ganirelix

[gan″ĭ-rel´iks] a synthetic compound derived from, and an antagonist to, hormone" >gonadotropin-releasing hormone; used as the acetate salt to inhibit premature hormone" >luteinizing hormone (LH) surges in women undergoing ovarian hyperstimulation in the treatment of female infertility, administered subcutaneously.

ganirelix

(ga-ni-rell-ix) ganirelix,

Antagon

(trade name)

Classification

Therapeutic: hormones
Pregnancy Category: X

Indications

As a component of infertility regimens (with recombinant follicle stimulating hormone [FSH], and human chorionic gonadotropin) to inhibit premature luteinizing hormone (LH) surges in patients undergoing controlled ovarian hyperstimulation.

Action

Induces a rapid, reversible suppression of gonadotropin (FSH and LH) secretion, which suppresses surges in LH. Ganirelix is a gonadotropin-releasing hormone antagonist.

Therapeutic effects

Suppression of LH surges increases the implantation and pregnancy rates in patients undergoing in vitro fertilization.

Pharmacokinetics

Absorption: Well absorbed following subcutaneous administration.Distribution: 44 L.Metabolism and Excretion: Metabolized to two primary metabolites; 18% excreted unchanged in urine.Half-life: 16 hr.

Time/action profile (blood levels)

ROUTE	ONSET	PEAK	DURATION
Subcut	unknown	1 hr	unknown

Contraindications/Precautions

Contraindicated in: Hypersensitivity to ganirelix, gonadotropin releasing hormone or any of its analogs; Obstetric: Known or suspected pregnancy.Use Cautiously in: None noted.

Adverse Reactions/Side Effects

Gastrointestinal

ovarian hyperstimulation syndrome (life-threatening)
abdominal pain
nausea

Genitourinary

pelvic pain
vaginal bleeding

Local

hypersensitivity reactions (life-threatening)
injection site reactions

Interactions

Drug-Drug interaction

Unknown.

Route/Dosage

Subcutaneous (Adults) 250 mcg once daily during the mid-to-late follicular phase of menstrual cycle after initiating FSH on day 2 or 3 of cycle. Treatment with ganirelix should be continue daily until day of administration of human chorionic gonadotropin (when adequate follicular response achieved).

Availability

Injection: 250 mcg/0.5 mL in prefilled syringes

Nursing implications

Nursing assessment

Assess patient for pregnancy prior to therapy. Therapy should not be initiated if patient is pregnant.
Lab Test Considerations: May cause elevated neutrophil counts and decreased hematocrit and total bilirubin concentrations.

Potential Nursing Diagnoses

Deficient knowledge, related to medication regimen (Patient/Family Teaching)

Implementation

Subcutaneous: Administer via subcutaneous injection only.

Patient/Family Teaching

Instruct patient on correct technique for subcutaneous injection. Most convenient sites are in the abdomen around the navel and in the upper thigh.

Evaluation/Desired Outcomes

Successful in vitro fertilization procedure.