Comprehensive medication guide to Fyremadel including estimated pricing, availability information, side effects, and how to find it in stock at your local pharmacy.
Estimated Insurance Pricing
$0–$50 copay per syringe when covered; many plans do not cover fertility medications at all. In the 21 states with fertility insurance mandates, coverage may be required. Prior authorization is almost always required when covered.
Estimated Cash Pricing
$150–$250 per 250 mcg prefilled syringe at retail; as low as $33–$44 per syringe with a GoodRx or SingleCare coupon for generic ganirelix acetate. Most IVF cycles require 4–6 syringes, so total per-cycle cost ranges from approximately $175–$1,500 depending on discounts and quantity.
Medfinder Findability Score
50/100
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Fyremadel is the brand name for ganirelix acetate, an injectable GnRH antagonist (gonadotropin-releasing hormone antagonist) manufactured by Ferring Pharmaceuticals and manufactured by Sun Pharmaceutical Industries. It is supplied as a prefilled, single-use sterile syringe containing 250 mcg of ganirelix acetate in 0.5 mL of solution, intended for subcutaneous (under-the-skin) injection.
Ganirelix acetate was originally approved by the FDA in 1999 under the brand name Antagon. Other names include Orgalutran (outside the US). A generic version is manufactured by Amphastar Pharmaceuticals and is FDA-approved as bioequivalent to Fyremadel. Fyremadel is not a controlled substance and has no DEA scheduling.
Fyremadel is FDA-approved for one indication: inhibition of premature luteinizing hormone (LH) surges in women undergoing controlled ovarian hyperstimulation (COH) as part of assisted reproductive technology (ART), primarily in vitro fertilization (IVF). Some off-label uses include management of endometriosis and precocious puberty, though these are uncommon.
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Fyremadel (ganirelix acetate) is a synthetic decapeptide that competitively blocks GnRH receptors on the pituitary gland. By occupying these receptors, Fyremadel prevents natural GnRH from binding and signaling — rapidly suppressing the secretion of both luteinizing hormone (LH) and follicle-stimulating hormone (FSH), with LH suppression being more pronounced.
During an IVF cycle, FSH injections stimulate the ovaries to produce multiple follicles. Without GnRH suppression, rising estrogen levels from growing follicles could trigger a premature LH surge — causing ovulation before egg retrieval. Fyremadel prevents this premature LH surge, giving the fertility doctor precise control over the timing of egg retrieval.
A key advantage of Fyremadel's antagonist mechanism is rapid reversibility: unlike GnRH agonists (like Lupron) that require weeks to suppress the pituitary, Fyremadel works within hours of the first injection and pituitary function fully recovers within 48 hours of stopping. This enables the hCG trigger shot to work properly after Fyremadel is discontinued. Steady-state blood concentrations are achieved after approximately 3 days of daily dosing.
250 mcg/0.5 mL — prefilled syringe (subcutaneous injection)
Single-use, sterile, ready-to-use prefilled 1 mL glass syringe. Standard FDA-approved dose for IVF. Injected once daily subcutaneously starting approximately Day 6-8 of stimulation, continued until hCG trigger.
Fyremadel scores a 50 out of 100 on our findability scale, meaning it can be moderately difficult to locate. As a specialty fertility injectable, Fyremadel is typically stocked only at specialty pharmacies and fertility clinic pharmacies rather than standard retail pharmacies. Most CVS, Walgreens, and Rite Aid locations do not routinely carry it.
As of early 2026, Fyremadel is not listed on the FDA or ASHP drug shortage databases — there is no formal nationwide shortage. However, periodic localized availability challenges at retail pharmacies are commonly reported. With only two primary manufacturers (Ferring Pharmaceuticals for Fyremadel and Amphastar Pharmaceuticals for the generic), supply can be vulnerable to regional demand spikes, particularly during peak IVF seasons.
If your local pharmacy doesn't carry Fyremadel, a specialty fertility pharmacy (Freedom Fertility, MDR Fertility, Encompass Rx) or your clinic's in-house pharmacy is your best bet. You can also use medfinder to quickly check which pharmacies near you have Fyremadel in stock.
Fyremadel (ganirelix acetate) is not a controlled substance, so there are no DEA scheduling restrictions on prescribers. However, the FDA prescribing information specifies that it should only be prescribed by physicians experienced in infertility treatment. IVF protocols require specialized monitoring (follicle ultrasounds, hormone blood draws) that makes fertility specialist oversight essential.
Qualified prescribers typically include:
Telehealth options are available for initial fertility consultations through platforms such as Progyny and Carrot Fertility, though active IVF cycles require in-person monitoring via follicle ultrasounds and blood draws at a local fertility clinic or monitoring site.
No. Fyremadel (ganirelix acetate) is not a controlled substance and is not scheduled by the Drug Enforcement Administration (DEA). It has no known abuse potential. Prescribers do not need a DEA registration number to prescribe it, and patients do not need any special identification to pick it up at the pharmacy.
While Fyremadel is not a controlled substance, it is a prescription-only medication that must be ordered by a licensed healthcare provider. The FDA prescribing information specifies that it should only be prescribed by physicians experienced in infertility treatment, given the complex monitoring required during IVF cycles. Patients cannot obtain Fyremadel without a valid prescription from a qualified fertility specialist.
The most commonly reported adverse reactions from clinical trials include:
Fyremadel is contraindicated in pregnancy (Category X) and should not be used by lactating women. The needle shield contains dry natural rubber/latex — latex-sensitive patients should inform their pharmacist before use.
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Cetrorelix (Cetrotide)
Most direct alternative — same drug class (GnRH antagonist), same dose (0.25 mg daily), same mechanism, equivalent IVF outcomes per ESHRE. Can be substituted mid-cycle. Requires powder reconstitution vs. Fyremadel's prefilled syringe.
Generic Ganirelix Acetate (Amphastar)
FDA-approved bioequivalent generic of Fyremadel. Same active ingredient, same dose, same prefilled syringe format. Significantly less expensive — especially with GoodRx coupon.
Leuprolide (Lupron)
GnRH agonist (not antagonist) — requires a completely different, longer IVF protocol. Cannot substitute for Fyremadel mid-cycle. Used in long-protocol IVF cycles as an alternative approach.
Nafarelin (Synarel)
GnRH agonist administered as a nasal spray. Requires a different protocol. Cannot substitute for Fyremadel mid-cycle but may be an option for future cycle planning in patients who prefer to avoid injections.
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GnRH analogs (Leuprolide, Nafarelin, Cetrorelix)
majorShould not be combined with Fyremadel simultaneously. Each IVF protocol uses one GnRH agent at a time. Combining GnRH analogs is not standard practice and could interfere with pituitary suppression.
Exogenous gonadotropins (FSH, hCG)
minorUsed together intentionally as part of the IVF protocol. Fyremadel suppresses endogenous gonadotropin secretion, so FSH dose may need adjustment based on follicle monitoring. Not an adverse interaction — a normal aspect of the antagonist protocol.
NSAIDs (ibuprofen, naproxen)
moderateNot a direct Fyremadel interaction, but most fertility specialists recommend avoiding NSAIDs throughout IVF cycles because they may interfere with ovulation and implantation. Acetaminophen is generally preferred.
St. John's Wort
moderateHerbal supplement known to affect CYP450 enzyme metabolism. May theoretically affect drug metabolism. Should be avoided during IVF cycles.
Fyremadel (ganirelix acetate) is a well-established, FDA-approved fertility medication that plays a critical role in IVF cycles by preventing premature ovulation at precisely the moment it matters most. It is a specialty injectable that requires a prescription from an experienced fertility specialist and close monitoring throughout your stimulation cycle.
While Fyremadel is not in a formal FDA shortage as of 2026, finding it at standard retail pharmacies can be challenging. Specialty fertility pharmacies are your most reliable source. Cost can be significant — $150-$250 per syringe at retail — but generic ganirelix acetate with a GoodRx coupon can bring the price down to $33-$44 per syringe. Patient assistance programs are available for qualifying uninsured patients.
If you're struggling to find Fyremadel in stock, medfinder can quickly check which pharmacies near you have it available. Don't let a supply issue derail your IVF cycle — with the right resources and a proactive approach, you can stay on track.
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