gonadotropin-releasing hormone (GnRH) Agonists
Trade names:
The mode of administration and dosage varies according to the drug being used, as shown in the table below.
The GnRH agonists are a group of drugs that resulted with pituitary down-regulation. They are modified versions of a naturally occurring hormone known as gonadotropin releasing hormone, which helps to control the menstrual cycle.
All the GnRH agonists are very similar chemically, but they come in different forms: three-monthly injection, monthly injection, daily injection and nasal spray. The names, forms and recommended dosages of the GnRH agonists used depend on the physician recommendation and the treatment protocol.
Lupron is injected with either the special Lupron syringes or the TB syringe and the 25-gauge ¼" needle.
Lupron is packaged with one multi-dose vial of Lupron, 14 syringes, and alcohol swabs.
Preparing Lupron
1. Always wash your hands with soap and water.
2. Make sure you have the medication, appropriate syringe, and an alcohol swab or alcohol and a cotton ball.
3. Take out the vial of Lupron and a vial of 10ml sterile saline, used to dilute the medication. Check the name and expiration date on each.
4. Unwrap a Lupron syringe; remove the protective caps from the vials and wipe the rubber stoppers with alcohol.
5. Pull all the way back on the plunger, filling the Lupron syringe with 50 units of air.
6. Place the needle through the rubber stopper on the vial and push the plunger to inject air into the vial.
7. Turn the vial upside down, keeping the needle inside and making sure the tip is below the level of the medication.
8. Pull the plunger back slowly to 50 units, allowing the fluid to fill the syringe.
9. Insert the needle through the rubber stopper of sterile saline; push on the plunger, injecting the entire 50 units into the vial.
10. Label the vial as "diluted Lupron" and write the date it was mixed; store both diluted and full-strength medication in the refrigerator for future use. (Discard unused, diluted Lupron once your cycle is completed.)
11. When it is time for your injection, have the diluted Lupron and a Lupron syringe ready; wipe the rubber stopper with the alcohol.
12. Pull back on the plunger to fill the Lupron syringe halfway (25 units) with air.
13. Place the needle through the rubber stopper on the diluted Lupron vial and push the plunger to inject air into the vial.
14. Turn the vial upside down, keeping the needle inside and making sure the tip is below the level of the medication.
15. Pull the plunger back, allowing the fluid to fill the syringe.
16. Push on the plunger, expelling air and fluid into the vial until it reaches the dosage level prescribed for you.
17. Tap the syringe with a flick of your finger to remove air bubbles.
Locating the Injection Site
It is important that you use the recommended areas of the body for injection, as they will help ensure proper delivery of the medication to your system. Subcutaneous injections should be administered to the lower abdomen (recommended site), the upper and outer side quadrant of the thigh or the upper outer arm. Because repeated injections are required, and the skin may become red and tender, you should move the exact location about two inches from the previous injection site but still within the desired area.
Administering the Medication
1. Cleanse the site with alcohol.
2. Grasp the skin gently between the thumb and forefinger.
3. Insert the needle at a 90 degree angle and slowly inject all of the medication.
4. Place gauze or a cotton ball on the site and remove the needle quickly, while applying pressure.
