Spray nasal de Nafareline
Synarel
Revu par Sid DajaniDernière mise à jour par Michael Stewart, MRPharmSLast updated 28 déc. 2022
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Nafarelin spray stops the production of naturally occurring female sex hormones.
Your doctor will tell you how often to use it.
If you sneeze straight after using the spray, you may need to repeat the dose.
Side-effects may occur, although not everyone experiences them. Common side-effects are similar to menopausal symptoms - such as hot flushes, sweating, and weight changes.
At a glance
Nafarelin is a nasal spray for women, used in fertility treatment and for endometriosis.
It changes hormone levels in your body.
Always read the manufacturer's leaflet before using the spray.
Your doctor will tell you how many sprays to use and when.
Common side effects include headaches, nose irritation, and menopausal symptoms.
Contact your doctor if you experience a rash, redness, or breathing difficulties.
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About nafarelin
Type de médicament | Gonadorelin analogue |
Utilisé pour | As part of a fertility programme; and endometriosis |
Aussi appelé | Synarel® |
Disponible sous forme de | A nasal spray |
Nafarelin is prescribed for women only. It is a synthetic form of a hormone which occurs naturally in women.
If you have been prescribed nafarelin as part of a fertility treatment, it acts on the pituitary gland in your brain to stop the production of natural hormones which control the release of eggs from your ovaries. It does this over a period of time. After this time, you will then be prescribed other hormone treatments to stimulate ovulation.
Nafarelin is also used to treat endometriosis. Endometriosis is a condition where tissue that normally lines the inside of your womb (uterus) is found elsewhere in your body, often in the pelvic area or abdomen. Nafarelin reduces the production of female sex hormones (such as oestrogen) by its action on your pituitary gland. Oestrogen can worsen certain problems such as endometriosis, so by reducing oestrogen levels, nafarelin will help to ease your symptoms.
Nafarelin is a medicine that cannot be taken in the usual way by mouth (as a tablet). Instead, it is given as a nasal spray because this gets the medicine into your bloodstream.
Before using nafarelin
Retour au sommaireSome medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. For these reasons, before you start taking nafarelin it is important that your doctor or pharmacist knows:
Si vous êtes enceinte ou si vous allaitez.
If you have had any bleeding from your vagina that you do not think is related to your periods.
If you have a bone disease such as osteoporosis.
Si vous prenez ou utilisez d'autres médicaments. Cela inclut tous les médicaments que vous prenez et qui sont disponibles à l'achat sans ordonnance, ainsi que les médicaments à base de plantes et complémentaires.
Si vous avez déjà eu une réaction allergique à un médicament.
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How to use nafarelin nasal spray
Retour au sommaireBefore you start this treatment, read the manufacturer's printed information leaflet from inside your pack. The leaflet will give you more information about nafarelin spray, and a full list of side-effects which you may experience from using it.
Your doctor will tell you how many sprays to use, and whether you should use it in one or both nostrils. This will depend upon the reason why you are using it, so follow the instructions you are given. If you are unsure about how or when to use the spray, ask your pharmacist to explain it to you again.
You will be asked to start using the spray on a set day - this is often (but not always) day two of your menstrual cycle.
It is important that you use this medicine regularly and space the doses out evenly throughout the day.
If you sneeze straight after using the spray, the medicine may not be absorbed and work as it should. If this happens, repeat your dose.
If you forget a dose, take it as soon as you remember unless it is almost time for your next dose; in which case, skip the missed dose and take your next dose when it is due. Do not take two doses together to make up for a forgotten dose.
How to use the spray
Read the instructions in the manufacturer's printed leaflet that comes with your medicine.
Remove the plastic cap, and the safety clip under the nozzle.
Before you use the spray for the first time, you must 'prime' the pump. This is so you get the right amount of medicine in each spray. Hold the bottle so that the nozzle is between two fingers, and your thumb is on the bottom of the bottle. Then aim the nozzle away from you and press your thumb upwards several times until a fine spray appears. You only need to do this the first time you use a new bottle.
Then, gently blow your nose to clear it. Do not be too concerned if you have a cold, as the medicine will still be absorbed. Bend your head forward a little, and put the nozzle into one of your nostrils. Hold your other nostril closed with a finger.
Breathe in through your open nostril and at the same time press the bottle once to release a spray. Try to aim the spray towards the back and outer side of your nostril.
Remove the spray and bend your head backwards for a few seconds to allow the spray to spread over the back of your nose.
If you have been told to use the spray in both nostrils at the same time of day, repeat steps 3 and 4 in your other nostril. If not, next time you use the spray, remember to use it in your other nostril.
Clean the nozzle by holding it under warm running water and gently wiping with your finger. It is important to do this before and after every use of the spray to prevent the nozzle from becoming blocked.
Wipe the nozzle with a clean tissue and replace the plastic cap and clip.
Tirer le meilleur parti de votre traitement
Retour au sommaireKeep your appointments with your doctor so that your progress can be monitored.
You may notice your symptoms become worse when you first start treatment with nafarelin for endometriosis. This can often be the case, but your symptoms should ease after a couple of weeks.
Even if you get a cold or your nose feels blocked, you should continue to use the spray, as it will still work. If you are using any other nasal sprays (such as decongestants), you should use nafarelin spray first, then wait at least 30 minutes after using it before you use any other nasal spray.
If you are being treated for endometriosis, you should use a non-hormonal method of contraception such as a condom. This is because hormonal methods (such as 'the pill' or 'mini-pill') will not work. Speak with your doctor if you need further advice about what methods of contraception are suitable.
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Can nafarelin cause problems?
Retour au sommaireAlong with their useful effects, all medicines can cause unwanted side-effects although not everyone experiences them. The table below lists some of the most common ones associated with nafarelin nasal spray. You will find a full list in the manufacturer's information leaflet supplied with your medicine. The unwanted effects often improve over the first few days of taking a new medicine, but speak with your doctor or pharmacist if any of the following side-effects continue or become troublesome.
Common nafarelin side-effects | Que puis-je faire si je ressens cela ? |
Headache, and muscle aches | Buvez beaucoup d'eau et demandez à votre pharmacien de vous recommander un analgésique approprié. Si les maux de tête persistent, consultez votre médecin |
Nose irritation, nosebleeds | If this becomes troublesome, speak with your doctor |
Menopausal symptoms such as hot flushes, dry vagina, increased sweating, reduced interest in sex | Si l'un de ces éléments devient problématique, parlez-en à votre médecin |
Acne, changes in your weight, feeling nervous or emotional, disturbed sleep | Si l'un de ces éléments devient problématique, parlez-en à votre médecin |
Important: if you get a skin rash or redness, or have any difficulties with breathing, you should contact your doctor for advice straightaway. These are rare but possibly serious symptoms, as they may be signs of an allergic reaction to the medicine.
Si vous ressentez d'autres symptômes que vous pensez être dus à ce médicament, parlez-en à votre médecin ou à votre pharmacien.
How to store nafarelin
Retour au sommaireGardez tous les médicaments hors de la portée et de la vue des enfants.
Conserver dans un endroit frais et sec, à l'abri de la chaleur et de la lumière directes.
Informations importantes sur tous les médicaments
Retour au sommaireInformations importantes sur tous les médicaments
Si vous achetez des médicaments, vérifiez avec un pharmacien qu'ils sont sans danger à prendre avec vos autres médicaments.
Ne prenez jamais plus que la dose prescrite. Si vous soupçonnez que vous ou quelqu'un d'autre avez pris une surdose de ce médicament, rendez-vous au service des urgences de votre hôpital local. Emportez le contenant avec vous, même s'il est vide.
Si vous subissez une opération ou un traitement dentaire, informez la personne qui effectue le traitement des médicaments que vous prenez.
Ce médicament est pour vous. Ne le donnez jamais à d'autres personnes, même si leur état semble être le même que le vôtre.
Ne gardez jamais de médicaments périmés ou indésirables. Apportez-les à votre pharmacie locale qui s'en débarrassera pour vous.
Si vous avez des questions concernant ce médicament, demandez à votre pharmacien.
Signaler les effets secondaires d'un médicament ou d'un vaccin
Si vous ressentez des effets secondaires, vous pouvez les signaler en ligne via le Yellow Card website.

Vous n'êtes pas sûr de mélanger des médicaments ?
Vérifiez les interactions possibles entre les médicaments, les compléments et les aliments avant de les prendre ensemble.
Questions fréquemment posées
Why should nafarelin only be used by women?
Nafarelin is specifically designed to affect hormones that control egg release from ovaries or reduce female sex hormones like oestrogen, which are processes unique to women. Its use is therefore restricted to female patients only.
How long does it take for nafarelin to work for endometriosis symptoms?
When you first begin treatment with nafarelin for endometriosis, you might notice your symptoms actually get worse. However, your symptoms should start to ease after about two weeks of using the spray.
What should I do if I have a blocked nose or a cold while using nafarelin?
Even if you have a cold or your nose feels blocked, you should continue to use the nafarelin spray. The medicine will still be absorbed and work effectively. If you are using other nasal sprays, such as decongestants, use nafarelin first and then wait at least 30 minutes before using any other nasal spray.
What kind of painkiller can I take if I get headaches or muscle aches from nafarelin?
If you experience headaches or muscle aches, you should drink plenty of water. You can ask your pharmacist to recommend a suitable painkiller for these symptoms. If headaches continue to be an issue, you should speak with your doctor.
Are there certain signs to look out for that might indicate a serious problem with nafarelin?
While rare, if you develop a skin rash or redness, or experience any difficulty with breathing, you should contact your doctor straight away. These could be signs of an allergic reaction to the medicine and require immediate medical advice.
Can I use hormonal contraception like the pill while on nafarelin for endometriosis?
If you are being treated for endometriosis with nafarelin, you should use a non-hormonal method of contraception, such as a condom. Hormonal methods, including 'the pill' or 'mini-pill', will not be effective. You should speak with your doctor for further advice on suitable contraception methods.
Lectures complémentaires et références
- Manufacturer's PIL, Synarel® nasal spray; Pfizer Limited, The electronic Medicines Compendium. Dated August 2022.
- Médicaments Complets BNF 89e Édition; Association Médicale Britannique et Société Royale Pharmaceutique de Grande-Bretagne, Londres.
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About the authorView full bio

Michael Stewart, MRPharmS
Medicine Leaflet Review Manager – Contractor, Pharmacist
BPharm (Hons), MRPharmS
Michael is a community pharmacist practicing in the Midlands and South Yorkshire with more than 20 years’ experience advising on medicines and medical conditions. He has a strong background in healthcare training, having produced and delivered training courses for pharmacy teams and staff of residential care settings, including nurses. He has also contributed to pharmacy advisory boards for the management of low acuity conditions in the community.
About the reviewer

Sid Dajani
Sultan Dajani qualified at the London School of Pharmacy in 1994 and became the youngest elected member of the Royal Pharmaceutical Society council since its founding in 1842.
Historique de l'article
Les informations sur cette page sont rédigées et examinées par des cliniciens qualifiés.
Prochaine révision prévue : 28 juin 2027
28 déc. 2022 | Dernière version

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