Currently Available Leuprorelin Formulations
In 1971, GnRH was first isolated and characterized in the laboratory.24 Leuprorelin, a synthetic analogue of GnRH, was first synthesized for clinical use in 1974.25 Leuprorelin has a longer half-life and is 80 times more potent than naturally occurring GnRH, because of its enhanced binding affinity and increased resistance to degradation by peptidases.26 Alterations in the chemical structure, including substitution of a D-amino acid for glycine at position 6 and deletion of glycine at position 10 with the insertion of ethylamide, are responsible for these properties.27
The clinical benefits of GnRH analogues in prostate cancer patients were first described by Tolis et al in 1982. Ten patients with locally advanced or metastatic prostate cancer were treated with leuprorelin given as daily subcutaneous injections or twice daily intranasal applications for a period of 6 weeks to 12 months. During the treatment period, those patients with urinary obstruction noted improvement in urine flow, and those with osseous metastases reported decreased bone pain.28
Technological advances have fostered the development of multiple long-acting depot formulations of GnRH in order to improve convenience of use, quality of life, and patient compliance. The first long-acting formulation was a monthly injection approved by the FDA in 1989 for treatment of advanced prostate cancer.30 In the US, leuprorelin is now available in monthly , 3-monthly , 4-monthly , and 6-monthly dosages.
What Is Lupron Depot
LUPRON DEPOT is in the class of hormonal therapy drugs called gonadotropin-releasing hormone agonists .1 While Lupron is not a cure for advanced prostate cancer, you and your doctor may choose LUPRON DEPOT as part of your treatment plan to suppress testosterone that may cause testosterone-dependent prostate cancer cells to grow.1,4
What Are Some Other Side Effects Of This Drug
All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away:
For all patients taking this drug:
- Feeling dizzy, tired, or weak.
- Upset stomach or throwing up.
- Trouble sleeping.
- Irritation where the shot is given.
- Back, muscle, or joint pain.
- Flu-like signs.
- Signs of a common cold.
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Quality Of Life On Hormone Therapy
Here, Id like to make 2 quick points. First, Id like to mention the general quality of life for those who are taking Lupron. If youre not having any side effects and your PC treatment is working, that is excellent news. If youre suffering from side effects of Lupron, how is your overall quality of life? While the medication is doing its job, is it making your life miserable? From what I have read about Lupron from the men on this site, something is not right. Yesthis medication is saving your life but at what cost?
Secondly, with any medication, you should ask the doctor to tell and explain the side effects. Most medications come with the fold-out sheet, written in 2-font, that is tough on the eyes to read and comprehend, which explains all the side effects. You should ask the doctor about the major side effects and what said medication will do to various aspects of your life . This way, you can make an informed decision and ask about other available treatments.
Removing a piece of a mans sexuality can have major mental and physical repercussions, including an effect on his relationship and lover. From reading the comments here, I read too many times where the lover didnt want to stay with a man who cannot perform sexually. Treating cancer is one thing, losing a is another.
What Is This Medication
LEUPROLIDE is a man-made protein that acts like a natural hormone in the body. It decreases testosterone in men and decreases estrogen in women. In men, this medicine is used to treat advanced prostate cancer. In women, some forms of this medicine may be used to treat endometriosis, uterine fibroids, or other female hormone-related problems.
This medicine may be used for other purposes ask your health care provider or pharmacist if you have questions.
COMMON BRAND NAME: Eligard, Fensolv, Lupron Depot, Lupron Depot-Ped, Viadur
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What Is The Most Important Information I Should Know About Lupron
You should not use this medicine if you are allergic to leuprolide or similar medicines such as buserelin, goserelin, histrelin, nafarelin, or if you have abnormal vaginal bleeding that has not been checked by a doctor.
Leuprolide can cause birth defects. Do not use if you are pregnant. Tell your doctor right away if you become pregnant.
Certain brands or strengths of leuprolide are used to treat only men and should not be used in women or children. Always check your medicine to make sure you have received the correct brand and strength.
Tell your doctor if you have ever had:
- depression, mental illness or psychosis
- seizures or epilepsy
- a brain tumor or spinal cord injury
- heart disease, congestive heart failure, long QT syndrome
- an electrolyte imbalance or
- risk factors for bone loss .
Do not give this medicine to any child without medical advice.
Leuprolide usually causes women to stop ovulating or having menstrual periods. However, you may still be able to get pregnant. Use a condom or diaphragm with spermicide to prevent pregnancy. Leuprolide can make hormonal birth control less effective .
You should not breast-feed while using this medicine.
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What Does Lupron Depot Cost
Costs of prescription drugs can vary depending on many factors. These factors include what your insurance plan covers and which pharmacy you use.
If you have questions about how to pay for your prescription, talk with your doctor or pharmacist. A program called myAbbVie Assist may also be available to help with the cost Lupron Depot.
To learn more about saving money on prescriptions, you can also check out this article.
Will Lupron Depot Affect My Ability To Get Pregnant Or Get My Partner Pregnant
Lupron Depot may temporarily decrease fertility in adults. However, once Lupron Depot treatment ends, this decrease in fertility typically goes away after a period of time. And use of Lupron Depot-Ped in children isnt known to affect fertility long term.
In some cases, Lupron Depot is prescribed off-label as a part of an infertility treatment called the luteal Lupron protocol.
For more details about Lupron Depot and fertility, see the Lupron Depot and pregnancy section below.
Drug Forms And Administration
Lupron Depot and Eligard are both given as an injection by your doctor. Lupron Depot is injected into the muscle of the upper arm, the area above the buttocks, or the outer part of the upper thigh. Eligard is injected under the skin into the abdomen , upper buttocks, or anywhere that has enough fatty tissue.
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Ideas For Future Studies Of Proton Therapy
Despite the studys limitations, these intriguing findings raise questions that should inform future prospective phase 3 trials, Dr. Buchsbaum said, although there are barriers to large studies of proton therapy.
For instance, it is particularly encouraging that proton therapy appeared to be safer in a group of older and sicker patients who typically experience more side effects, Dr. Baumann noted.
Dr. Buchsbaum agreed that proton therapy may be especially helpful for older and sicker patients, but he noted that ongoing phase 3 trials were not designed to analyze this group of patients.
And because proton therapy may cause fewer side effects, future trials could also explore whether combining proton therapy with chemotherapy might be more tolerable for patients, the authors wrote.
For example, both chemotherapy and traditional radiation for lung cancer can irritate the esophagus, making it painful and difficult for patients to eat. But proton therapy might limit damage to the esophagus, making it easier for a patient to tolerate the combination, Dr. Baumann explained.
Future studies could also explore whether combining proton therapy with higher doses of chemotherapy might increase cures without causing more side effects, he added.
Dr. Buchsbaum agreed, saying that it would be worthwhile to explore this possibility. Just asking the question: Is more effective? might not be giving it a fair opportunity to demonstrate its benefit to society, he said.
What To Do In Case Of Overdose
If you think youve been given too much of this drug, call your doctor. You can also call the American Association of Poison Control Centers at 800-222-1222 or use its online tool. But if your symptoms are severe, call 911 or go to the nearest emergency room right away.
The following information is provided for clinicians and other healthcare professionals.
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What Happens If I Stop Lupron Depot
If Lupron treatment is stopped, testosterone levels can rise and your cancer may worsen. Do not discontinue Lupron Depot unless your doctor tells you to stop treatment.
In men, testosterone is reduced to castrate concentrations with Lupron Depot treatment. This is called medical castration, as opposed to surgical castration when the testicles are removed surgically. The testicles make most of the testosterone in a man, about 95%. The adrenal glands above the kidney also produce a small amount of testosterone.
In patients with advanced prostate cancer, you may also receive other medicines along with Lupron Depot. These may include chemotherapy drugs, immunotherapy or targeted drug treatments, or corticosteroids depending upon your stage of cancer.
You may experience side effects with Lupron Depot treatment such as:
- hot flashes or sweats
Serious Side Effects Of Lupron Depot
Along with its needed effects, leuprolide may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur while taking leuprolide:
- Bone, muscle, or joint pain
- chest tightness
- numbness or tingling of the hands or feet
- puffiness or swelling of the eyelids or around the eyes
- sudden, severe decrease in blood pressure and collapse
- trouble breathing
- Arm, back, or jaw pain
- bloody or cloudy urine
- difficult, burning, or painful urination
- difficulty with moving
- increased urge to urinate during the night
- muscle pain or stiffness
- pain in the arms or legs
- pain in the joints
- waking to urinate at night
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How Lupron Depot Works
Lupron Depot contains the drug leuprolide acetate, which belongs to a class of drugs called gonadotropin releasing hormone agonists. It works by blocking your body from creating certain hormones, like estrogen and testosterone.
These hormones play key roles in many of our bodily functions. However, when the hormones are out of balance, they can cause negative side effects. For example, testosterone signals prostate cancer cells to grow. Lupron Depot works by stopping the production of testosterone in your body. This can help stop prostate cancer cells from growing.
With endometriosis, estrogen affects lesions by stimulating them to bleed like uterine tissue. This is often uncomfortable and painful.
Estrogen also can cause uterine fibroids to develop and grow. By blocking estrogen production, Lupron Depot helps reduce pain and can shrink or get rid of lesions and uterine fibroids.
Lupron Depot-Ped is used for central precocious puberty, a condition in which a child experiences the effects of puberty earlier than usual. Lupron Depot-Ped works by blocking certain hormones that make childrens bodies undergo puberty. This delays puberty as long as the child uses the medication.
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Surgical procedures to remove the diseased prostate are usually necessary. Surgical procedures are not always necessary. If the disease is caused by bacterial infections, a doctor can treat the symptoms using alpha-blockers or surgery. Physical therapy, relaxation exercises, and warm baths are all recommended. A physician may also prescribe antibiotics to cure the infection. A bacterial infection can also cause a recurrence of the condition.
An enlarged prostate can be uncomfortable for both men and women. Some of the symptoms of an enlarged male reproductive organ include a weakened urine stream, urgent need to urinate, and urinary tract infections. BPH can also cause damage to the kidneys. A sudden inability to urinate can be life-threatening, as it can lead to bladder and kidney damage. Unfortunately, most men with enlarged prostrates put up with the symptoms for years before they seek treatment. However, many of the men with symptoms finally decide to go to a doctor for proper gynecological evaluation and to begin enlarged prostatic therapy.
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Evidence About Hormone Therapy And Prostatectomy
Gleave ME, La Bianca S, Goldenberg SL. Neoadjuvant Hormonal Therapy Prior to Radical Prostatectomy: Promises and Pitfalls. Prostate Cancer and Prostatic Diseases 2000 3:13644. PMID: 12497089.
Hurtado-Coll A, Goldenberg SL, Klotz L, Gleave ME. Preoperative Neoadjuvant Androgen Withdrawal Therapy in Prostate Cancer: The Canadian Experience. Urology 2002 60:4551. PMID: 12231047.
Kumar S, Shelley M, Harrison C, et al. Neo-adjuvant and Adjuvant Hormone Therapy for Localized and Locally Advanced Prostate Cancer. Cochrane Database of Systematic Reviews 2006 CD006019. PMID: 17054269.
Soloway MS, Sharifi R, Wajsman Z, et al. Randomized Prospective Study Comparing Radical Prostatectomy Alone Versus Radical Prostatectomy Preceded by Androgen Blockade in Clinical Stage B2 Prostate Cancer. The Lupron Depot Neoadjuvant Prostate Cancer Study. Journal of Urology 1995 154:4248. PMID: 7541859.
How Does It Work
The class of drugs to which Lupron belongs speaks a lot about its mechanism of action. Leuprolide acetate works to suppress gonadotrope secretion of follicle-stimulating and luteinizing hormone . This action eventually inhibits gonadal sex steroid production.
A more detailed explanation would be the following.
At first, administration of Lupron stimulates pituitary gland gonadotropins luteinizing hormone, and follicle-stimulating hormone .
As a result, steroidogenesis in a mans testicles increases.
When that happens, men may have elevated serum testosterone and dihydrotestosterone levels.
This is called tumor flare when the initial stages of treatment worsen symptoms of the disease.
That said, continuous administration of Lupron decreases gonadotropins and gonadal steroids.
With time, consistent administration of leuprolide acetate lowers the concentration of serum testosterone levels by inhibiting LH and FSH.
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Side Effects Not Requiring Immediate Medical Attention
Some side effects of leuprolide may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.
Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
- Sudden sweating and feeling of warmth
- pain or discomfort at the injection site
- redness of the face, neck, arms, and occasionally, upper chest
- unusual drowsiness, dullness, tiredness, weakness, or feeling of sluggishness
- inability to have or keep an erection
Incidence not known
- Increased sensitivity of the skin to sunlight
- redness or other discoloration of the skin
- redness of the face, neck, arms and occasionally, upper chest
Will I Have Withdrawal Symptoms When I Stop Taking Lupron Depot
There arent any known withdrawal symptoms after stopping Lupron Depot. But for some people, their condition may worsen if they stop using treatment.
Dont stop treatment with Lupron Depot unless youre directed to do so by your doctor. Your doctor will continue to schedule injection appointments for as long as you should be using Lupron Depot.
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Lupron Depot For Central Precocious Puberty
Lupron Depot-Ped is FDA-approved for the treatment of central precocious puberty in children. With this condition, children to begin their sexual development earlier than usual . This can lead to a growth spurt earlier in life. However, children with this condition may stop growing earlier than their peers.
Children with central precocious puberty may be shorter as adults than they would be otherwise. The condition can also lead to emotional, psychological, and behavioral problems due to experiencing hormonal changes earlier than their peers.
Lupron Depot-Ped contains the active drug leuprolide acetate, which belongs to a class of drugs called gonadotropin releasing hormone agonists. It works by stopping the body from releasing certain sex hormones, which will delay puberty while its being given.
* Sex and gender exist on spectrums. Use of the terms female and male in this article refers to sex assigned at birth.
Effectiveness for central precocious puberty
In a clinical study, 55 children with central precocious puberty were treated with Lupron Depot-Ped. By the end of the first month of treatment, Lupron Depot-Ped successfully reduced sex hormones to prepuberty levels in 96% of the children.
* Sex and gender exist on spectrums. Use of the term female in this article refers to sex assigned at birth.
What Are The Results Of Using Proton Therapy In Patients
For patients facing prostate cancer, treatments and side effects present unique challenges in choosing a therapy. Proton radiation for prostate cancer treats the disease with successful outcomes and a low risk of side effects.
For thousands with cancer of the prostate, proton therapy has offered an effective, virtually painless option for prostate cancer treatment. Since the University of Florida Health Proton Therapy Institute opened in 2006, thousands have undergone proton therapy for prostate cancer, and prostate cancer patients at the UF Health Proton Therapy Institute enjoy a close-knit community of fellow patients, caregivers and spouses. Today, prostate cancer is one of many types of cancer treated at the Institute.