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 should be closely monitored. The risk of cardiac side effects with Zoladex is a concern, particularly in patients with existing heart conditions, older adults, and those with other cardiovascular risk factors 2. Some of the key cardiac side effects that may occur with Zoladex include:
- Heart palpitations
- Abnormal heart rhythms
- Heart attack
- Heart failure These effects are thought to occur because Zoladex is a gonadotropin-releasing hormone (GnRH) agonist that reduces sex hormone levels, which can impact cardiovascular health 3. A recent study found that GnRH antagonists, such as degarelix, are associated with a significantly lower incidence of major adverse cardiovascular events compared to GnRH agonists like Zoladex 4. Therefore, patients with prostate cancer and cardiovascular risk factors may benefit from treatment with a GnRH antagonist instead of Zoladex. Regular cardiac monitoring may be recommended for high-risk patients, and patients on Zoladex should monitor for symptoms like chest pain, shortness of breath, irregular heartbeat, or swelling in the extremities and report these immediately to their healthcare provider 5. The cardiac side effects typically develop gradually rather than immediately after starting treatment, and the risk-benefit profile remains favorable for most patients requiring this medication for prostate cancer, breast cancer, or certain gynecological conditions 6. In terms of specific CV disorders, GnRH antagonists have been shown to have a lower risk of hypertension, myocardial infarction, and thrombosis compared to GnRH agonists 2. Overall, the choice of treatment should be individualized based on the patient's specific risk factors and medical history, and patients should be closely monitored for cardiac side effects while on Zoladex or other GnRH agonists.