Goserelin Acetate, Implant

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KEY POINTS

• This medicine is an implant placed just under the skin of the stomach to treat prostate cancer or breast cancer. It may also be used to relieve the pain and to reduce the lesions caused by endometriosis, and to treat uterine bleeding.
• Keep all appointments for tests to see how this medicine affects you.
• This medicine may increase the risk for a heart attack or stroke in men, or cause other unwanted side effects. Tell your healthcare provider if you have any side effects that are serious, continue, or get worse.
• Tell all healthcare providers who treat you about all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take.

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What are other names for this medicine?

Type of medicine: antineoplastic (anticancer)

Generic and brand names: goserelin acetate, implant; Zoladex

What is this medicine used for?

This medicine is an implant placed just under the skin of the stomach to treat prostate cancer or breast cancer. The implants are designed to allow slow release of the drug into your body. It may also be used to relieve the pain and to reduce the lesions caused by endometriosis, and to treat uterine bleeding.

This medicine may be used to treat other conditions as determined by your healthcare provider.

What should my healthcare provider know before I take this medicine?

Before taking this medicine, tell your healthcare provider if you have ever had:

• An allergic reaction to any medicine
• A stroke or transient ischemic attack (TIA)
• Diabetes
• Heart disease or a heart attack
• High blood pressure
• High cholesterol
• Long QT syndrome (problems with electrical activity in the heart muscle)
• Osteoporosis
• Problems with low levels of potassium or magnesium in the blood
• Unexplained vaginal bleeding

Tell your provider if you smoke cigarettes or regularly drink alcohol.

Females of childbearing age: This medicine has been reported to cause birth defects. Before starting treatment with this medicine you should have a negative pregnancy test. Use effective nonhormonal birth control methods while you are taking this medicine and for 12 weeks after stopping it. Talk with your healthcare provider about effective nonhormonal birth control methods. Stop taking this medicine at the first sign that you may be pregnant and contact your healthcare provider right away. Do not breast-feed while taking this medicine.

How do I use it?

This medicine is given by your healthcare provider as a tiny implant inserted through a needle injected under the skin of your upper stomach. Your healthcare provider will prescribe the exact dose of this medicine and tell you how often you will receive it.

This medicine is usually given every 28 days or every 12 weeks to treat prostate cancer in men. Women will usually be given this medicine every 28 days. Your schedule will depend on the reason you are receiving this medicine. Keep all appointments. If you miss an appointment for an implant, contact your healthcare provider right away to reschedule.

What should I watch out for?

When you first start this treatment, your symptoms may become worse. This medicine may cause you to lose some bone strength. Talk to your healthcare provider about this.

You will need to have tests regularly to see how this medicine affects you. Keep all appointments for these tests.

Males: This medicine may increase your risk for a heart attack or stroke. Contact your healthcare provider right away if you have dizziness, lightheadedness, fainting, or abnormal heartbeats.

Females: The implant given every 28 days should stop your periods. If regular periods or vaginal bleeding continue, contact your healthcare provider. If you miss one or more doses, you may have breakthrough bleeding. When you stop treatment, the return of regular monthly periods may be delayed.

Hormonal forms of birth control (pills, patches, rings) may not prevent pregnancy while you are receiving this medicine. You will need to use another method of birth control. Talk to your healthcare provider about this.

This medicine may make you dizzy. Do not drive or operate machinery unless you are fully alert.

If you need emergency care, surgery, lab tests, or dental work, tell the healthcare provider or dentist you have received this medicine.

You may develop diabetes when you take this medicine. If you already have diabetes, it may get worse. Talk with your healthcare provider about this.

What are the possible side effects?

Along with its needed effects, your medicine may cause some unwanted side effects. Some side effects may be very serious. Some side effects may go away as your body adjusts to the medicine. Tell your healthcare provider if you have any side effects that continue or get worse.

Life-threatening (Report these to your healthcare provider right away. If you cannot reach your healthcare provider right away, get emergency medical care or call 911 for help.): Allergic reaction (hives; itching; rash; trouble breathing; tightness in your chest; swelling of your lips, tongue, and throat); sudden weakness, numbness, or tingling, especially on one side of your body; sudden or severe headache; sudden trouble with vision, speech, balance, or walking.

Serious (Report these to your healthcare provider right away.): Trouble urinating, inability to urinate, or increased urination; severe dizziness or fainting; swelling in your hands; swelling, pain, redness, or warmth in calf or leg; unusual nausea or vomiting; severe constipation; chest pain; fast or irregular heartbeat; numbness of tingling in legs or feet; trouble breathing; new or worsening depression; increased thirst or hunger; severe back or bone pain; unexplained vaginal bleeding.

Other: Hot flushes, change in sexual desire or ability, pain around the implant, mild rash, sweating, loss of appetite, trouble sleeping, vaginal dryness or itching, tiredness, nervousness, diarrhea, headache, mood swings, acne.

What products might interact with this medicine?

When you take this medicine with other medicines, it can change the way this or any of the other medicines work. Nonprescription medicines, vitamins, natural remedies, and certain foods may also interact. Using these products together might cause harmful side effects. Talk to your healthcare provider if you are taking:

• Alfuzosin (Uroxatral)
• Antibiotics such as azithromycin (Zithromax, Zmax), bedaquiline (Sirturo), ciprofloxacin (Cipro), clarithromycin (Biaxin), erythromycin (E.E.S., Ery-Tab, Erythrocin), levofloxacin (Levaquin), moxifloxacin (Avelox), ofloxacin, pentamidine (NebuPent, Pentam), and telithromycin (Ketek)
• Antidepressants such as amitriptyline, citalopram (Celexa), clomipramine, escitalopram (Lexapro), fluoxetine (Prozac), imipramine (Tofranil), sertraline (Zoloft), trazodone, and venlafaxine (Effexor)
• Antifungal medicines such as fluconazole (Diflucan), itraconazole (Sporanox), ketoconazole (Nizoral), and voriconazole (Vfend)
• Antipsychotic medicines such as aripiprazole (Abilify), asenapine (Saphris), chlorpromazine, clozapine (Clozaril, FazaClo), haloperidol (Haldol), iloperidone (Fanapt), paliperidone (Invega), pimozide (Orap), quetiapine (Seroquel), risperidone (Risperdal), thioridazine, and ziprasidone (Geodon)
• Apomorphine (Apokyn)
• Cancer medicines such as arsenic trioxide (Trisenox), crizotinib (Xalkori), degarelix (Firmagon), lapatinib (Tykerb), nilotinib (Tasigna), pazopanib (Votrient), sorafenib (Nexavar), sunitinib (Sutent), toremifene (Fareston), vandetanib (Caprelsa), and vemurafenib (Zelboraf)
• Eliglustat (Cerdelga)
• Fingolimod (Gilenya)
• Heart medicines such as amiodarone (Cordarone, Pacerone), disopyramide (Norpace), dofetilide (Tikosyn), dronedarone (Multaq), flecainide, mexiletine, procainamide, propafenone (Rythmol), quinidine, ranolazine (Ranexa), and sotalol (Betapace, Sorine)
• HIV medicines such as atazanavir (Reyataz), lopinavir/ritonavir (Kaletra), ritonavir (Norvir), and saquinavir (Invirase)
• Malaria medicines such as artemether/lumefantrine (Coartem), chloroquine, mefloquine, primaquine, and quinine
• Medicines to treat breathing or lung problems such as arformoterol (Brovana), formoterol (Perforomist), salmeterol (Serevent), and vilanterol (Breo Ellipta)
• Methadone (Dolophine, Methadose)
• Mifepristone (Korlym, Mifeprex)
• Nausea medicines such as dolasetron (Anzemet), droperidol (Inapsine), granisetron (Sancuso), ondansetron (Zofran), and promethazine
• Paroxetine (Brisdelle, Paxil, Pexeva)
• Solifenacin (VESIcare)
• Tetrabenazine (Xenazine)

If you are not sure if your medicines might interact, ask your pharmacist or healthcare provider. Keep a list of all your medicines with you. List all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take. Be sure that you tell all healthcare providers who treat you about all the products you are taking.

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This advisory includes selected information only and may not include all side effects of this medicine or interactions with other medicines. Ask your healthcare provider or pharmacist for more information or if you have any questions.

Keep all medicines out of the reach of children.

Do not share medicines with other people.