Can Zoladex (goserelin) lead to broken bones?

Zoladex (goserelin) can cause weaker bones, which can make it easier for your bones to break. Your provider will most likely want you to take [calcium](https://www.goodrx.com/well-being/supplements-herbs/calcium) and vitamin D supplements and do weight-bearing exercises, like walking, hiking, or dancing, to prevent broken bones.

Zoladex

goserelin

Used for Breast Cancer, Endometriosis, Prostate Cancer

Basics Side effects Pros & cons Pharmacist tips FAQs Warnings Dosage Interactions Cost Alternatives Latest news Prices Medicare

Zoladex (goserelin) works well to treat prostate cancer in men and breast cancer and endometriosis in women. It's an implant that's injected under the skin of your stomach by a healthcare provider every 4 weeks.

Reviewed by:

Allison Gourley, PharmD

Last reviewed on August 17, 2021

Basics Side effects Pros & cons Pharmacist tips FAQs Warnings Dosage Interactions Cost Alternatives Latest news Prices Medicare

What is Zoladex (goserelin)?

What is Zoladex (goserelin) used for?

Prostate cancer
Advanced hormone-receptive positive (HR+) breast cancer
Endometriosis
Endometrial thinning before endometrial ablation

How Zoladex (goserelin) works

Zoladex (goserelin) is a gonadotropin-releasing hormone (GnRH) agonist, which is a synthetic (man-made) hormone similar to the GnRH your body naturally makes. It lowers testosterone, which helps lower cancer cell growth in the prostate. It also lowers estrogen, which helps lower cancer cell growth in the breast.

In endometriosis, estrogen causes normal endometrial tissue inside your uterus and abnormal endometrial tissue outside your uterus to grow. During the menstrual cycle, endometrial tissue sheds, causing pain. By lowering estrogen, Zoladex (goserelin) also helps thin and shrink endometrial tissue to relieve pain.

Drug facts

Common BrandsZoladex

Drug ClassGnRH agonist

Controlled Substance ClassificationNot a controlled medication

Generic StatusNo lower-cost generic available

AvailabilityPrescription only

Side effects of Zoladex (goserelin)

The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.

Common Side Effects

Hot flashes (46%)
Diarrhea (40%)
Nausea (9%)
Skin rash (8%)

Less Common Side Effects

Sexual dysfunction
Body pain
Breast pain
Headache
Dizziness
Edema (swelling)
Difficulty urinating
Urinary tract infection

Zoladex (goserelin) serious side effects

Contact your healthcare provider immediately if you experience any of the following.

Allergic reactions
Heart attack: Chest pain, pain radiating or spreading to your arm or shoulder, cold, sweat, trouble breathing
Stroke: Confusion, facial drooping, weakness on one side of the body, trouble walking or speaking, sudden, severe headache
QT prolongation syndrome: Palpitations, fluttering in your chest
Shock: Racing heart, fever, cold and pale skin, nausea and vomiting, trouble breathing, feeling faint

Source: DailyMed

The following Zoladex (goserelin) side effects have also been reported

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor or nurse immediately if any of the following side effects occur:

For all adults

Less common

Fast or irregular heartbeat

Rare

Bone, muscle, or joint pain

changes in skin color of the face

fainting

fast or irregular breathing

numbness or tingling of the hands or feet

puffiness or swelling of the eyelids or around the eyes

skin rash, hives, or itching

sudden, severe decrease in blood pressure and collapse

tightness in the chest

troubled breathing

For females only

Rare

Anxiety

deepening of voice

increased hair growth

mental depression

mood changes

For males only

Rare

Pain in the chest

pain in the groin or legs (especially in the calves of the legs)

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

For all adults

More common

Sudden sweating and feelings of warmth (also called hot flashes)

Less common

Blurred vision

burning, itching, redness, or swelling at the place of injection

decreased interest in sexual intercourse

dizziness

headache

nausea or vomiting

swelling and increased tenderness of the breasts

swelling of the feet or lower legs

trouble sleeping

weight gain

For females only

More common

Light, irregular vaginal bleeding

stopping of menstrual periods

Less common

Burning, dryness, or itching of the vagina

pelvic pain

For males only

Less common

Bone pain

constipation

decreased size of the testicles

inability to have or keep an erection

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Get your GoodRx coupon

Avg retail price

$1640.31(Save 30.62%)

GoodRx discount

$1138.11

See prices

Pros and cons of Zoladex (goserelin)

Pros

Convenient 4-week or 3-month implant, so you will only to have to get it once a month or every 3 months
Works well for several different conditions and for pain caused by endometriosis
Can still use if you have liver or kidney problems

Cons

Can cause breast tenderness, hot flashes, changes in breast size, or a temporary worsening of your symptoms
Can raise your risk of broken bones
Only available as an implant through an injection
Is very expensive and no generic is available yet

Pharmacist tips for Zoladex (goserelin)

Zoladex (goserelin) is an implant that is given by a shot into your abdominal (belly) area. Medicine from the implant will absorb into your body slowly over 28 days (4 weeks) after the dose is given.
Zoladex (goserelin) is used in both men and women for different conditions. Most commonly, this medication will be given in a hospital or clinic setting. If you ever need to get it removed, you'll need to come back to the hospital or clinic.
Your provider might talk to you about taking calcium and vitamin D supplements and doing exercises to help strengthen your bones. This is because Zoladex (goserelin) has the ability to weaken your bones.
Less than 1% of people in clinical studies have had injection reactions. People who are underweight are more likely to have a reaction. Call your provider if you experience belly pain, bloating, dizziness, trouble breathing, or if you're not as awake or alert.
Zoladex (goserelin) can affect some of your lab results, like liver tests and cholesterol levels. Tell all your healthcare providers and lab staff that you're taking Zoladex (goserelin).
If you get pregnant while taking Zoladex (goserelin), tell your provider right away. Zoladex (goserelin) can harm an unborn baby.

Common questions about Zoladex (goserelin)

No, Zoladex (goserelin) is not chemotherapy. It's used as hormone therapy and doesn't affect your immune system.

Zoladex (goserelin) can cause weaker bones, which can make it easier for your bones to break. Your provider will most likely want you to take calcium and vitamin D supplements and do weight-bearing exercises, like walking, hiking, or dancing, to prevent broken bones.

Hair loss not a common side effect of Zoladex (goserelin). However, it is possible, because Zoladex (goserelin) affects the levels of your hormones (specifically testosterone and estrogen) and can lead to hair loss in some people.

Once your provider injects Zoladex (goserelin) below your belly button, the medication releases into your body slowly over time as it dissolves under the skin. This is why you only need to get it every 4 weeks. The medication tells your body to stop making certain hormones in order to lower your hormone levels.

If for some reason you need to stop taking Zoladex (goserelin), you'll need to go to your provider to have them surgically remove it. They'll likely use an ultrasound machine to find the implant.

How to save using GoodRx

1. Compare PricesSpecify your dosage and quantity to find out exactly how much you can save.

2. Select your free couponYou can use the displayed coupon, or compare prices at other pharmacies near you.

3. Show coupon to your pharmacistPresent your printed or electronic coupon when you pick up your prescription.

Get free coupon Learn more

Risks and warnings for Zoladex (goserelin)

Zoladex (goserelin) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.

HARM TO UNBORN BABY

Zoladex (goserelin) can harm an unborn baby. If you're a woman of child-bearing age or haven't had menopause, you will need a negative pregnancy test result before starting Zoladex (goserelin). You will also need to be taking a non-hormonal birth control (e.g., condoms, diaphragm, intrauterine device or IUD) during and for 12 weeks after stopping Zoladex (goserelin). Since the medication affects your hormones, taking hormonal birth control may not work as well. Your healthcare provider will help you decide which is the right non-hormonal birth control for you. If you are planning on becoming pregnant, speak to your provider before starting Zoladex (goserelin).

TUMOR-FLARE SYNDROME

If you're taking Zoladex (goserelin) for prostate or breast cancer, it can cause worsening bone pain and inflammation of the tissues around the tumor during the first few weeks of treatment, known as tumor-flare. This can mean your symptoms may get worse before they get better. Tell your healthcare provider if you experience bone pain, trouble urinating, weakness, or worsening of any symptoms. There may be ways to help treat these symptoms during the tumor-flare.

HIGH BLOOD SUGARS

Risk factors: Diabetes | Pre-diabetes

Zoladex (goserelin) can raise your blood sugar levels. This can cause new or worsening diabetes. Your healthcare provider might have you test your blood sugars more regularly while taking Zoladex (goserelin).

HEART PROBLEMS

Risk factors: History of heart problems | Taking medications to control your heart rhythm, like antidepressants, mental health medications, antibiotics, and antifungals

GnRH agonists like Zoladex (goserelin) can raise the risk of heart attack, stroke, and heart-related death in men. Call 911 and get medical help right away if you experience chest or arm pain, cold sweat, confusion, facial drooping, weakness on one side of the body, shortness of breath, or trouble walking or speaking.

Zoladex (goserelin) can also cause heart rhythm problems, like QT prolongation. If you notice that your heart is racing or a fluttering feeling in your chest, seek medical attention as soon as possible.

INJECTION SITE INJURY

*Risk factors: Underweight or low body mass index (BMI) *

Zoladex (goserelin) can cause injuries at the site of injection. Tell your provider if you experience any abdominal (around the stomach) swelling, bruising, or bleeding near the injection site. Also, tell your provider if you have any shortness of breath, dizziness, or feeling faint.

SEVERE ALLERGIC REACTIONS

Zoladex (goserelin) can cause dangerous allergic reactions. If you have trouble breathing, notice hives on your skin, or swelling in your tongue, lips, neck, or face, tell your healthcare provider right away.

Zoladex (goserelin) dosage

The average cost for 1 implant of 3.6mg of Zoladex (goserelin) is $1,138.11 with a free GoodRx coupon. This is 30.62% off the average retail price of $1,640.31.

Implant

Dosage	Quantity	Price as low as	Price per unit
10.8mg	1 implant	$3,090.64	$3,090.64
3.6mg	1 implant	$1,138.11	$1,138.11

Typical dosage for Zoladex (goserelin)

The typical dose is 1 implant containing 3.6 mg of Zoladex (goserelin) placed subcutaneously (under the skin) into the upper stomach wall once every 28 days (4 weeks).

For prostate cancer, there's also a 3-month implant containing 10.8 mg of Zoladex (goserelin) available that's placed subcutaneously (under the skin) into the upper stomach wall once every 3 months.

The 3-month implant containing 10.8 mg of Zoladex (goserelin) is not approved for use in women.

Interactions between Zoladex (goserelin) and other drugs

Zoladex (goserelin) may interact with certain medications or supplements. Always let your doctor and pharmacist know about any other medications or supplements (including prescribed and over-the-counter medications, vitamins, and dietary or herbal supplements) that you are currently taking. The list below does not include all possible drug interactions with Zoladex (goserelin). Please note that only the generic name of each medication is listed below.

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

Bepridil
Cisapride
Dronedarone
Mesoridazine
Pimozide
Piperaquine
Saquinavir
Sparfloxacin
Terfenadine
Thioridazine
Ziprasidone

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.