How Effective Is It
Hormone therapies, such as Lupron, are often effective in combination with other treatments for people with late-stage prostate cancer. Many doctors do not recommend hormone therapy during the early stages of this disease.
One potential issue is that prostate cancer can become resistant to LHRH agonists over time in some people.
According to the ACS, doctors may recommend hormone therapies, such as Lupron, for:
Secondary Treatment Following Relapse
Hormone therapy may also be used as a secondary or salvage treatment when PSA levels rise following initial prostate cancer treatment, indicating the cancer has returned. This situation is known as biochemical recurrence. The salient points to keep in mind are that hormone therapy is most often used as a salvage treatment when PSA doubling time is less than six months, indicating that the cancer is aggressive or may have already metastasized.
When To Contact Your Team
Your doctor or nurse will go through the possible side effects. They will monitor you closely during treatment and check how you are at your appointments. Contact your advice line as soon as possible if:
- you have severe side effects
- your side effects arent getting any better
- your side effects are getting worse
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Lupron Side Effects List For Healthcare Professionals
Clinical Trials
- In the majority of patients testosterone levels increased above baseline during the first week, declining thereafter to baseline levels or below by the end of the second week of treatment.
- This transient increase was occasionally associated with a temporary worsening of signs and symptoms, usually manifested by an increase in bone pain.
- In a few cases a temporary worsening of existing hematuria and urinary tract obstruction occurred during the first week.
- Temporary weakness and paresthesia of the lower limbs have been reported in a few cases.
- Potential exacerbations of signs and symptoms during the first few weeks of treatment is a concern in patients with vertebral metastases and/or urinary obstruction which, if aggravated, may lead to neurological problems or increase the obstruction.
- In a comparative trial of Lupron Injection versus DES, in 5% or more of the patients receiving either drug, the following adverse reactions were reported to have a possible or probable relationship to drug as ascribed by the treating physician.
- Often, causality is difficult to assess in patients with metastatic prostate cancer.
- Reactions considered not drug related are excluded.
MiscellaneousDepression, Diabetes, Fatigue, Fever/chills, Hypoglycemia, Increased BUN, Increased calcium, Increased creatinine, Infection/inflammation, Ophthalmologic disorders, Swelling .
Endocrine SystemLibido increase, Thyroid nodule
Postmarketing
Hemic and Lymphatic System-Decreased WBC
What Is Intermittent Adt
Researchers have investigated whether a technique called intermittent androgen deprivation can delay the development of hormone resistance. With intermittent androgen deprivation, hormone therapy is given in cycles with breaks between drug administrations, rather than continuously. An additional potential benefit of this approach is that the temporary break from the side effects of hormone therapy may improve a mans quality of life.
Randomized clinical trials have shown similar overall survival with continuous ADT or intermittent ADT among men with metastatic or recurrent prostate cancer, with a reduction in some side effects for intermittent ADT .
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What Should I Watch For While Using This Medicine
Visit your doctor or health care professional for regular checks on your progress. During the first weeks of treatment, your symptoms may get worse, but then will improve as you continue your treatment. You may get hot flashes, increased bone pain, increased difficulty passing urine, or an aggravation of nerve symptoms. Discuss these effects with your doctor or health care professional, some of them may improve with continued use of this medicine.
Female patients may experience a menstrual cycle or spotting during the first months of therapy with this medicine. If this continues, contact your doctor or health care professional.
This medicine may increase blood sugar. Ask your healthcare provider if changes in diet or medicines are needed if you have diabetes.
How Lupron Depot Is Given
LUPRON DEPOT is a prescription medicine that must be administered under the supervision of a physician. Its given as a single intramuscular injection, which means it is injected into one of your muscles, instead of under the skin or into a vein. Your doctor will determine the most appropriate injection site for you.1
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Tips For A Better Lupron Treatment Experience
Making the choice to treat your advanced prostate cancer can have its rewards and its challenges. To help yourself have the best possible treatment experience, take an active role in your therapy. These suggestions may help.
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If you start experiencing side effects, don’t be silent. Talk to your doctor. He or she may have some ideas for helping to manage side effects. Its also important to let your healthcare team know if you experience new or worsening symptoms.
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Stay committed to your LUPRON DEPOT therapy by going to all of your appointments. Get all the doses you are prescribed so you can get the most from your LUPRON DEPOT therapy.
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If you miss an appointment, schedule another one as soon as you can. If scheduling is a problem, talk to your doctor about any options he or she may have.
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Get monitored regularly to check your progress. During your scheduled visit, your Prostate Specific Antigen should be tested , and some doctors may also test your blood for testosterone levels to help your doctor determine how LUPRON DEPOT is working.1
Keep focused on the positive aspects of your life and the time you can spend with family and friends
Taking an active role in your treatment plan may help you feel more in control of what you’re going through.
How To Use Lupron Solution
Read the Medication Guide and, if available, the Patient Information Leaflet provided by your pharmacist before you start using leuprolide and each time you get a refill. If you have any questions, ask your doctor or pharmacist.
This medication is given by injection under the skin as directed by your doctor, usually once a day.
In children, the dosage is based on weight and response to treatment. The doctor should consider stopping treatment before age 11 for girls and age 12 for boys. Consult the doctor for details.
If you are using this medication at home, learn all preparation and usage instructions from your health care professional and the product package. Learn how to store and discard medical supplies safely.
Before using, check this product visually for particles or discoloration. If either is present, do not use the liquid. Before injecting each dose, clean the injection site with rubbing alcohol. Change the injection site each time to lessen injury under the skin.
Use this medication regularly to get the most benefit from it. To help you remember, use it at the same time each day.
During the first few weeks of treatment, your hormone levels will actually go up before they go down. This is a normal response to this medication. Your symptoms may get worse for a few weeks.
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Treatment To Lower Androgen Levels From The Adrenal Glands
LHRH agonists and antagonists can stop the testicles from making androgens, but cells in other parts of the body, such as the adrenal glands, and prostate cancer cells themselves, can still make male hormones, which can fuel cancer growth. Drugs are available that block the formation of androgens made by these cells.
Abiraterone blocks an enzyme called CYP17, which helps stop these cells from making androgens.
Abiraterone can be used in men with advanced prostate cancer that is either:
- High risk
- Castrate-resistant
This drug is taken as pills every day. It doesnt stop the testicles from making testosterone, so men who havent had an orchiectomy need to continue treatment with an LHRH agonist or antagonist. Because abiraterone also lowers the level of some other hormones in the body, prednisone needs to be taken during treatment as well to avoid certain side effects.
Ketoconazole , first used for treating fungal infections, also blocks production of androgens made in the adrenal glands, much like abiraterone. It’s most often used to treat men just diagnosed with advanced prostate cancer who have a lot of cancer in the body, as it offers a quick way to lower testosterone levels. It can also be tried if other forms of hormone therapy are no longer working.
Ketoconazole also can block the production of cortisol, an important steroid hormone in the body, so men treated with this drug often need to take a corticosteroid .
How To Use Lupron Depot 375 Mg Intramuscular Syringe Kit
Read the Patient Information Leaflet if available from your pharmacist before you start using leuprolide and each time you get a refill. If you have any questions, ask your doctor or pharmacist.
This medication is given by injection into a muscle by a health care professional. It is given as directed by your doctor, usually once every month. This product slowly releases the medication into your blood over a 1-month period.
If you are using this medication at home, learn all preparation and usage instructions from your health care professional and the product package. Learn how to store and discard medical supplies safely.
Wash your hands and properly mix the medication. Before injecting each dose, clean the injection site with rubbing alcohol. Change the injection site each time to lessen injury under the skin. Inject each dose within 2 hours of mixing. If more than 2 hours have passed since mixing, throw out the product and prepare another syringe/dose.
The length of treatment is based on your medical condition, response to treatment, and lab tests.
Use this medication regularly to get the most benefit from it. To help you remember, mark your calendar to keep track of when to receive the next dose.
During the first few weeks of treatment, your hormone levels will actually go up before they go down. This is a normal response to this medication. Your symptoms may get worse for a few weeks.
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Less Common But Serious Risks
Less common but more serious side effects can accompany leuprolide including Tumor Flare Phenomenon, increased blood sugar, and injection site reaction. Additionally, leuprolide may increase an individuals risk of developing diabetes and cardiovascular complications, including an increased risk of heart attack, stroke, and sudden cardiac death. Individuals taking leuprolide should also be monitored for convulsions. Leuprolide may also cause a decrease in bone mineral density, leading to osteoporosis .
Tumor Flare Phenomenon is possible while taking leuprolide, in which tumor growth is accelerated for a short time before it is halted. Alert your provider immediately if you notice any serious signs of Tumor Flare Phenomenon including:
- Weakness or loss of feeling in legs
- Have trouble urinating or are unable to urinate
- Experience new or worsening bone pain
You should also contact your provider if you notice any signs of an allergic reaction to the medication, including chest pain or difficulty breathing.
Before starting leuprolide talk to your provider if you:
- Have any heart or blood vessel conditions such as irregular heart beat
- Have a history of seizures or epilepsy
- Are taking any medications for any cardiovascular conditions
- Have high blood pressure
- Have a condition that affects the strength of your bones
- Are taking any other medications , vitamins, or herbal supplements
% Of Firmagon Patients Reached Goal Testosterone Levels By Day 3
Lupron Depot initially increased testosterone levels65% by the third day, compared to a 94% reduction with FIRMAGON. Some patients may require additional medication to prevent a symptomatic flare with Lupron Depot.
TESTOSTERONE LEVELS IN THE FIRST 28 DAYS OF THERAPY
FIRMAGON
- Severe itching
- Swelling of your face, lips, mouth, or tongue
- Women who are pregnant or may become pregnant should not take FIRMAGON. FIRMAGON can harm an unborn baby when given to a pregnant woman.
- Before receiving FIRMAGON, tell your healthcare provider about all your medical conditions, including if you have any heart problems including a condition called long QT syndrome, have problems with blood levels such as sodium, potassium, calcium, and magnesium, have kidney or liver problems.
- The common side effects of FIRMAGON include: hot flashes, injection site pain, redness and swelling, weight gain, increase in some liver enzymes, decreased sex drive, and erectile function problems.
Tell your healthcare provider if you have any side effects that bother you or that does not go away. These are not all the possible side effects. You may report side effects to FDA at 1-800-FDA-1088.
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How Is Lupron Depot Injected
Your doctor or other healthcare provider will prepare and give you this injection for the treatment of prostate cancer.
Lupron Depot comes as 7.5 mg for 1-month administration, 22.5 mg for 3-month administration, 30 mg for 4-month administration, and 45 mg for 6-month injection in a kit with pre-filled dual chamber syringe, for reconstitution. Your doctor will select your dose based on your schedule.
Directions for healthcare providers
Prior to and during administration, healthcare providers should review the illustrated directions for reconstitution and use here.
Reconstitute and administer the lyophilized microspheres as a single intramuscular injection. Do not use concurrently a fractional dose, or a combination of doses of this or any depot formulation due to different release characteristics.
Lupron Depot does not contain a preservative. Inject the suspension immediately or discard if not used within two hours.
Pharmacist Tips For Lupron Depot
Lupron Depot raises your testosterone levels in the first few weeks. This can cause a flare-up or an increase in your symptoms, such as bone pain, nerve pain, bladder pain, blood in your urine, or other urinary problems. Let your provider know if these symptoms don’t go away after a month.
Your healthcare provider will check your labs regularly to make sure the medication is working.
Lupron Depot can make it difficult for you to get or maintain an erection, because this medication lowers testosterone levels. This is a normal side effect.
It’s possible for Lupron Depot to cause infertility in males, so discuss this with your healthcare provider before starting this medication.
Prices for Lupron Depot start at just $447.14 with a GoodRx coupon. Theyâre fast, easy-to-use and free!
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Dosage Forms & Strengths
injection, lyophilized powder for reconstitution
- Reconstitution results in suspension for IM injection
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monthly
- Reconstitution results in suspension for IM injection
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Kit contains 2 syringes
- Syringe A contains diluent for reconstitution
- Syringe B contains 45 mg lyophilized leuprolide acetate powder
injectable solution
- 5mg/mL
Lupron Depot Isan Agonist
Lupron Depot triggers a receptor called the luteinizing hormonereleasing hormone receptor, which results in an initial surge in testosterone. This initial surge subsequently reduces over a few weeks. Additional medication may be required to prevent the effects of the testosterone surge.
Get to T goal fast with FIRMAGON
FIRMAGON is the only GnRH antagonist approved to treat advanced prostate cancer .
FIRMAGON immediately lowered T, nearly 90% on the first day
By day 28 of treatment, both FIRMAGON and Lupron Depot® achieved similar testosterone levels.
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Intermittent Versus Continuous Hormone Therapy
Most prostate cancers treated with hormone therapy become resistant to this treatment over a period of months or years. Some doctors believe that constant androgen suppression might not be needed, so they advise intermittent treatment. The hope is that giving men a break from androgen suppression will also give them a break from side effects like decreased energy, sexual problems, and hot flashes.
In one form of intermittent hormone therapy, treatment is stopped once the PSA drops to a very low level. If the PSA level begins to rise, the drugs are started again. Another form of intermittent therapy uses hormone therapy for fixed periods of time for example, 6 months on followed by 6 months off.
At this time, it isnt clear how this approach compares to continuous hormone therapy. Some studies have found that continuous therapy might help men live longer, but other studies have not found such a difference.
Dr Roach: Hot Flashes Remain Post
Dear Dr. Roach: Im a 76-year-old man who was treated for prostate cancer starting in summer 2017. Following radiation therapy, I was given Lupron injections every six months for two years. Its been two years since my last injection, but I still experience hot flashes as a result. Will these hot flashes stay with me for the rest of my life? My urologist assured me that the hot flashes would subside approximately a year after the final shot.
D.T.
Dear D.T.: Leuprolide is a medicine that prevents the body from making testosterone. Back in 1941, depleting testosterone was proven to slow prostate cancer growth, but even in the first group of subjects, there were men with severe hot flashes. The sudden drop in testosterone causes vasomotor instability, meaning that the blood vessels in the skin suddenly dilate, causing an intense heat sensation. The whole body can cool down with this, leading sufferers to feel cold afterward.
I cant predict how long these symptoms will last, but it does not shock me that they have continued for two years. Given that they seem to be quite bothersome, you should ask your urologist or oncologist about treatment. Just as with menopausal women who have hot flashes, there are treatments that can reduce, though perhaps not eliminate, the number of hot flashes you get per day.
J.P.
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