Firmagon

Indications

Degarelix is a hormone treatment used for adult men with advanced prostate cancer that depends on male hormones to grow. It lowers testosterone quickly and is used when hormone-lowering treatment is needed, including when a rapid fall in testosterone is important.

How It Works

The pituitary gland in the brain controls testosterone production by releasing hormones (LH and FSH) when it is stimulated by gonadotropin-releasing hormone (GnRH). Degarelix blocks GnRH receptors on the pituitary. This quickly reduces LH and FSH, so the testicles make much less testosterone. Unlike some other hormone treatments, it does not cause a temporary rise (flare) in testosterone at the start.

Dosage and Administration

Degarelix is given by a doctor or nurse as an injection under the skin of the abdomen. Treatment starts with a higher starting dose given as two injections, followed by a monthly maintenance injection, with doses as prescribed by the specialist. The injection site should be changed each time and areas exposed to pressure (such as near the belt line or ribs) avoided. Treatment is usually long term, and testosterone and PSA levels are checked regularly.

Interactions

• Lowering testosterone can prolong the QT interval (a heart rhythm measure); caution is needed with other medicines that do this, such as Quinidine, Amiodarone, Sotalol, Methadone, Moxifloxacin and some antipsychotics.
• Tell your doctor about all medicines you take.

Contraindications

• Allergy to Degarelix or any ingredient.
• Not for use in women or children.

Side Effects

Very common side effects are hot flushes and reactions at the injection site (pain, redness, swelling, a lump). Others include weight gain, tiredness, sleep problems, dizziness, headache, reduced sex drive and erectile problems, breast tenderness, sweating, joint pain, raised liver enzymes and, with long-term use, thinning of the bones. It can affect heart rhythm.

Get urgent medical help if you have a fast, pounding or irregular heartbeat, fainting, chest pain, signs of a severe allergic reaction (swelling of the face or throat, difficulty breathing, widespread rash), or a red, hot, very painful or pus-filled injection site.

Pregnancy and Lactation

Degarelix is used only in men and is not relevant to pregnancy or breastfeeding in women. It may affect fertility in men while treatment continues.

Precautions and Warnings

• Tell your doctor about any heart rhythm problem, heart disease or low potassium or magnesium; an ECG may be done.
• Long-term testosterone lowering can weaken bones and raise blood sugar and cholesterol; these may be monitored.
• Use with care in severe liver or kidney disease.
• Do not miss maintenance injections; keep to the schedule.

Overdose

It is given by healthcare staff, so overdose is unlikely. If too much is given, the patient will be monitored and treated for any symptoms.

Therapeutic Class

Antineoplastic hormone therapy, gonadotropin-releasing hormone (GnRH) antagonist.

Storage

Store as directed on the pack, usually below 30°C and out of the reach of children. The prepared injection should be used straight away.