Nafarelin nasal (for the nose) is used to treat central precocious puberty in boys and girls. Central precocious puberty is early sexual development that occurs at or before 8 years of age in girls or 9 years of age in boys, with bone development that is advanced for the child's age.

Nafarelin nasal is also used to treat endometriosis in women who are at least 18 years old.

Nafarelin nasal may also be used for purposes not listed in this medication guide.

You should not use this medicine if you are allergic to nafarelin or similar medicines such as goserelin, leuprolide, histrelin, or triptorelin.

If you are woman, you should not use nafarelin nasal if you have:

• abnormal vaginal bleeding that has not been checked by a doctor; or
• if you are pregnant or breastfeeding.

Tell your doctor if you have ever had:

• epilepsy or other seizure disorder;
• mental illness;
• a tumor or blood vessel problem in your brain;
• polycystic ovary disease;
• low bone mineral density;
• osteoporosis (in you or a family member); or
• if you smoke or drink large amounts of alcohol.

Do not use nafarelin nasal if you are pregnant. It could harm the unborn baby. You may need to have a negative pregnancy test before starting this treatment.

Even though this medicine may cause you not to ovulate or have regular menstrual periods, you should use effective nonhormonal birth control to prevent pregnancy while you are using this medicine.

Nafarelin nasal can make hormonal birth control less effective, including birth control pills, injections, implants, skin patches, and vaginal rings. Use barrier birth control to prevent pregnancy: condom, diaphragm, cervical cap, or contraceptive sponge.

You should not breastfeed while using nafarelin nasal.

Use Nafarelin Nasal (Synarel) exactly as directed on the label, or as prescribed by your doctor. Do not use in larger or smaller amounts or for longer than recommended.

Get emergency medical help if you have signs of an allergic reaction: itching, rash, or hives; chest pain, difficult breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

• vaginal spotting or continued menstrual bleeding;
• pelvic pain or swelling;
• a seizure;
• depression--mood changes, feelings of low self-worth, loss of interest in things you once enjoyed, new sleep problems, thoughts about hurting yourself;
• increased pressure inside the skull--severe headaches, ringing in your ears, dizziness, nausea, vision problems, pain behind your eyes; or
• signs of a pituitary gland problem--sudden headache, confusion, vision changes, vomiting, weak pulse, slowed breathing.

Some children using nafarelin have had new or worsening mental problems. Call your doctor right away if your child has any unusual changes in mood or behavior (anger, aggression, crying, feeling restless or irritable).

Some side effects can be expected during the first month of using nafarelin nasal and are not a reason to stop using the medicine. Tell your doctor if you have any side effect that is ongoing or bothersome.

Common side effects may include:

• vaginal bleeding, discharge, or dryness;
• hot flashes;
• acne;
• increase or decrease in breast size;
• runny nose;
• headaches, muscle pain;
• mood changes;
• decreased interest in sex;
• itchy, red, or flaky rash;
• increased body odor; or
• increase in pubic hair growth.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Try not to sneeze or blow your nose just after using the spray. This can make nafarelin less effective.

Avoid using any other nasal sprays within 2 hours after your dose of nafarelin nasal. If you have a stuffy nose, ask your doctor before using a decongestant nasal spray.