CETRORELIX

CETRORELIX
(ce-tro-re'lix)
Cetrotide
Classifications: hormone; gonadotropin-releasing hormone antagonist;
Therapeutic:gonadotropin-releasing hormone

Pregnancy Category: X

Availability

0.25 mg, 3 mg injection

Action

Cetrotide is a luteinizing hormone-releasing hormone (LHRH) antagonist.

Therapeutic Effect

It prevents premature LH surges in patients undergoing controlled ovarian hyperstimulation for assisted reproduction.

Uses

Treatment of infertility as part of an assisted reproduction program.

Contraindications

Hypersensitivity to cetrorelix, extrinsic peptide hormones, mannitol, gonadotropin-releasing hormone analogs; primary ovarian failure; renal failure; pregnancy (category X); known or suspected pregnancy; lactation.

Cautious Use

Hepatic insufficiency; polycystic ovary syndrome.

Route & Dosage

Infertility
Adult: SC 0.25 mg/d during early to mid follicular phase of the cycle (stimulation day 5 or 6) following the initiation of FSH or 3 mg as a single dose is administered when the serum estradiol level is indicative of an appropriate stimulation response, usually on FSH stimulation day 7 (range day 5–9). If HCG has not been administered within 4 d after the injection of 3 mg, then 0.25 mg should be administered once daily until HCG administration

Administration

Subcutaneous
  • Reconstitute the 0.25 or 3 mL vial with 1 or 3 mL, respectively, of sterile water for injection.
  • Inject into lower abdominal wall following reconstitution. Rotate injection sites.
  • Store the 3 mg dose at room temperature, 15°–30° C (59°–86° F). Store the 0.25 mg dose in the refrigerator.

Adverse Effects (≥1%)

CNS: Headache. GI: Nausea, vomiting, abdominal pain. Endocrine: Hot flashes. Skin: Pruritus at injection site. Urogenital: Ovarian enlargement, ovarian hyperstimulation syndrome, pelvic pain.

Interactions

Drug: Cimetidine, methyldopa, metoclopramide, reserpine, phenothiazines may interfere with fertility efforts. Herbal: Black cohosh, DHEA may antagonize fertility efforts.

Pharmacokinetics

Absorption: 85% absorbed from SC injection site. Peak: 1–2 h. Metabolism: Metabolized by peptidases. Elimination: 2–4% in urine, 5–10% in bile. Half-Life: 62 h after single dose, 20 h after multiple doses.

Nursing Implications

Assessment & Drug Effects

  • Lab test: Monitor routine blood chemistries.
  • Monitor weight and report development of edema and/or shortness of breath.

Patient & Family Education

  • Contact physician immediately for any of the following: Abdominal or stomach pain, persistent or severe nausea, vomiting or diarrhea; decreased urination; pelvic pain; moderate to severe bloating, rapid weight gain; shortness of breath; swelling of lower legs.
  • Understand that hot flashes are a common side effect of this drug.

Common adverse effects in italic, life-threatening effects underlined; generic names in bold; classifications in SMALL CAPS; Canadian drug name; Prototype drug

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