Lupron Depot (leuprolide)

Warning: There are several warnings that a patient should understand concerning Lupron Depot.  Participants with metastatic vertebral lesions or urinary tract obstruction should be closely observed during the initial weeks of administration. Men receiving this treatment have been reported with hyperglycemia and an increased chance of developing diabetes.  Men have also been found to have increased chances of suffering myocardial infarction, stroke or sudden cardiac death.  The risks of these events must be balanced against the efficacy of the drug against the cancer.

Patients with congenital long QT syndrome should understand that this medication works through long-term androgen deprivation which in turn extends the QT interval.    This warning also targets patients with electrolyte abnormalities, congestive heart failure, or those taking class IA or Class III antiarrhythmic mediations.

Physicians must carefully monitor the serum levels of testosterone.  Most patients experience a rise in serum levels above the baseline for the first four weeks of therapy.

Indications: Lupron Depot is leuprolide acetate, which is a synthetic nonapeptide counterpart of naturally occurring gonadotropin-releasing hormone (GnRH).  The fabricated synthesis is more potent than the natural hormone.  The drug comes ready for administration in a prefilled dual-chamber syringe.  This contains sterile lyophilized microspheres which are mixed with a diluent to become a suspension suitable for intramuscular injection.

Lupron Depot can be used in the treatment of the following medical conditions:

  • prostate cancer
  • breast cancer
  • ovarian cancer
  • endometrial cancer
  • endometriosis
  • infertility
  • Benign prostatic hypertrophy (BPH).

Dosage:  Lupron Depot must follow a particular timetable, according to a physician’s specifications. The timing and dosage must not be altered or the efficacy of the drug is severely compromised. Treatments come in 3 administration periods, 3 month, 4 month, and 6 month. The dosages for these treatment plans are 22.5 mg, 30 mg, and 45 mg, respectively. The dosages are injections which must be administered every 12 weeks for the 3 month plan, every 16 weeks for the 4 month plan, and every 24 weeks for the 6 month plan.

Storage:  The vials or kits of Lupron Depot 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:  Lupron Depot 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: 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: This medication is contraindicated in people with known hypersensitivity to GnRH agonists or any of the excipients of the medication.  These have been reported to induce anaphylactic reactions in some recipients.

For patients who are pregnant, this drug can cause harm to the fetus.  This drug is contraindicated to patients who are or may become pregnant.  The physician should be careful to inform the patient of the potential hazards of this drug to the patient.

Mechanism of action (MOA): Your body produces a group of cells called gonadotropes. Located in the pituitary glands (hypophysis), those cells produce the 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. Lupron Depot works by inhibiting  the secretion of gonadotropes.

Interactions:  Although No interaction studies have been performed with Lupron Depot, it is important to  tell your doctor about all prescription and nonprescription medications you are taking; the list include but not limited to aspirin, vitamins 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,Lupron Depot also affects normal (healthy) cells, which lead to, in certain patients, the following side effects:

  • hot flashes
  • h  air loss
  • fatigue
  • headache
  • nausea and vomiting
  • decreased appetite
  • diarrhea or constipation
  • weight loss
  • nervousness
  • memory and concentration problems
  • darkening of the skin or nails
  • depression or anxiety
  • 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
  • decrease in size of testicles
  • vaginal discharge, dryness, or itching (women)
  • absence of menstrual periods (women)
  • Hardness at subcutaneous injection spot
  • incapacity or decrease in sexual desire in men and women

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
  • painful or difficult urination
  • inability to move arms or legs
  • painful urination or red urine
  • unusual bruising or bleeding
  • swelling of the feet or legs
  • Yellowing of the skin or eyes
  • severe depression symptoms
  • numbness, tingling, weakness, or pain in the feet or legs .

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