Precocious puberty

Prescribing Notes:

• Refer to (MSAN 2025) 09 Triptorelin acetate (Gonapeptyl® Depot) 3.75mg powder and solvent for suspension for injection pre-filled syringes for further details of supply disruption. 
• Initial agonist activity is seen with Gonadotrophin-releasing hormone (GnRH) analogues. This is expected to diminish over approximately 4-6 weeks, which may result in a withdrawal bleed.
• Cyproterone acetate may be used alone in rare forms of precocious puberty involving primary ovarian overactivity.
• Long-term use of cyproterone may result in adrenal insufficiency.
• Patients (or parents of children) receiving long-term cyproterone should carry a steroid card.
• Appetite stimulation and weight gain are frequently encountered problems seen with cyproterone acetate use.
• Refer to guidance in Scottish Paediatric Endocrine Group and British Society for Paediatric Endocrinology and Diabetes.
• For prescribing Gonadotrophin-releasing hormone (GnRH) analogue (any medicinal product that consists of or contains buserelin, gonadorelin, goserelin, leuprorelin acetate, nafarelin or triptorelin), please refer to Scottish Drug Tariff part 12 Schedule 2 ‘Drugs to be prescribed in certain circumstances under the NHS Pharmaceutical services’ for items that must be endorsed ‘SLS’.