Nafarelin nasal spray
Synarel
Granskad av Sid DajaniSenast uppdaterad av Michael Stewart, MRPharmSLast updated 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.
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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
Tillbaka till innehållSome 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.
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How to use nafarelin nasal spray
Tillbaka till innehållBefore 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
Tillbaka till innehållKeep 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.
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Can nafarelin cause problems?
Tillbaka till innehållAlong 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 | Drink plenty of water and ask your pharmacist to recommend a suitable painkiller. If the headaches continue, speak with your doctor |
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
Tillbaka till innehållFörvara 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
Tillbaka till innehållViktig 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 website.

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Kontrollera möjliga interaktioner mellan läkemedel, kosttillskott och livsmedel innan du tar dem tillsammans.
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.
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About the authorView full bio

Michael Stewart, MRPharmS
Medicine Leaflet Review Manager – Contractor, Pharmacist
BPharm (Hons), MRPharmS
Michael is a community pharmacist practicing in the Midlands and South Yorkshire with more than 20 years’ experience advising on medicines and medical conditions. He has a strong background in healthcare training, having produced and delivered training courses for pharmacy teams and staff of residential care settings, including nurses. He has also contributed to pharmacy advisory boards for the management of low acuity conditions in the community.
About the reviewer

Sid Dajani
Sultan Dajani qualified at the London School of Pharmacy in 1994 and became the youngest elected member of the Royal Pharmaceutical Society council since its founding in 1842.
Artikelhistorik
Informationen på denna sida är skriven och granskad av kvalificerade kliniker.
Next review due: 28 Jun 2027
28 Dec 2022 | Senaste versionen

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