Nafarelin nasal spray
Synarel
Granskad av Sid DajaniSenast uppdaterad av Michael Stewart, MRPharmSSenast uppdaterad 28 dec 2022
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Nafarelin spray stops the production of naturally occurring female sex hormones.
Your doctor will tell you how often to use it.
If you sneeze straight after using the spray, you may need to repeat the dose.
Side-effects may occur, although not everyone experiences them. Common side-effects are similar to menopausal symptoms - such as hot flushes, sweating, and weight changes.
Överblick
Nafarelin is a medicine for women, given as a nasal spray.
It is used as part of fertility treatment or for endometriosis.
For fertility treatment, it stops the production of hormones that control egg release.
For endometriosis, it reduces female sex hormones, easing symptoms.
It is important to know how to use the nasal spray correctly.
Possible side-effects include headaches, nose irritation, and menopausal symptoms.
About nafarelin
Typ av medicin | Gonadorelin analogue |
Används för | As part of a fertility programme; and endometriosis |
Även kallad | Synarel® |
Tillgänglig som | A nasal spray |
Nafarelin is prescribed for women only. It is a synthetic form of a hormone which occurs naturally in women.
If you have been prescribed nafarelin as part of a fertility treatment, it acts on the pituitary gland in your brain to stop the production of natural hormones which control the release of eggs from your ovaries. It does this over a period of time. After this time, you will then be prescribed other hormone treatments to stimulate ovulation.
Nafarelin is also used to treat endometrios. Endometriosis is a condition where tissue that normally lines the inside of your womb (uterus) is found elsewhere in your body, often in the pelvic area or abdomen. Nafarelin reduces the production of female sex hormones (such as oestrogen) by its action on your pituitary gland. Oestrogen can worsen certain problems such as endometriosis, so by reducing oestrogen levels, nafarelin will help to ease your symptoms.
Nafarelin is a medicine that cannot be taken in the usual way by mouth (as a tablet). Instead, it is given as a nasal spray because this gets the medicine into your bloodstream.
Before using nafarelin
Some medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. For these reasons, before you start taking nafarelin it is important that your doctor or pharmacist knows:
Om du är gravid eller ammar.
If you have had any bleeding from your vagina that you do not think is related to your periods.
If you have a bone disease such as osteoporosis.
Om du tar eller använder några andra läkemedel. Detta inkluderar alla läkemedel du tar som finns att köpa utan recept, samt växtbaserade och komplementära läkemedel.
Om du någonsin har haft en allergisk reaktion mot en medicin.
How to use nafarelin nasal spray
Before you start this treatment, read the manufacturer's printed information leaflet from inside your pack. The leaflet will give you more information about nafarelin spray, and a full list of side-effects which you may experience from using it.
Your doctor will tell you how many sprays to use, and whether you should use it in one or both nostrils. This will depend upon the reason why you are using it, so follow the instructions you are given. If you are unsure about how or when to use the spray, ask your pharmacist to explain it to you again.
You will be asked to start using the spray on a set day - this is often (but not always) day two of your menstrual cycle.
It is important that you use this medicine regularly and space the doses out evenly throughout the day.
If you sneeze straight after using the spray, the medicine may not be absorbed and work as it should. If this happens, repeat your dose.
If you forget 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.
How to use the spray
Read the instructions in the manufacturer's printed leaflet that comes with your medicine.
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. This 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 this 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 in through your open nostril and at the same time 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 backwards 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, 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 with your finger. It is important to do this 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.
Få ut det mesta av din behandling
Keep your appointments with your doctor so that your progress can be monitored.
You may notice your symptoms become worse when you first start treatment with nafarelin for endometriosis. This can often be the case, but your symptoms should ease after a couple of weeks.
Even if you get a cold or your nose feels blocked, you should continue to use the spray, as it will still work. If you are using any other nasal sprays (such as decongestants), you should use nafarelin spray first, then wait at least 30 minutes after using it before you use any other nasal spray.
If you are being treated for endometriosis, you should use a non-hormonal method of contraception such as a condom. This is because hormonal methods (such as 'the pill' or 'mini-pill') will not work. Speak with your doctor if you need further advice about what methods of contraception are suitable.
Can nafarelin cause problems?
Along with their useful effects, all medicines can cause unwanted side-effects although not everyone experiences them. The table below lists some of the most common ones associated with nafarelin nasal spray. You will find a full list in the manufacturer's information leaflet supplied with your medicine. The unwanted effects often improve over the first few days of taking a new medicine, but speak with your doctor or pharmacist if any of the following side-effects continue or become troublesome.
Common nafarelin side-effects | Vad kan jag göra om jag upplever detta? |
Headache, and muscle aches | Drick mycket vatten och be din apotekare rekommendera en lämplig smärtstillande. Om huvudvärken fortsätter, kontakta din läkare |
Nose irritation, nosebleeds | If this becomes troublesome, speak with your doctor |
Menopausal symptoms such as hot flushes, dry vagina, increased sweating, reduced interest in sex | Om något av dessa blir besvärligt, tala med din läkare |
Acne, changes in your weight, feeling nervous or emotional, disturbed sleep | Om något av dessa blir besvärligt, tala med din läkare |
Viktigt: if you get a skin rash or redness, or have any difficulties with breathing, you should contact your doctor for advice straightaway. These are rare but possibly serious symptoms, as they may be signs of an allergic reaction to the medicine.
Om du upplever några andra symtom som du tror kan bero på denna medicin, tala med din läkare eller apotekare.
How to store nafarelin
Förvara alla läkemedel utom räckhåll och synhåll för barn.
Förvara på en sval, torr plats, borta från direkt värme och ljus.
Viktig information om alla läkemedel
Viktig information om alla läkemedel
Om du köper några mediciner, kontrollera med en apotekare att de är säkra att ta tillsammans med dina andra mediciner.
Ta aldrig mer än den föreskrivna dosen. Om du misstänker att du eller någon annan kan ha tagit en överdos av denna medicin, gå till akutmottagningen på ditt lokala sjukhus. Ta med behållaren, även om den är tom.
Om du ska genomgå en operation eller tandbehandling, informera den som utför behandlingen om vilka mediciner du tar.
Denna medicin är för dig. Ge den aldrig till andra människor även om deras tillstånd verkar vara detsamma som ditt.
Behåll aldrig föråldrade eller oönskade mediciner. Ta dem till ditt lokala apotek som kommer att ta hand om dem åt dig.
Om du har några frågor om denna medicin, fråga din apotekare.
Rapportera biverkningar av ett läkemedel eller vaccin
Om du upplever biverkningar kan du rapportera dem online via Yellow Card webbplats.

Osäker på att blanda mediciner?
Kontrollera möjliga interaktioner mellan läkemedel, kosttillskott och livsmedel innan du tar dem tillsammans.
Vanliga frågor
What is nafarelin and what is it used for?
Nafarelin, also known as Synarel, is a synthetic form of a natural hormone found in women. It is prescribed for women as part of a fertility treatment program or to treat endometriosis.
Can I use nafarelin if I have a cold or blocked nose?
Yes, you should continue to use the spray even if you have a cold or your nose feels blocked, as the medicine will still be absorbed and work. If you are using other nasal sprays, such as decongestants, use nafarelin first and then wait at least 30 minutes before using the other spray.
What should I do if I sneeze right after using the spray?
If you sneeze immediately after using the spray, the medicine may not have been absorbed properly. In this case, you should repeat the dose.
Why is nafarelin given as a nasal spray instead of a tablet?
Nafarelin is administered as a nasal spray because this method is effective in getting the medicine into your bloodstream, which it cannot do if taken by mouth as a tablet.
What kind of contraception should I use while on nafarelin for endometriosis?
If you are being treated for endometriosis, you should use a non-hormonal method of contraception, such as a condom. Hormonal methods like 'the pill' or 'mini-pill' will not be effective. You should discuss suitable contraception methods with your doctor.
Vidare läsning och referenser
- Manufacturer's PIL, Synarel® nasal spray; Pfizer Limited, The electronic Medicines Compendium. Dated August 2022.
- Mediciner Komplett BNF 89:e Utgåvan; Brittiska Läkarföreningen och Kungliga Farmaceutiska Sällskapet i Storbritannien, London.
Om författarenVisa fullständig biografi

Michael Stewart, MRPharmS
Ansvarig för granskning av medicinbroschyrer – Konsult, Apotekare
BPharm (Hons), MRPharmS
Michael är en apotekare som arbetar i Midlands och South Yorkshire med mer än 20 års erfarenhet av att ge råd om läkemedel och medicinska tillstånd. Han har en stark bakgrund inom vårdutbildning och har producerat och levererat utbildningskurser för apoteksteam och personal inom vårdboenden, inklusive sjuksköterskor. Han har också bidragit till apoteksrådgivande styrelser för hantering av mindre allvarliga tillstånd i samhället.
Om recensenten

Sid Dajani
Sultan Dajani tog examen vid London School of Pharmacy 1994 och blev den yngsta valda medlemmen i Royal Pharmaceutical Society-rådet sedan dess grundande 1842.
Artikelhistorik
Informationen på denna sida är skriven och granskad av kvalificerade kliniker.
Artikeln finns också på Engelska, Tyska, Spanska, Franska, Italienska, Portugisiska, Hindi, Hebreiska, Arabiska, och Svenska.
Next review due: 28 Jun 2027
28 dec 2022 | Senaste versionen

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