Self administration of GnRHa
Video courtesy of Takeda UK Limited.
Where PMS/PMDD symptoms are causing a significant psychological or physical effect on well-being, full cycle suppression with a gonadotropin releasing against (GnRHa) with hormonal add-back may be indicated, as illustrated in the NAPS treatment pathway.
There are two main treatment options with GnRHa either, the self-administered Syneral nasal spray twice daily or, a depo-injection usually given every three months. Most women will receive their depo-injection via the GP or healthcare provider but for some individuals this may not be possible, so we have put together a training package for the self-administration of Prostap depo-injection.
Prosptap, is only licenced for administration by a qualified practitioner and will only be offered for self-administration if there is no other suitable option. However, due to the impact of the COVID-19, flexible off-label prescribing options have been agreed to ensure the safe continuation of treatment.
Qualification
To qualify for self-administration of Prostap:
- You will have been assessed and counselled by the PMS team at Chelsea and Westminster Hospital.
- You have no known allergies to Prostap or its excipients, contra-indications or experienced previous adverse side-effects.
- You will have had a baseline bone density scan and on suitable hormonal add-back.
- You will have had face-to-face teaching either, in person or, via a video consultation.
- You will have read the patient support information and given informed verbal consent.
- You will have watched the training video.
- You will have been given to the patient support contact details on the Chelsea and Westminster website.
Information about administration
Patient support information
Make sure you read the enclosed patient information leaflet that comes with your injection and that your are familiar with the indications, side-effects and contra-indications.
If you are allergic to any of the product’s constituents, you must not administer this drug and you will need to contact the clinic or prescribing healthcare practitioner for further advice.
This drug is for your own use only and must not be given to any other person.
- This product should be stored as directed by the patient information leaflet and be kept out of the reach of children or vulnerable adults.
- If it is not needed, damaged or expired, it should be returned to your local pharmacist for safe disposal.
You will be prescribed a sharps box for safe disposal of the bottle and needle.
- A used box should not be kept for more than 1 month as this will be an infection risk.
- The box should be sealed closed, dated and signed and returned to local pharmacist for safe disposal.
If you accidentally stab yourself with the needle, clean the area under running water and cover with a plaster. There is no need to attend A&E or see your doctor.
- If the injection has not been given correctly contact the clinic or prescribing healthcare practitioner for immediate advice or replacement prescription.
GnRHa are not licenced contraceptives and pregnancy remains a small risk even when on treatment.
- Before the injection is given you must be using reliable contraception, have a negative pregnancy test or the risk of pregnancy has been excluded.
- Contraception should be continued while on treatment—for example, condoms or a hormone coil such as the Mirena IUS.
GnRHa are only licensed for 6 months as there is a risk of bone demineralisation.
- A baseline bone density scan (BMD) must be performed before treatment is started and repeated every 12–18 months. Discuss this with the clinic or your health care provider if you are not sure if you have an up-to-date scan.
Repeat prescriptions are requested either from your health care provider or via the clinic contact page.
- Hospital supplied prescriptions (FP10) will be posted and can be dispensed at your local pharmacist.