From the FDA Drug Label
CARDIOVASCULAR – arrhythmia, cerebrovascular accident, hypertension, myocardial infarction, peripheral vascular disorder, chest pain The following additional adverse reactions were reported in greater than 1% but less than 5% of the patients treated with ZOLADEX: CARDIOVASCULAR – arrhythmia, cerebrovascular accident, hypertension, myocardial infarction, peripheral vascular disorder, chest pain; CARDIOVASCULAR – hemorrhage, hypertension, migraine, palpitations, tachycardia
Cardiac Side Effects of Zoladex: The FDA drug label for Zoladex reports the following cardiac side effects:
- Arrhythmia
- Cerebrovascular accident
- Hypertension
- Myocardial infarction
- Peripheral vascular disorder
- Chest pain
- Hemorrhage
- Migraine
- Palpitations
- Tachycardia These side effects were reported in greater than 1% but less than 5% of patients treated with Zoladex 1 1.
From the Research
Zoladex (goserelin) is associated with a higher risk of cardiac side effects compared to GnRH antagonists, and patients with pre-existing cardiovascular disease or risk factors should be closely monitored. The cardiac effects of Zoladex are primarily related to its mechanism as a gonadotropin-releasing hormone (GnRH) agonist, which reduces sex hormone levels, impacting cholesterol levels and vascular function 2. According to a recent study published in 2023, GnRH agonists, including Zoladex, are associated with a higher risk of cardiovascular adverse events compared to GnRH antagonists, with a pooled relative risk of 1.28 (95% CI 0.59-2.79) 2. Key points to consider when prescribing Zoladex include:
- Regular cardiac monitoring, especially in patients with pre-existing heart conditions
- Screening for cardiovascular risk factors, such as diabetes, high cholesterol, or smoking history
- Consideration of alternative treatments, such as GnRH antagonists, in patients with high cardiovascular risk
- Education on symptoms of cardiac side effects, such as chest pain, shortness of breath, or severe headaches, and the importance of seeking immediate medical attention if they occur. Overall, while Zoladex is an effective treatment for various conditions, including prostate cancer, breast cancer, and endometriosis, its potential cardiac side effects must be carefully considered and monitored to minimize risks and optimize patient outcomes 2, 3.