When This Medicine Should Not Be Used:
You should not use this medicine if you have had an allergic reaction to nafarelin, gonadotropin releasing hormone, or other gonadotropin releasing hormone agonists, such as leuprolide (Lupron®) or goserelin (Zoladex®). You should not use this medicine if you have unusual vaginal bleeding, or if you are pregnant or breastfeeding.

How to Use This Medicine:
Spray

• Your doctor will tell you how much of this medicine to use and how often. Do not use more medicine or use it more often than your doctor tells you to.
• To use, tilt your head back slightly. Put the tip of the bottle into your nostril and spray the medicine into your nose.
• Allow 30 seconds between sprays.
• Try not to sneeze during or right after using this medicine.
• For premature puberty, it is important to use this medicine regularly without missing doses. Keep using the medicine until your doctor tells you to stop.
• For endometriosis, start using this medicine between days 2 and 4 of your menstrual cycle, unless instructed otherwise by your doctor. This medicine is used for a period of six months. It is important to use this medicine regularly without missing doses.

Drugs and Foods to Avoid:
Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Make sure your doctor knows if you are also using or have used seizure medicines or steroids.
• Tell your doctor if you have used alcohol or tobacco for a long time.

Warnings While Using This Medicine:

• For premature puberty, your doctor may want to check your progress regularly while you are using this medicine.
• During the first month of using this medicine for premature puberty, girls may have vaginal bleeding or breast enlargement. This should go away. If you have used this medicine for 2 months or more and still have vaginal bleeding or breast enlargement, tell your doctor.
• If you get a stuffy nose, and need to use a nasal decongestant, call your doctor. If your doctor tells you to use a decongestant, wait at least 2 hours after using nafarelin to use the decongestant.
• You should not get pregnant while using this medicine to treat endometriosis. Talk to your doctor about effective methods of birth control to use. If you do get pregnant, tell your doctor right away.
• If you are using this medicine to treat endometriosis, you should stop having menstrual periods. If you have a period after taking this medicine for more than a month, call your doctor.
• Make sure your doctor knows if you have a family history of osteoporosis if you are being treated for endometriosis.

Possible Side Effects While Using This Medicine:
If you notice these less serious side effects, talk with your doctor:

• Acne, or skin rash or flaking
• Breasts becoming smaller (during endometriosis treatment)
• Dryness of vagina (during endometriosis treatment)
• Headache, muscle aches (during endometriosis treatment)
• Hot flashes (during endometriosis treatment)
• Irritation of the nostrils
• Loss of interest in sex (during endometriosis treatment)
• Mood changes
• Weight gain or fluid retention (during endometriosis treatment)

If you notice other side effects that you think are caused by this medicine, tell your doctor.
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088