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Nafarelin (Synarel)

Peptide

Nafarelin is a synthetic GnRH agonist decapeptide with D-Nal(2) substitution at position 6. FDA-approved for endometriosis and central precocious puberty. Administered via nasal spray. Double-blind trials show >80% reduction in endometriosis extent, symptoms reduced from 40% severe to 5-10%. 39% pregnancy rate post-treatment. Also approved for CPP in children ages 8/9 and under.

Quick Answer

What it is

Nafarelin is a synthetic GnRH agonist decapeptide with D-Nal(2) substitution at position 6. FDA-approved for endometriosis and central precocious puberty.

Key findings

  • Grade A: Endometriosis Reduction (Endometriosis)
  • Grade A: Pain Reduction (Endometriosis)
  • Grade A: Post-Treatment Fertility (Endometriosis)

Safety

No specific caution or interaction language was detected in the current summary/outcome notes.

⚠️ Research Notice

This peptide information is for educational and research purposes only. Peptides may not be FDA-approved for human use and may only be legally available for research purposes. Consult qualified healthcare professionals before considering any peptide compounds.

ℹ️ Quick Facts: Nafarelin (Synarel)

Quick Facts: Nafarelin (Synarel)

  • Best Evidence:Grade A
  • Conditions Studied:2
  • Research Outcomes:11
  • Grade A Findings:5
  • Grade B Findings:1
  • Key Effect:Endometriosis
A5
B1
C3
D2
2 conditions · 11 outcomes

Detailed Outcomes

|
A
Endometriosis Reduction
Double-blind trial: >80% of patients had laparoscopic reduction in endometriosis. AFS scores significantly improved vs baseline.
large↓Improves
A
Pain Reduction
Severe painful symptoms decreased from 40% to 5-10%. 3-month course provides effective symptom relief with continued benefit at 1 year.
large↓Improves
A
Post-Treatment Fertility
39% (58/149) achieved pregnancy after treatment completion. Comparable to danazol pregnancy rates.
moderate↑Improves
A
Post-Surgical Efficacy
6 months nafarelin after laparoscopic surgery significantly delays symptom return vs placebo.
moderate↑Improves
A
Puberty Suppression
Suppresses LH and sex steroids to prepubertal levels. Arrests secondary sexual development and slows linear growth.
large↓Worsens
B
Reproductive Outcomes
6 human trials and systematic reviews support this finding. Evidence includes systematic reviews/meta-analyses. Human clinical trial data available.
small↑Improves
C
Safety/Tolerability
4 human trials support this finding. Human clinical trial data available.
small↑Improves
C
Bone Mineral Density
4 preclinical studies support this finding. Primarily preclinical evidence.
small↑Improves
C
Hormone Levels
3 preclinical studies support this finding. Primarily preclinical evidence.
small↑Improves
D
Lipid Profile
2 preclinical studies support this finding. Primarily preclinical evidence.
small↓Improves
D
Liver Protection
2 human trials support this finding. Human clinical trial data available.
small↑Improves

Research Citations (35)

Elagolix (Orilissa)--an oral GnRH antagonist for endometriosis pain.
(2018)
PMID: 30383729
Prolonged injectable formulation of Nafarelin using in situ gel combination delivery system.
(2018)
PMID: 28430010
A randomized, parallel, comparative study of the efficacy and safety of nafarelin versus danazol in the treatment of endometriosis in Taiwan.
(2005)
PMID: 16038370
Delivery and stability of LHRH and Nafarelin in human skin: the effect of constant/pulsed iontophoresis.
(2004)
PMID: 14757511
The case of the elusive androgen.
(2002)
PMID: 15260009
Efficacy of nafarelin in assisted reproductive technology: a meta-analysis.
(2001)
PMID: 11212082
Treatment of endometriosis with a decreasing dosage of a gonadotropin-releasing hormone agonist (nafarelin): a pilot study with low-dose agonist therapy ("draw-back" therapy)
(2000)
PMID: 10731543
Treatment with nafarelin for endometriosis in young women. Efficacy, safety and lipid metabolism. Niigata Nafarelin Study Group.
(2000)
PMID: 10900577
[Conservative treatment of interstitial ectopic pregnancy and endometriosis with laparoscopic methotrexate and potassium chloride and complementary management with nasal nafarelin. Report of a case and review of the literature].
(2000)
PMID: 10774100
Clinical use of nafarelin in the treatment of leiomyomas. A review of the literature.
(2000)
PMID: 10900582

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