part of a supervised fertility programme.
How to take Synarel
Always use this medicine exactly as your doctor or pharmacist has told you. Check with your doctor or pharmacist if you are not sure. How to use your medicine For endometriosis: the usual dose is one spray twice each day for six months. Spray into one nostril in the morning, and the other nostril in the evening (a total of 2 sprays per day). You should use the spray for the first time between the second and fourth day of your period. For endometriosis, the longest time for which you should be taking your medicine is 6 months. For use in fertility programmes: if you are taking this medicine as part of a fertility programme, the dose is usually one spray to both nostrils in the morning, and one spray to both nostrils in the evening (4 sprays per day). If you are taking this medicine as part of a fertility programme, your doctor will tell you how long to keep taking your medicine. This will usually be for no longer than 8 weeks. Take your spray as your doctor has told you to. If you are still not sure, ask your doctor or pharmacist. It is important to keep taking your spray. If you have any questions, don’t wait until your nasal spray is finished before seeing your doctor. Important Tips about using Synarel:
• Your pump should produce a fine mist, which can only happen by a quick and firm pumping action. It is normal to see some larger droplets of liquid within the fine mist. However, if Synarel comes out of the pump as a thin stream of liquid instead of a fine mist, Synarel may not work as well, and you should talk to your pharmacist.
• Be sure to clean the Spray Tip after priming (at the time of the first use). The spray tip should then be cleaned before and after every use. Failure to do this may result in a clogged tip that may cause you not to get the right amount of medicine that is prescribed for you. Always replace the safety clip and the plastic dust cap on the nasal piece after use to help prevent the tip becoming clogged.
• The pump is made to deliver only a set amount Do not clean the spray tip with a pointed object. This could cause an improper dose of the spray to be delivered. Do not remove the pump from the bottle, as this will release the priming pressure. Wipe the tip dry with a clean soft cloth or tissue. Using the Spray Pump 1. Gently blow your nose to clear the nostrils. 2. Remove and save the safety clip and the plastic cap to uncover the nasal piece. Hold the bottle as shown previously. 3. Clean the tip of pump. Hold the bottle in a horizontal position and rinse the spray tip with warm water, while wiping the tip with your finger or a clean soft cloth for 15 seconds. Do not clean the spray tip with a pointed object. This could cause an improper dose of the spray to be delivered. Do not remove the pump from the bottle, as this will release the priming pressure. Wipe the tip dry with a clean soft cloth or tissue. 4. Bend head forward slightly. Close one nostril and put the spray tip into the other, aiming towards the back and outer side of your nose. 5. Press the bottle firmly up between thumb and fingers once only whilst gently breathing in through the nostril. If your doctor has told you to take 4 sprays every day, now spray into your other nostril. 6. Remove the sprayer from the nostril. Bend head backwards for a few seconds to let the spray spread over back of the nose. 7. Clean the tip of pump. Hold the bottle in a horizontal position and rinse the spray tip with warm water, while wiping the tip with your finger or a clean soft cloth for 15 seconds. Do not clean the spray tip with a pointed object. This could cause an improper dose of the spray to be delivered. Do not remove the pump from the bottle, as this will release the priming pressure. Wipe the tip dry with a clean soft cloth or tissue. Cleaning the spray tip before and after use is important to prevent clogging of the tip that may cause you to get the wrong dose of medicine. 8. Replace the safety clip and the plastic dust cap on the nasal piece. This is important as it helps to prevent the spray tip becoming clogged. If you use more Synarel than you should
• If you have taken too many sprays at once, or in one day contact your doctor or go to your nearest hospital casualty department immediately. If you forget to use Synarel
• If you forget to take your spray at the proper time, take it as soon as you remember and take the next spray at your normal time. Do not take a double dose to make up for a forgotten dose.
• If you miss one or more doses, vaginal bleeding (often called breakthrough bleeding) may occur. Also, release of an egg from the ovary (ovulation) may occur. If you have had sexual intercourse and not used contraception, you could become pregnant. It is then important that you stop taking Synarel and see your doctor to make sure that you are not pregnant. (This is why it is very important to use a barrier method of contraception when you are taking this medicine.).
• Take your spray as your doctor has told you to.
• If you are still not sure, ask your doctor or pharmacist.
• It is important to keep taking your spray.
• If you have any questions, don't wait until your nasal spray is finished before seeing your doctor.
Possible side effects
Like all medicines, Synarel can cause side effects although not everybody gets them. Stop taking Synarel and tell your doctor straight away if you have an allergy to this medicine. If you are allergic to it, you may become short of breath, have chest pain, or a rash which may or may not be itchy. Synarel may lead to enlargement of the ovaries due to excess egg production (OHSS – Ovarian Hyperstimulation Syndrome). This can lead to pain in the pelvis, stomach or calf, swelling or feeling bloated, passing less urine, difficulty in breathing or an increase in weight. If you experience any of these symptoms, tell your doctor immediately.
Other side effects Synarel may cause are listed below by frequency:
Very common side effects: may affect more than 1 in 10 people
• weight increase
• swings of emotion
• sex drive decrease
• hot flushes
• nasal irritation and/or inflammation
• oily appearance on the skin and the formation of grease scales
• painful muscles
• breast size decrease
• vaginal dryness
Common side effects: may affect up to 1 in 10 people
• allergic reaction which may include shortness of breath, chest pain and a rash which may or may not be itchy
• itching which may be accompanied by swelling
• skin rash including hives
• oestrogen deficiency
• weight decrease
• tingling sensation in parts of your body
• excessive hair growth
• artificial menopause
• abnormal bleeding from the vagina
• sex drive increase
• difficulty sleeping (insomnia)
• bone density decreases
Uncommon side effects: may affect up to 1 in 100 people
• hair loss
• joint pain
• breast size increase
• ovarian cyst formation
Not known side effects: the frequency cannot be estimated from the available data
• blurred vision
• liver enzyme increases
• short term increase in symptoms of endometriosis
• enlargement of the ovaries due to excess egg production Tell your doctor if you are due to have any medical tests as the results may be affected. If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet.
Reporting of side effects If you get any side effects, talk to your doctor, pharmacist or nurse. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via the Yellow Card Scheme at: www.mhra.gov.uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store. . By reporting side effects you can help provide more information on the safety of this medicine.
How to Store Synarel
You should always put the safety clip and the plastic dust cap back on when you are not using the medicine.
• Keep your spray out of the reach and sight of children.
• Do not use Synarel after the expiry date which is stated on the carton after EXP. The expiry date refers to the last day of that month.
• Do not store above 25°C and protect from freezing.
• Keep the bottle upright and store away from light.
• Do not throw away any medicines via household waste. Ask your pharmacist how to throw away medicines you no longer use. These measures will help protect the environment.
2 to 3 weeks on average
The average shipping time is 2 weeks in North America and 4 weeks internationally. We offer free shipping on all orders shipped to North America. Shipping is a flat rate of $20.00 for all other countries.
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