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All about: Nafarelin acetate

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Generic name: Nafarelin acetate
Brand names: Synarel

Why is Nafarelin acetate prescribed?

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.

Some doctors prescribe Synarel as a contraceptive for both men and women.

Most important fact about Nafarelin acetate

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.

How should you take Nafarelin acetate?

Take Nafarelin acetate exactly as prescribed.

Synarel is sprayed into one nostril in the morning and the other nostril in the evening. If your doctor increases the dose, you will spray Synarel into both nostrils morning and evening.

Try not to sneeze during or immediately after spraying Synarel into your nostrils.

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

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

Before you use each new bottle of Synarel for the first time, you have to prime the spray pump. Remove the plastic wrap from the spray bottle and hold it in an upright position pointed away from you. Applying pressure evenly to the "shoulders," push down quickly and firmly 7 to 10 times. Usually the spray will appear after about 7 pumps. Priming need only be done once.

To use the Synarel Nasal Spray Unit, follow these steps:

  1. Gently blow your nose to clear both nostrils.
  2. Remove the safety clip and clear plastic dust cover from the spray bottle.
  3. Bend your head forward a little and put the spray tip into one nostril. Close the other nostril with your finger.
  4. Applying pressure evenly to the "shoulders," quickly and firmly pump the sprayer one time while gently sniffing in.
  5. Remove the sprayer from your nose and tilt your head backwards for a few seconds. Do not take additional sprays unless your doctor has specifically instructed you to do so.
  6. Wipe tip of the pump with a soft cloth or tissue after each use.

--If you miss a dose...

Take it as soon as you remember. If it is almost time for your next dose, skip the one you missed and go back to your regular schedule. Never try to "catch up" by doubling the dose.

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

--Storage instructions...

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

What side effects may occur?

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

  • More common side effects may include:
    Acne, decrease in breast size, decreased sex drive, depression, dry skin, hair growth, headaches, hot flashes, insomnia, muscle pain, nasal inflammation, nasal irritation, oily skin, rapidly shifting or changing emotions, swelling due to fluid retention, vaginal dryness, weight gain

When Synarel is used in the treatment of early puberty, it causes body odor and a transient increase in the amount of pubic hair.

Why should Nafarelin acetate not be prescribed?

Do not take Synarel is you are sensitive to it or have ever had an allergic reaction to it or to any of its ingredients.

Your doctor should not prescribe Synarel if you have undiagnosed vaginal bleeding between menstrual periods.

You should not take Synarel if you are pregnant or breastfeeding.

Special warnings about Nafarelin acetate

Because Synarel works by temporarily reducing the body's production of estrogen, you may experience some of the same changes that normally occur at the time of menopause when the body's production of estrogen decreases naturally. For the first 2 months after you start using Synarel, you may have some irregular vaginal bleeding. This will stop by itself.

Your menstrual periods should stop completely during Synarel therapy. If you continue to bleed regularly, or if you spot or bleed between periods, inform your physician immediately. Vaginal bleeding can occur if you are not following your doctor's instructions carefully or if you need a higher dosage of the medication.

Synarel can cause vaginal dryness. If this is a problem, especially during sexual intercourse, you may want to use a vaginal lubricant. Ask your doctor or pharmacist for a recommendation.

Synarel may cause a small amount of bone loss over the course of your treatment. If you consume large amounts of alcohol, smoke, have a strong family history of osteoporosis, or use drugs that can reduce bone mass such as anticonvulsants or steroids, discuss your condition with your doctor before using Synarel. It may be wiser for you to take another medication.

If your nasal passages become inflamed, your doctor may prescribe a medication to relieve your congestion while you are taking Synarel.

Possible food and drug interactions when taking Nafarelin acetate

No interactions have been reported.

Special information if you are pregnant or breastfeeding

Although the effects of Synarel during pregnancy have not been adequately studied, it is known that the medication 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 Nafarelin acetate.

It is not known whether Synarel appears in breast milk. If Nafarelin acetate is essential to your health, your doctor will advise you to discontinue breastfeeding until your treatment with the medication is finished.

Recommended dosage

The recommended dosage of Synarel is 400 micrograms daily, divided into 2 doses--one spray (200 micrograms) into one nostril in the morning and one spray into the other nostril in the evening. Start your treatment between days 2 and 4 of your 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 micrograms daily--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.


Although there is no information on Synarel overdose, any medication taken in excess can have serious consequences. If you suspect an overdose, seek medical attention immediately.

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