Before taking nafarelin

Before taking nafarelin make sure your doctor or pharmacist knows:

• If you are pregnant, trying for a baby or breast-feeding.
• If you have bone disease.
• If you are experiencing vaginal bleeding which is not related to your monthly period.
• If you are taking other medicines, including those available to buy without a prescription, herbal or complementary medicines.
• If you have ever had an allergic reaction to this or to any other medicine.

How to take nafarelin

• Before beginning treatment, read the printed information you have been given.
• Use this spray exactly as you have been directed to by your doctor.
• If you are using nafarelin for endometriosis the usual dose is one spray into one nostril in the morning and one spray into the other nostril in the evening (that is, a total of 2 sprays each day). The longest time you can use this spray in endometriosis is six months.
• If you are using nafarelin as part of a fertility programme, the usual dose is one spray to both nostrils in the morning, and one spray to both nostrils in the evening (that is, a total of 4 sprays each day). You will be told how long to use the spray for but this will usually be no longer than 8 weeks.
• If you sneeze during or immediately after spraying a dose of nafarelin into your nostril, repeat the dose straight away.
• If you forget to use the spray, use it as soon as you remember and then continue as usual.

1. Remove the plastic cap and the safety clip under the nozzle. Hold the bottle so that the nozzle is between two fingers, and your thumb is on the bottom of the bottle. (If it is the first time you have used the spray, you must 'prime' the bottle by pressing your thumb upwards several times until a fine spray appears. This is only needed when you first open the spray.)
2. Blow your nose gently. Do not be too concerned if you have a cold as the medicine will still be absorbed.
3. Close one nostril and put the nozzle into the other nostril.
4. Press up on the bottle to release a spray as you breathe in through the nostril.
5. Remove the spray from your nostril and bend your head backwards for a few seconds to allow the spray to spread over the back of your nose.
6. Wipe the nozzle on the bottle with a clean tissue and replace the plastic cap and clip.

Getting the most from your treatment

• It is important not to become pregnant while you are being treated with nafarelin. If you have been taking 'the pill' you must tell your doctor. You will need to use an alternative method of contraception such as a condom while you are taking nafarelin.
• Do not use any other nasal sprays or drops (such as nasal decongestants) for 30 minutes before, and for at least 30 minutes after using this spray.
• You may notice your symptoms become worse when you first start treatment with nafarelin. This is nothing to worry about and your symptoms should start to improve after a couple of weeks.
• Keep your regular doctor's appointments so your progress can be monitored.

Can nafarelin cause problems?

Along with their useful effects, all medicines can cause unwanted side-effects although not everyone experiences them. These usually improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following side-effects continue or become troublesome.

How to store nafarelin

• Keep all medicines out of the reach and sight of children.
• Store in a cool, dry place, away from direct heat and light.

Important information about all medicines

References

• Manufacturer's PIL, Synarel® nasal spray, Pharmacia Limited, electronic Medicines Compendium. Dated July 2009, accessed June 2010.
• British National Formulary; 59th Edition (March 2010) British Medical Association and Royal Pharmaceutical Society of Great Britain, London (link to current BNF)