Leuprolide

(loo-proh-lide)

Trade/other name(s): Lupron, Lupron Depot, Eligard, Viadur Implant, leuprorelin

Why would this drug be used?

Leuprolide is used to treat advanced prostate cancer. It is also used to treat uterine fibroids, endometriosis, and other conditions.

How does this drug work?

Leuprolide, a member of the general class of drugs known as hormone antagonists, works similarly to the luteinizing-hormone-releasing hormone (LHRH) produced by the pituitary gland. LHRH reduces the production of FSH (follicle-stimulating hormone) and LH (luteinizing hormone). A decrease in LH reduces the amount of the male hormone testosterone in the body. When you take this drug, cancer cells that depend on testosterone are no longer able to grow.

Before taking this medicine

Tell your doctor…

• If you are allergic to anything, including medicines, dyes, additives, or foods.
• If you have any medical conditions such as kidney disease, liver disease (including hepatitis), congestive heart failure, gout, or infections. These conditions may require that your medicine dose, regimen, or timing be changed.
• If you have ever had diabetes, heart disease, high blood pressure, high cholesterol, heart attack, or stroke. Also tell your doctor if you have ever smoked. Your doctor may watch you more closely for heart and blood vessel problems while you take this drug.
• If you or others in your family have weakened bones (osteoporosis), if you have ever been a smoker, a heavy user of alcohol, or if you have taken steroids or medicines to prevent seizures, which can cause bone loss. Leuprolide can speed up loss of bone minerals. Your doctor may need to watch you for this.
• If you are pregnant, trying to get pregnant, or if there is any chance of pregnancy. There may be an increased risk of miscarriage or other harm to the fetus if a woman takes this drug during pregnancy.
• If you are breast-feeding. It is not known whether this drug passes into breast milk. If it does, it could harm the baby.
• If you think you might want to have children in the future. This drug may affect fertility. Talk with your doctor about the possible risk with this drug and options that may preserve your ability to have children.
• About any other prescription or over-the-counter medicines you are taking, including vitamins and herbs. In fact, keeping a written list of each of these medicines (including the doses of each and when you take them) with you in case of emergency may help prevent complications if you get sick.

Interactions with other drugs

No serious interactions are known at this time. But this does not necessarily mean that none exist. Check with your doctor, nurse, or pharmacist about other medicines, vitamins, herbs, and supplements, and whether alcohol can cause problems with this medicine.

Interactions with foods

No serious interactions with food are known at this time. Check with your doctor, nurse, or pharmacist about whether foods may be a problem.

Tell all the doctors, dentists, nurses, and pharmacists you visit that you are taking this drug.

How is this drug taken or given?

Leuprolide is given as an injection into a muscle (intramuscular injection) or under the skin (subcutaneous injection). Depending on how stable your cancer is, the injection can be given each month or every 3 months, 4 months, or 6. The dose is the same for all patients.

You can also be given this drug as a yearly implant. Leuprolide implant is a drug-delivery system that contains the drug. It looks like a small, thin metal tube. It is placed under the skin, where it delivers leuprolide to the body continuously for 12 months. Your doctor numbs your arm, makes a small incision, and then inserts the implant under your skin. The incision is closed with special surgical tape and covered with a bandage. The incision should heal in a few days. After 12 months, the implant is removed and may be replaced by your doctor.

Precautions

Leuprolide may briefly increase testosterone in men when the drug is first started. This causes the symptoms of prostate cancer to get worse for about a week and is called a "disease flare." These symptoms usually improve after a week or two, but sometimes extra treatment is needed:

• The prostate gland may enlarge, and you may have blood in your urine, painful urination, or trouble passing urine. Call your doctor if you have these symptoms.
• Bone pain may also worsen. Call your doctor or nurse right away if your pain medicine is not stopping the pain. They will help you get the right dose or drug for the increased pain.
• If prostate cancer has spread to the bones of the spine, leg weakness may also occur. To prevent this, most doctors give drugs that block testosterone for the first week of treatment. Call your doctor right away if you develop numbness or tingling of the fingers/hands, toes/feet, weakness in the legs, and/or trouble urinating or moving your bowels.
• Tell your doctor right away if you have any of the above flare symptoms lasting longer than 2 weeks.

Call your doctor right away if you develop skin welts (hives), itching, swelling in the face, mouth, or throat, or other signs of an allergic reaction.

Get help right away if you have sudden headache, vomiting, changes in vision, confusion, or collapse. Rarely, the drug can cause emergencies with symptoms like those caused by tumors of the pituitary gland.

Your doctor may watch you for signs of diabetes and cardiovascular disease (which can result in heart attacks and strokes) while you are on this medicine.

It is important to keep taking this drug, even if you feel well. If you are bothered by side effects, talk to your doctor or nurse to find out if the problems are serious. Many side effects can be managed with help from your doctor.

Possible side effects

You will probably not have most of the following side effects, but if you have any talk to your doctor or nurse. They can help you understand the side effects and cope with them.

Common

• Hot flashes
• Headache
• Dizziness
• "Flare" reaction at the start of treatment for prostate cancer*
• Low energy
• Reaction in the area of implant: bruising, burning
• Menstrual periods stop in women, and may resume after treatment is stopped

Less common

• Breast tenderness or swelling
• Decreased sexual desire
• Decreased sexual ability (impotence or erectile dysfunction)

Rare

• Swelling of the hands and feet
• Increased breast size
• Loss of appetite
• Testicles get smaller
• Nausea
• Vomiting
• High blood sugar
• Seizures (convulsions)
• Diabetes*
• Blood vessel disease (which can cause heart attacks and strokes)*

*See "Precautions" section for more detailed information.

There are some other side effects not listed above that can also occur in some patients. Tell your doctor or nurse if you develop these or any other problems.

FDA approval

Yes – first approved in 1985.

Disclaimer: This information does not cover all possible uses, actions, precautions, side effects, or interactions. It is not intended as medical advice, and should not be relied upon as a substitute for talking with your doctor, who is familiar with your medical needs.