Degarelix

(day-gare-uh-liks)

Trade/other name(s): Firmagon

Why would this drug be used?

Degarelix is used to treat advanced prostate cancer, although it is being studied for use in other conditions. Degarelix is mainly used in men who cannot take certain other hormone therapies, who refuse castration, and who have one or more of the following problems:

• risk of neurological (brain or nervous system) problems due to the spread of prostate cancer
• blockage of the ureter or bladder because the prostate cancer has spread
• severe bone pain from prostate cancer in the bones that opioid (such as morphine or hydromorphone) pain medicines do not control

How does this drug work?

Degarelix belongs to the general class of drugs known as hormones or hormone antagonists. It blocks gonadotropin-releasing hormone (GnRH), also known as luteinizing hormone-releasing hormone (LHRH). This lowers the level of the male hormone testosterone in the blood. Since prostate cancer usually depends on testosterone to help it grow and spread, this helps stop it from growing.

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 heart disease, congestive heart failure, heart rhythm problems, or a rare condition that prolongs the heart’s electrical pathway (QTc interval). These conditions may require that you be observed more closely during treatment.
• If you have osteoporosis (weakened or thinned bones). Degarelix may make this problem worse.
• If you are pregnant, trying to get pregnant, or if there is any chance of pregnancy. This drug may cause birth defects if either the male or female is taking it at the time of conception or during pregnancy. Men and women who are taking this drug need to use some kind of birth control. It is important to check with your doctor about what kinds of birth control can be used with this medicine.
• 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. It is not known whether or not this drug can affect fertility. Talk with your doctor about the possible risk with this drug and the 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

If this drug is used with other medicines that affect heart rhythm, such as quinidine, procainamide, amiodarone, or sotalol, it may increase the risk of dangerous heart rhythms. 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?

Degarelix is given as 2 injections under the skin for the first dose, then 1 injection once a month. The dose is the same for all patients being treated for prostate cancer. Your doctor will test your testosterone blood levels before treatment, then at 4 weeks, and then every 8 weeks after that to see how well the treatment is working.

Precautions

Degarelix can increase the time it takes for the heartbeat impulse to pass through the heart. Call the doctor or nurse right away if your heart rate changes or becomes irregular, if you pass out (faint), or have a seizure.

The effects of degarelix in women and children have not yet been studied.

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
• difficulty sleeping
• pain
• enlarged breasts
• breast pain, nipple tenderness
• back pain
• constipation
• headache
• fatigue
• increased urination

Less common

• swelling of hands and feet
• dizziness
• upper respiratory tract infection
• diarrhea
• pain when urinating
• nausea
• urinary retention
• urinary tract infection
• swollen testicles
• osteoporosis (thin or weakened bones) with longer treatment
• abnormal blood test results which suggest that the drug is affecting the liver (Your doctor will discuss the importance of this finding, if any.)

Rare

• allergic reaction*
• changes in the way your heart conducts electrical impulses*

*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 2008

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.