Generic Name: Nafarelin

  • What is Synarel?

    Synarel is used to relieve the symptoms of endometriosis, including menstrual cramps or low back pain during menstruation, painful intercourse, painful bowel movements, and abnormal and heavy menstrual bleeding. Endometriosis is a condition in which fragments of the tissue that lines the uterus are found in the other parts of the pelvic cavity.

    Synarel is also used to treat unusually early puberty in children of both sexes.

  • What is the most important information I should know about Synarel?

    Although Synarel usually stops ovulation and menstruation, there is still a possibility of becoming pregnant while taking the medication. Since Synarel could harm a fetus, be sure to use a nonhormonal, barrier form of birth control, such as condoms and diaphragms. If you should become pregnant, stop the drug and tell your doctor immediately.

  • Who should not take Synarel?

    Do not take Synarel if you are sensitive to any of its ingredients, gonadotropin, or drugs similar to Synarel such as leuprolide.

    Do not use Synarel if you have undiagnosed vaginal bleeding between menstrual periods or if you are pregnant or breastfeeding.

  • What should I tell my doctor before I take the first dose of Synarel?

    Tell your doctor about all prescription, over-the-counter, and herbal medications you are taking before beginning treatment with Synarel. Also, talk to your doctor about your complete medical history, especially if you drink a lot of alcohol, smoke, have a family history of osteoporosis (thinning of the bones with fractures), or use drugs that can reduce bone mass, such as steroids.

  • What is the usual dosage?

    The information below is based on the dosage guidelines your doctor uses. Depending on your condition and medical history, your doctor may prescribe a different regimen. Do not change the dosage or stop taking your medication without your doctor's approval.


    Adults: The recommended daily dose is 400 micrograms (mcg) in the form of a nasal spray: one spray (200 mcg) into one nostril in the morning and one spray into the other nostril in the evening. Treatment should be started between days 2 and 4 of the menstrual cycle.

    If the above dosage does not stop your menstrual period after 2 months of treatment, your doctor may increase your dosage to 800 mcg. This is achieved by one spray into each nostril in the morning and a second spray into each nostril in the evening.

    Treatment should last no more than 6 months.

    Early Puberty

    Children: The recommended daily dose is 1,600 mcg. This is divided into two sprays into each nostril in the morning and two sprays into each nostril in the evening, for a total of eight sprays per day. The dose can be increased to 1,800 mcg daily if needed. The 1,800 mcg dose is achieved by three sprays into alternating nostrils, three times a day, for a total of nine sprays per day.

  • How should I take Synarel?

    Take Synarel exactly as prescribed. Try not to sneeze during or immediately after spraying Synarel into your nostrils.

    Wait 2 hours after taking Synarel before using a decongestant nasal spray or drops.

    You should not use Synarel for more than 6 months. If your symptoms recur after you have finished taking Synarel, your doctor will usually not prescribe it again.

    See the package insert that accompanied Synarel for detailed instructions on how to use the nasal spray. Or ask your doctor if you have any questions.

  • What should I avoid while taking Synarel?

    Avoid breathing in the spray during priming.

    Do not miss a single dose.

    Do not use a bottle of Synarel for longer than 30 days (60 sprays). At the end of 30 days, a small amount of liquid will be left in the bottle. Do not try to use up that leftover amount.

    Do not attempt to clean the spray tip using a pointed object. Do not take apart the pump, or try to enlarge the tiny hole in the sprayer.

  • What are possible food and drug interactions associated with Synarel?

    No significant interactions have been reported with Synarel. However, always tell your doctor about any medicines you take, including over-the-counter drugs, vitamins, and herbal supplements.

  • What are the possible side effects of Synarel?

    Side effects cannot be anticipated. If any develop or change in intensity, tell your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking this drug.

    Side effects may include: acne, body odor, decrease in breast size, decreased sex drive, depression, dry skin, hair growth, headaches, hot flashes, insomnia, mood swings, muscle pain, nasal inflammation, nasal irritation, oily skin, swelling due to fluid retention, temporary increase in the amount of pubic hair, vaginal dryness, weight gain

  • Can I receive Synarel if I am pregnant or breastfeeding?

    Synarel could cause harm to a developing baby. If you are pregnant, inform your doctor immediately. Use a barrier method of birth control to prevent pregnancy while you are taking Synarel.

    Do not use Synarel if you are breastfeeding.

  • What should I do if I miss a dose of Synarel?

    Take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and go back to your regular schedule. Never take two doses at once.

    Try not to miss any doses. If you miss successive doses, bleeding and ovulation can start again.

  • How should I store Synarel?

    Store the bottle upright at room temperature. Protect from excessive heat and freezing. Keep away from light.

Meet the Pharmacists

I'm Shereen A. Gharbia, PharmD. Welcome to PDR Health!

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