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Leuprolide (Eligard TM, Lupron®, Lupron Depot®, ViadurTM)

Warning: There are many benefits to taking this drug; however, Leuprolide is not recommended in patients with hypersensitivity to GnRH, GnRH agonist analogs or any of the components of ELIGARD.  The medication is not recommended either in in women. The drug can cause fetal harm when administered to a pregnant woman; spontaneous abortion may occur. 

Although rare, isolated cases of ureteral obstruction and spinal cord compression have been observed in patients treated with Leuprolide. This can contribute to paralysis with or without fatal complications. 

Indications:  This drug is for the treatment of prostate cancer. It is not a cure. Testosterone is a hormone the body makes that is needed for cancer to grow and spread throughout the body. This medication works by slowing the production of testosterone the body makes, therefore slowing or stopping cancer cell growth. You can also suffer less from painful/difficult urination while taking this treatment.

This medication can also be used for other diseases or disorders, but should only be done so with a prescription from your doctor. It can be used for disorders of the uterus in women (endometriosis, fibroids). It has also been known to help children that are having an early puberty.

Dosage:  There are many ways that your doctor may prescribe you to take Leuprolide. You may take it intramuscularly or subcutaneously. You may inject it yourself, or have a medical professional do it for you. Read all instructions your doctor gives you before attempting to treat yourself. Your dosage and method of treatment will depend on your response to therapy, weight and body size. 

Your oncologist may do an implant under your skin to inject the drug. If so, keep the area where you received the implant clean and dry for 24 hours; therefore, swimming and/or bathing is not recommended during 24 hours after an Leuprolide injection. You may also need to cover the area with a bandage until the wound heals.  

Storage:  The vials or kits of Leuprolide should be refrigerated at a temperature between 2 ° C and 8 ° C, and protected from light. Do not let the drug at the children reach. After opening, powder and solvent for the solution must be reconstituted and administered immediately. The physicochemical stability of the reconstituted solution last about 30 minutes at 25 ° C.  

Overdose:  Leuprolide overdose is very rare, in fact, no cases of misuse or overdose has been reported in clinical practice. However, if overdose occurs, medical attention is very important. In some cases, symptomatic treatment can be recommended.  

Missing dose: It is important to take medication on time as recommended by your health care provider. If for some reasons you forget a dose or cannot be present at the hospital for the treatment, contact your oncologist before the date of the appointment. In fact, this case is rarely reported. 

Contraindications: Tell your doctor and any medical professional you are working with about all your allergies. You may be allergic to some ingredients in this medication, such as the preservative benzyl alcohol, that will cause an allergic reaction. Consult with your doctor before taking any medication.

Adults have been known to be at a greater risk for osteoporosis (weakening of the bones) after taking Leuprolide for a prolonged period of time. If you have osteoporosis, tell your doctor before starting this drug. If you are taking any medications that may increase your risk for osteoporosis, such as corticosteroids (prednisone) or anti-seizure medications (phenytoin), tell your doctor before taking this medication.

You may become dizzy while taking this drug. You shouldn’t do anything that will require you to be alert, such as driving or operating machinery while on this medication. Avoid alcohol consumption.

Mechanism of action (MOA): gonadotropes are a group of cells that the body produces. They produce certain homones such as gonadotropins follicle-stimulating hormone (FSH) and luteinizing hormone (LH). FSH and LH are controlled by gonadotropin-releasing hormone (GnRH), another hormone produced and controlled by the hypothalamus. Certain cancer cells such as those of prostate and breast cancers need those hormones to survive. Leuprolide works by inhibiting  the secretion of gonadotropes.  

Interactions: Your pharmacist and doctor should be aware of all the possible interactions you may have with this drug. You should always keep a list of all medications you are taking to avoid possible interactions.

Talk to your doctor about all prescription and nonprescription medications you are taking; the list include but not limited to aspirin, vitamins or food supplements, and the following dugs:  

  • dexamethasone (Decadron, Dexone)  
  • methylprednisolone (Medrol)  
  • Prednisone (Deltasone)  
  • Lanthanum carbonate (Fosrenol);  
  • Phenothiazine  
  • Sevelamer (Renagel)  
  • Cyclosporine (Neoral, Restasis, Sandimmune)  
  • Diuretics ('water pills').   

Side effects: attacking cancer cells,Leuprolide  also affects normal (healthy) cells, which lead to, in certain patients, the following side effects:      

  • hot flashes
  • hair loss
  • fatigue
  • headache
  • nausea and vomiting
  • decreased appetite
  • bowel disorder (diarrhea or constipation)
  • weight loss
  • anxiety or nervousness
  • depression
  • memory and concentration problems
  • sensitivity of skin to sunlight
  • tingling in the hands or feet
  • increased need to urinate, especially at night
  • breast tenderness or change in breast size (both men and women)
  • incapacity or decrease in sexual desire in men and women
  • decrease in size of testicles
  • vaginal discharge, dryness, or itching (women)
  • absence of menstrual periods (women)
  • Firmness or hardness at subcutaneous injection spot
  • drying or darkening of the skin or nails 

If the side effects above become severe or persist for weeks, contact your oncologist. In addition, contact your doctor immediately if you experience any of these symptoms:  

  • fever and chills  
  • bone pain   
  • persistent cough   
  • testicular or prostate pain  
  • inability to move arms or legs  
  • painful or difficult urination  
  • painful urination or red urine  
  • unusual bruising or bleeding  
  • swelling of the feet or legs  
  • numbness, tingling, weakness, or pain in the feet or lower legs  
  • Yellowing of the skin or eyes.   

 

References: 

 

1 - vidalpro.net, LEUPROLIDE ® 45 mg – leuproréline 

2 - santecheznous.com 

3 - nlm.nih.gov 

4 - Ganong, William F.: "Review of Medical Physiology", page 248. Lange, 2005