Indications
Leuprorelin (leuprolide) acetate is a hormone medicine used to treat advanced or hormone sensitive prostate cancer, some breast cancers in women before menopause, endometriosis (womb lining tissue growing outside the womb), fibroids of the womb (often before surgery), and central precocious puberty (puberty starting too early) in children. It is also used in some fertility treatments under specialist care.
How It Works
Leuprorelin is a man made version of gonadotrophin releasing hormone (GnRH). Given continuously, it first stimulates and then switches off the pituitary gland’s release of the hormones LH and FSH. As a result, the testes make much less testosterone and the ovaries much less oestrogen. Lowering these hormones slows hormone driven cancers, shrinks endometriosis and fibroids, and halts early puberty.
Dosage and Administration
Leuprorelin is given as prescribed, usually as a long acting (depot) injection under the skin or into a muscle by a doctor or nurse, commonly once every 1, 3 or 6 months depending on the product and condition. Doses for children are set by the specialist. In prostate cancer, an anti androgen tablet such as Bicalutamide may be given at the start to prevent a temporary flare. Do not miss scheduled injections.
Interactions
- Medicines that prolong the QT interval, such as Amiodarone, Sotalol, some antipsychotics, Methadone and some antibiotics like Moxifloxacin, increase the risk of heart rhythm problems, because lowering testosterone can also prolong the QT interval.
- Hormonal medicines containing oestrogen may reduce its effect in endometriosis and fibroids.
Contraindications
- Allergy to leuprorelin, GnRH or similar medicines, or any ingredient.
- Pregnancy and breastfeeding.
- Undiagnosed abnormal vaginal bleeding.
- Use as the only treatment in prostate cancer where there is a risk of spinal cord compression from spread to the spine, without other protection against flare.
Side Effects
Very common: hot flushes, sweating, reduced sex drive, erectile problems in men, vaginal dryness and stopped periods in women, tiredness, headache and injection site pain or lumps. Others: mood changes or depression, sleep problems, joint and muscle pain, weight gain, breast swelling, thinning of bones with long use, raised blood sugar and cholesterol, and heart rhythm changes. At the start, a temporary flare can worsen bone pain or urinary problems in prostate cancer, or cause some bleeding in women.
Get urgent medical help for chest pain, fainting or a fast or irregular heartbeat, sudden weakness or numbness in the legs, loss of bladder or bowel control, inability to pass urine, severe headache with vision changes, swelling of the face or throat, or thoughts of self harm.
Pregnancy and Lactation
Leuprorelin must not be used during pregnancy, as it can cause miscarriage or harm the baby. Pregnancy should be ruled out before starting, and women should use non hormonal contraception (such as condoms) during treatment, because periods stopping does not reliably prevent pregnancy. It must not be used while breastfeeding.
Precautions and Warnings
Long term use lowers bone density; calcium, vitamin D, exercise and bone scans may be advised. Use with care in diabetes, heart disease, depression, or a history of seizures. For endometriosis and fibroids, treatment length is usually limited, often with add back therapy. Children treated for early puberty need regular growth monitoring. The doctor will check hormone levels, blood sugar and, if needed, an ECG.
Overdose
Overdose is unlikely because it is given by health professionals. No serious effects specific to overdose are known; any symptoms are treated as needed.
Therapeutic Class
Gonadotrophin releasing hormone (GnRH) agonist, hormonal antineoplastic
Storage
Store below 25°C or as directed on the pack, in the original carton, protected from light. Do not freeze. Usually kept by the clinic or pharmacy.
Prepared by the Oshud Alo team from standard drug references. For information only; always follow your doctor's advice.