Indications
Synarel Nasal Spray is a medication used to treat endometriosis, a condition where the tissue that normally lines the inside of the uterus grows outside of the uterus in women. It can help to decrease the abnormal tissue and the symptoms of endometriosis (such as pelvic pain, painful menstrual cramps, and pain during/after sex).
Synarel contains the active ingredient nafarelin acetate, which is a synthetic hormone analog that suppresses the production of natural female sex hormones. It works by decreasing the testosterone hormones in boys and estrogen hormones in women and girls.
Use and Dosage
Synarel Nasal Spray is administered as a spray to the nasal mucosa, as directed by your doctor, usually twice daily (about every 12 hours). If you are using more than 1 spray at a time, wait 30 seconds between each spray. Avoid spraying it on your eyes. Also, avoid sneezing during or right after using the Spray because it may decrease the amount of medication absorbed.
- Remove the plastic cap and the safety clip under the nozzle.
- Before you use the spray for the first time, you must 'prime' the pump. It is so you get the right amount of medicine in each spray.
- Hold the bottle so that the nozzle is between two fingers, and your thumb is on the bottom of the bottle.
- Then aim the nozzle away from you and press your thumb upwards several times until a fine spray appears. You only need to do it the first time you use a new bottle.
- Then, gently blow your nose to clear it. Do not be too concerned if you have a cold, as the medicine will still be absorbed. Bend your head forward a little and put the nozzle into one of your nostrils. Hold your other nostril closed with a finger.
- Breathe through your open nostril and press the bottle once to release a spray. Try to aim the spray towards the back and outer side of your nostril.
- Remove the spray and bend your head backward for a few seconds to allow the spray to spread over the back of your nose.
- If you have been told to use the spray in both nostrils at the same time of day, repeat steps 3 and 4 in your other nostril. If not, the next time you use the spray, remember to use it in your other nostril.
- Clean the nozzle by holding it under warm running water and gently wiping it with your finger. Do it before and after every use of the spray to prevent the nozzle from becoming blocked.
- Wipe the nozzle with a clean tissue and replace the plastic cap and clip.
If you miss a dose, take it as soon as you remember unless it is almost time for your next dose; in which case, skip the missed dose and take your next dose when it is due. Do not take two doses together to make up for a forgotten dose.
Side Effects
Common Side Effects of Synarel Nasal Spray (Nafarelin Acetate):
- Acne
- Breast pain
- Change in sex drive
- Depression
- Headache
- Hot flushes
- Irritation inside the nose
- Mood changes
- Muscle pains
- Vaginal dryness
Serious Side Effects of Synarel Nasal Spray (Nafarelin Acetate):
- Chest pain or rashes due to allergy
- Excessive vaginal bleeding
- Hair loss or tingling feeling of the skin
- Shortness of breath
Forms and Strength
Synarel Nasal Spray (Nafarelin Acetate) is available in the following forms and strength:
Synarel Nasal Spray: Nasal Spray
- 2mg/mL
Cautions
- Nafarelin Acetate may cause side effects, including hot flashes, vaginal dryness, headache, dizziness, and decreased sex drive.
- Nafarelin Acetate may suppress the production of female sex hormones, which may cause a decrease in bone density.
- Compliance problems should be excluded before considering the possibility of gonadotropin-independent sexual precocity. Before using the medication, appropriate examinations should be done to rule out the possibility of gonadotropin-independent sexual precocity.
- The medication should not be used if the patient is pregnant or breastfeeding.
- The patient's medical history should be evaluated before using the medication as it may not be suitable for patients with certain medical conditions or taking certain medications.
- Nafarelin Acetate should only be used as prescribed by a healthcare provider.
- The bottle of Nafarelin nasal spray (brand name Synarel) lasts for about 30 days at a dosage of 400 g/day
- Patients using Synarel Nasal Spray may experience worsening of symptoms related to endometriosis initially, such as pelvic pain, dysmenorrhea, and dyspareunia.
- Synarel Nasal Spray may cause disturbances in vision like impaired visual acuity.
- Use of alcohol along with Synarel Nasal Spray may cause dizziness and can increase the severity of the side effects. So, patients are advised to avoid alcohol while using the medication.
- Synarel Nasal Spray may interact with other medications, patients must inform their healthcare provider about all medications they are taking before starting treatment with Synarel.
- Synarel Nasal Spray should not be used for longer than six months, as it may cause irreversible bone loss.
- Synarel Nasal Spray may cause a delay in the return of fertility, so patients who wish to become pregnant should discuss with their healthcare provider before starting treatment with Synarel.
- Patients using Synarel Nasal Spray should have regular follow-up appointments with their healthcare provider to monitor their response to the medication and to assess for any potential side effects or complications.
Frequently Asked Questions (FAQ)
Can Synarel Nasal Spray (Nafarelin Acetate) cause bone loss?
Yes, Synarel Nasal Spray may suppress the production of female sex hormones, which can lead to a decrease in bone density and potentially irreversible bone loss, particularly if used for more than six months.
Is it safe to use Synarel Nasal Spray (Nafarelin Acetate) during pregnancy or while breastfeeding?
No, Synarel Nasal Spray should not be used during pregnancy or while breastfeeding.
How long should a patient use Synarel Nasal Spray (Nafarelin Acetate)?
Synarel Nasal Spray should not be used for more than six months.
Resources
- https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=d0aa57cb-d2f4-46d7-af43-7c8b06aa81a6&type=display
- https://www.accessdata.fda.gov/drugsatfda_docs/label/2012/019886s030lbl.pdf
- https://labeling.pfizer.com/ShowLabeling.aspx?id=515&Section=PPI
- https://patient.info/medicine/nafarelin-nasal-spray-synarel
- https://www.ivf.com.au/sites/ivfa/files/2022-12/IVFA59%20Single%20Sheets%20Drug%20Info-Synarel%2028.04.22-LR.pdf
- https://www.webmd.com/drugs/2/drug-6479/synarel-nasal/details
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