BNF for Children 2011-2012

BNFC 2011–2012 6.4.3 Anabolic steroids 381and anaphylaxis; changes in scalp and body hair,weight changes, withdrawal bleeding, ovarian cysts(may require withdrawal), breast swelling and tenderness(males and females), visual disturbances,paraesthesia, local reactions at injection siteLicensed use not licensed for use in childrenIndication and doseGonadotrophin-dependent precocious pubertySee notes above; for doses, see under preparationsbelowNote Injections may be required more frequently in somecasesAdministration Rotate injection site to prevent atrophyand nodule formationNovgos c (Genus) AImplant, goserelin (as acetate) 3.6 mg in prefilledsyringe, net price = £58.50Dose. Implant, by subcutaneous injection into anteriorabdominal wall3.6 mg every 28 daysZoladex c (AstraZeneca) AImplant, goserelin (as acetate) 3.6 mg in Safe-Systemc syringe applicator, net price each = £65.00Dose. Implant, by subcutaneous injection into anteriorabdominal wall3.6 mg every 28 daysZoladex c LA (AstraZeneca) AImplant, goserelin (as acetate) 10.8 mg in Safe-System c syringe applicator, net price each = £235.00Dose. Implant, by subcutaneous injection into anteriorabdominal wall10.8 mg every 12 weeksLEUPRORELIN ACETATECautions see GoserelinContra-indications see GoserelinPregnancy avoid—teratogenic in animal studiesBreast-feeding avoidSide-effects see GoserelinLicensed use not licensed for use in childrenIndication and doseGonadotrophin-dependent precocious pubertySee notes above; for doses, see under preparationsbelowNote Injections may be required more frequently in somecasesAdministration Rotate injection site to prevent atrophyand nodule formationProstap c SR (Wyeth) AInjection (microsphere powder for reconstitution),leuprorelin acetate, net price 3.75-mg vial with 1-mLvehicle-filled syringe = £75.24Dose. By subcutaneous or by intramuscular injection3.75 mg every four weeks (half this dose is sometimesused in children with body-weight under 20 kg)Prostap c 3 (Wyeth) AInjection (microsphere powder for reconstitution),leuprorelin acetate, net price 11.25-mg vial with 2-mLvehicle-filled syringe = £225.72Dose. By subcutaneous or by intramuscular injection11.25 mg every 12 weeksTRIPTORELINCautions see GoserelinContra-indications see GoserelinPregnancy avoidBreast-feeding avoidSide-effects see Goserelin; also gastro-intestinal disturbances;asthenia; arthralgiaIndication and doseGonadotrophin-dependent precocious pubertySee notes above; for doses, see under preparationsbelowAdministration rotate injection site to prevent atrophyand nodule formationDecapeptyl c SR (Ipsen) AInjection, (powder for suspension), m/r, triptorelin (asacetate), net price 11.25-mg vial (with diluent) =£207.00Dose. By intramuscular injection11.25 mg every 3 monthsNote Each vial includes an overage to allow accurateadministration of 11.25 mg doseGonapeptyl c Depot (Ferring) AInjection (powder for suspension), triptorelin (asacetate), net price 3.75-mg prefilled syringe (withprefilled syringe of vehicle) = £81.69Dose. By subcutaneous or intramuscular injectionBody-weight under 20 kg initially 1.875 mg on days 0,14, and 28, then 1.875 mg every 4 weeksBody-weight 20–30 kg initially 2.5 mg on days 0, 14,and 28, then 2.5 mg every 4 weeksBody-weight over 30 kg initially 3.75 mg on days 0, 14,and 28, then 3.75 mg every 4 weeks; discontinue whenbone maturation consistent with age over 12 years ingirls and over 13 years in boysNote May be given every 3 weeks if necessary6.4.3 Anabolic steroidsAnabolic steroids have some androgenic activity but ingirls they cause less virilisation than androgens. Theyare used in the treatment of some aplastic anaemias(section 9.1.3). Oxandrolone is used to stimulate latepre-pubertal growth prior to induction of sexual maturationin boys with short stature and in girls with Turner’ssyndrome; specialist management is required.OXANDROLONECautions see Testosterone (section 6.4.2); interactions:Appendix 1 (oxandrolone)Contra-indications see Testosterone (section 6.4.2)Hepatic impairment see Testosterone (section 6.4.2)6 Endocrine system