Shared care Protocol for Relugolix-estradiol-norethisterone acetate(Ryeqo®) for moderate to severe symptoms of uterine fibroids in adult patients linked to IMOC website Click Here
Relugolix 1 mg, estradiol (as hemihydrate), and 0.5 mg norethisterone acetate
Uterine fibroids
Follow Shared Care protocol
| Pack | Price |
|---|---|
| 28 tablet | |
| 84 tablet |
Endometriosis or fibroids
Prescribing for gynaecological conditions:
Licensed status:
All GnRH analogues are licensed to treat endometriosis, however only goserelin, leuprorelin and triptorelin are licensed to treat fibroids.
Duration of treatment:
Maximum duration of treatment will be 6 months as per product licence.
Monitoring requirements:
No specific biochemical monitoring is required by Secondary or Primary Care
Secondary care review process:
Most patients will be reviewed after a 3 month period to evaluate response to treatment and review side effects. Benefit is unlikely to be seen before the 3rd injection.
Transfer of prescribing:
Secondary Care will administer the initial injection, thereafter prescribing responsibility will be passed to Primary Care. GP’s are advised to contact the Gynaecology department for further advice if they have enquiries regarding prescribing or the clinical management of these patients
Verbal communication Mr Alloub, Consultant Gynaecologist, DBH FT
January 2013
For treatment of endometriosis: Suitable for restricted prescribing under defined conditions
The gonadorelin analogues (buserelin, goserelin, leuprorelin, nafarelin and triptorelin) are suitable for prescribing in primary care upon the advice of a specialist (or a primary care prescriber with a special interest in womens health).
Gonadorelin analogues for the treatment of endometriosis
MTRAC Verdict & Summary November 2010
| Pack | Price |
|---|---|
| 1 pre-filled disposable injection | £235.00 |
| Pack | Price |
|---|---|
| 1 pre-filled disposable injection | £94.50 |
Prescribing for gynaecological conditions:
Licensed status:
All GnRH analogues are licensed to treat endometriosis, however only goserelin, leuprorelin and triptorelin are licensed to treat fibroids.
Drug choice:
Goserelin 3.6mg preparation is the first line choice.
Leuprorelin is the second line choice
Duration of treatment:
Maximum duration of treatment will be 6 months as per product licence.
Monitoring requirements:
No specific biochemical monitoring is required by Secondary or Primary Care
Secondary care review process:
Most patients will be reviewed after a 3 month period to evaluate response to treatment and review side effects.
Benefit is unlikely to be seen before the 3rd injection.
Transfer of prescribing:
Secondary Care will administer the initial injection, thereafter prescribing responsibility will be passed to Primary Care.
GP's are advised to contact the Gynaecology department for further advice if they have enquiries regarding prescribing or the clinical management of these patients
Verbal communication Mr Alloub, Consultant Gynaecologist, DBH FT
January 2013
-----------------------
For treatment of endometriosis: Suitable for restricted prescribing under defined conditions
The gonadorelin analogues (buserelin, goserelin, leuprorelin, nafarelin and triptorelin) are suitable for prescribing in primary care upon the advice of a specialist (or a primary care prescriber with a special interest in womens health).
Gonadorelin analogues for the treatment of endometriosis
MTRAC Verdict & Summary November 2010
| Pack | Price |
|---|---|
| 1 vial | £207.00 |
| Pack | Price |
|---|---|
| 1 pre-filled disposable injection | £81.69 |
| Pack | Price |
|---|---|
| 1 vial | £69.00 |
| Pack | Price |
|---|---|
| 1 vial | £414.00 |
Endometriosis
For treatment of endometriosis: Suitable for restricted prescribing under defined conditions
The gonadorelin analogues (buserelin, goserelin, leuprorelin, nafarelin and triptorelin) are suitable for prescribing in primary care upon the advice of a specialist (or a primary care prescriber with a special interest in womens health).
Gonadorelin analogues for the treatment of endometriosis
MTRAC Verdict & Summary November 2010
The recommended duration of therapy is six months; only one 6-month course is advised.
Nafarelin Acetate (Synarel nasal spray) Summary of Product Characteristics (9/8/2007)
| Pack | Price |
|---|---|
| 60 dose | £52.43 |
Treatment of female infertility
Rationale 1
| Pack | Price |
|---|---|
| 1 vial | |
| 7 vial |
| Pack | Price |
|---|---|
| 1 vial |
IVF
Rational:1,2,3
Central precocious puberty in children
Rationale: 1,2,3
Ovarian function (preservation) in pre-menopausal women with neoplastic disease undergoing chemotherapy treatment that can cause premature ovarian insufficiency
Rationale: 1,2,3
Treatment of moderate to severe symptoms of uterine fibroids in adult women of reproductive age
For treating symptoms of endometriosis
Rationale 1
IVF
Rationale 1,2
The recommended duration of therapy is six months; only one 6-month course is advised.
Nafarelin Acetate (Synarel nasal spray) Summary of Product Characteristics (9/8/2007)
Used to suppress puberty as part of treating gender incongruence or gender dysphoria in children and young people who are under 18 years of age
MHRA New restrictions on puberty blockers Click here
New regulations restrict the prescribing and supply of puberty-suppressing hormones to children and young people under 18.