Leuprorelin acetate is a hormone therapy used to treat prostate cancer.
HOW DOES LEUPRORELIN WORK?
Hormones are substances produced naturally in the body. These act as chemical messengers and help control the activity of cells and organs. Hormone therapies interfere with the way hormones are made or formed in the body.
Most prostate cancers need the hormone testosterone to grow. Almost all of the testosterone in men is made by the testicles. A small amount is made by the adrenal glands, which are located above the kidneys. Leuprorelin stops the testicles from producing testosterone. This lowers testosterone levels and may shrink the prostate cancer or stop its growth.
WHEN IS LEUPRORELIN GIVEN?
Leuprorelin can be used alone or with other types of treatment. It can be used before or after surgery or radiotherapy. It can also be used to control prostate cancer that has spread to other parts of the body (advanced or metastatic prostate cancer).
Leuprorelin can be given over months or years depending on the patient's situation. Some men with advanced prostate cancer may receive intermittent therapy with leuprorelin. This means having leuprorelin treatment over a number of months until the cancer is at a very low level (measures by a blood test called a PSA test). Following this, you have a rest from the treatment and resume leuprorelin when it is necessary.
Your doctor or nurse will explain how long you are going to be taking leuprorelin.
HOW IS LEUPRORELIN ADMINISTERED?
Leuprorelin is given as an injection. It can be given under the skin (subcutaneously) of the abdomen or the arm or it can be administered into a muscle (intramuscular) in the buttocks or thighs. It is given once a month or as a longer-acting preparation every three months.
Tell your doctor or nurse if you are taking any drugs to thin your blood out, as these can increase bruising and may have implications in the way the injection can be given.
Some people may find the injection to be a bit uncomfortable and notice reddening or a dark discoloration around the area. You may have a local anesthetic cream applied before the injection to reduce any discomfort.
POSSIBLE SIDE EFFECTS OF LEUPRORELIN
Here, we explain the most common side effects of leuprorelin. You may experience some of the side effects mentioned here, though it is rare for a patient to have all of them. If you are taking other drugs, you may have certain side effects that are not listed here.
Always inform your doctor or nurse of the side effects you experience. They can prescribe drugs to help control them and can also give you advice on managing side effects.
In rare cases, leuprorelin can cause an allergic reaction a few hours after it is given. The signs of a reaction may include flu-like symptoms (headache, high temperature, or chills), dizziness or difficulty breathing, pain in the back, abdomen, or chest, or feeling unwell overall. If you have any of these symptoms, tell your doctor immediately so they can give you advice on this.
You may have a temporary increase in your levels of testosterone in the first days or weeks after starting on leuprorelin. This may worsen the symptoms caused by the cancer. Doctors cause this tumor flare. Your doctor may describe a hormone treatment in pill form to prevent or reduce tumor flare. You usually begin to take the tablets before starting treatment with leuprorelin and continue taking them for a few weeks afterward. If you notice any increase in symptoms in the first month after starting on leuprorelin, let your doctor know. In particular, if you have blood in your urine, back pain, or numbness or ticking of the legs, let your doctor know immediately.
HOT FLASHES AND SWEATING
These are common and can be mild or severe. While having a hot flash, you feel warmth in the neck and face, and your skin may turn red. Mild hot flashes can last from a few seconds to about a couple of minutes. More severe hot flashes can last 10 minutes or more. You may sweat or feel chills or clammy. Some people feel anxious or irritable during a hot flash.
There are things you can do to treat or reduce hot flashes. These include lowering your intake of nicotine, alcohol, and hot beverages containing caffeine such as tea and coffee.
If the hot flashes are bothersome, your doctor can prescribe medication to help lessen them.
Hot flashes and sweating reduce as your body adapts to the hormone treatment. They usually stop completely a few months after the treatment ends.
Most men can lose their sex drive and have erection difficulties during the hormone therapy. These often return to normal after they stop taking the medication, though some keep having difficulties after the treatment is over. Your doctor can prescribe treatments to help with erection problems, though these do not influence sex drive.
Tiredness is a common side effect. Evidence indicates that exercise and resistance training (such as lifting weights) at least twice a week can reduce tiredness in men taking hormone therapy. It is important to get medical advice before starting to exercise.
If you feel drowsy, don't drive or operate heavy machinery.
Some people find that leuprorelin gives them headaches. These are usually mild and can be easily controlled with drugs.
You may find that your skin dries out. Some men develop a skin rash, though this is normally mild and often gets better without treatment. Tell your doctor if you notice any changes to your skin.
DIZZINESS, BLURRINESS OF VISION, DROWSINESS
Leuprorelin can sometimes cause dizziness, blurriness of vision, or drowsiness. Do not drive or operate heavy machinery if you have these side effects.
Leuprorelin can make you feel nauseous, though this tends to be mild. If this does not get better, your doctor may prescribe antiemetic drugs.
POSSIBLE SIDE EFFECTS OF LONG-TERM USE OF LEUPRORELIN
Men who take leuprorelin for more than six months may also have some of the following side effects:
WEIGHT GAIN AND LOSS OF MUSCLE STRENGTH
You may gain weight—especially in the waist—and you may lose some muscle strength. Eating a healthy diet and getting regular exercise can help you control your weight. Resistance exercises such as lifting weights can help reduce loss of muscle strength. Talk to your doctor or nurse for advice.
You may have changes in your mood. Some men feel down or depressed for a few months or longer after taking leuprorelin. Tell your doctor if you notice any changes in your mood.
MEMORY AND CONCENTRATION
You may notice changes in your memory or ability to concentrate. Try to use a notebook, post-it notes, and a calendar to help keep a log of things. Talk to your doctor if you are having problems.
CHEST SWELLING OR SENSITIVITY
You may notice slight swelling in the chest area. This is called gynecomastia. Your doctor can give you advice on how to prevent or treat this.
BONE THINNING (OSTEOPOROSIS)
Taking leuprorelin for a number of years increases the risk of bone thinning (osteoporosis), which may increase the risk of bone fractures. Your doctor can give you advice on controlling and treating this. Exercise such as walking and resistance exercises such as lifting weights can help keep your bones strong. Eating a healthy diet, not smoking, and keeping alcohol intake within recommended limits can also help protect your bones.
Tell your doctor if you have any discomfort in the bones or joints.
EFFECTS ON THE LIVER
Your doctor will take blood samples from you to see how well your liver is working. Leuprorelin can sometimes change the quantity with which the liver produces certain chemicals. This is generally mild, and you can go on taking leuprorelin. On rare occasion, people have to stop taking the drug.
RISK OF DIABETES AND CHANGES TO THE HEART
When taking leuprorelin, there may be a higher risk of developing diseases of the heart, changes in heart rate, or diabetes. Overall, however, the benefits of the treatment outweigh its possible risks. You can talk to a specialist about the possible risks and benefits of your situation. It is important that you notify your doctors if you have ever had problems with your heart rate or if you are taking any medication for this.
Eating a healthy diet, not smoking, keeping alcohol consumption within recommended limits, maintaining a healthy weight, and physical activity can help reduce the risk of heart disease and diabetes.
MORE INFORMATION ABOUT LEUPRORELIN
DELAYS IN INJECTIONS
If an injection is delayed for 2 to 3 days, it should not make much of a difference. However, you should try to have your injections as regularly as possible.
Leuprorelin can interact with other drugs. This includes medications that can be purchased in a store or pharmacy. Tell your doctor if you are taking any drugs, including complementary therapies, vitamins, and herbal remedies.
If you have to go to the hospital for whatever reason other than cancer, always tell the doctors and nurses that you are taking leuprorelin. Explain to them that you are undergoing hormone therapy that no one should stop or restart if it is not done under the advice of a cancer doctor.