Zoladex Warnings and Precautions

Specific Precautions and Warnings With Zoladex

Some warnings and precautions to be aware of prior to using this medicine include the following:
 
  • Like similar medicines, Zoladex causes an initial increase in hormone levels (estrogen and testosterone). As a result, your symptoms may become worse in the first few weeks of treatment. Contact your healthcare provider if you develop any new symptoms or if your symptoms do not go away after a few weeks.
 
  • Men who have prostate cancer that has spread to the spine or urinary tract are at an increased risk for urinary tract blockage and pressure on the spine during the initial few weeks of treatment, when testosterone levels are high. In rare cases, these problems can lead to paralysis and potentially death. Therefore, your healthcare provider will monitor you more closely when you first start treatment.
 
  • Your healthcare provider may monitor your blood glucose levels during treatment. This is because medications like Zoladex have been reported to cause high blood sugar levels and increase the risk for developing diabetes in men. If you currently have diabetes, you may find your blood sugar levels are not as well controlled during treatment.
 
  • Zoladex can cause bone loss, increasing your risk for osteoporosis and bone fractures. Your bones may not completely return to normal even after stopping the medication. People who already have osteoporosis, or who have risk factors for osteoporosis, may be more susceptible to this side effect. To help reduce your risk for bone loss, your healthcare provider may give you an additional medicine, such as:
 
 
  • This medicine may cause a condition known as pituitary apoplexy, which occurs when tissue from the pituitary gland becomes damaged and dies, leading to pituitary gland failure. Although this side effect is rare, it can be dangerous. Seek immediate medical attention if you develop signs of pituitary apoplexy, such as:
 
    • A sudden, severe headache
    • Weakness of the muscles around the eye
    • Changes in vision
    • Low blood pressure
    • Confusion.
 
  • Zoladex can increase low density lipoprotein (LDL) cholesterol and triglycerides. It may also cause high blood calcium levels (hypercalcemia). Your healthcare provider may need to check your cholesterol and calcium levels with a blood test during treatment.
 
  • Zoladex has been reported to cause mood changes, including depression and anxiety. There have also been cases of abnormal thinking in people using this medicine. If you develop mood changes or abnormal thinking (such as seeing or hearing things that are not really there or believing things that are not true), contact your healthcare provider right away.
 
  • Medications like Zoladex may increase the risk for a stroke, heart attack, and sudden death in men, although the actual risk for these problems seems to be low. Your healthcare provider will evaluate your risk for these serious side effects before starting treatment, and periodically thereafter. Seek immediate medical attention if you develop any signs of a heart attack or stroke (see Heart Attack Symptoms and Signs of a Stroke).
 
  • The higher strength of this medicine (Zoladex 10.8 mg) is not approved for use in women. Women should receive the 3.6-mg strength.
 
  • The majority of women using Zoladex will stop having monthly periods within two months of starting treatment. Tell your healthcare provider if you continue to have menstrual periods. Do not use this drug as birth control, even if you are no longer menstruating.
 
 
  • It is unknown if Zoladex passes through breast milk. Therefore, if you are breastfeeding or plan to start, discuss this with your healthcare provider prior to using the drug (see Zoladex and Breastfeeding).
 
  • Zoladex is a pregnancy Category D medication in women with advanced breast cancer, and a pregnancy Category X medicine in other women. It can harm an unborn baby (see Zoladex and Pregnancy). Women of childbearing potential should use nonhormonal forms of birth control during treatment and for at least 12 weeks after treatment is stopped.
 
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