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Histrelin Implant

(hiss-trel-in)

Trade/other name(s): Vantas

Why would this drug be used?

Histrelin implant is used to treat advanced prostate cancer.

How does this drug work?

Histrelin is a member of the general class of drugs known as hormones or hormone antagonists. It is a hormone similar to luteinizing hormone-releasing hormone (LHRH) in your body, which controls the production of other hormones which in turn control testosterone. In men, histrelin causes a reduction in testosterone. Cancer cells that depend on testosterone stop dividing. To find out how well you respond to this drug, your doctor will check your blood levels of testosterone and prostate-specific antigen (PSA).

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 are pregnant, trying to get pregnant, or if there is any chance of pregnancy. This drug may cause birth defects if taken at the time of conception or during pregnancy. It is important to check with your doctor about what kinds of birth control can be used with this medicine.
  • If you think you might want to have children in the future. This drug may reduce 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

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?

Histrelin implant, the drug-delivery system that contains histrelin, looks like a small thin tube and is placed under the skin. After numbing your upper arm, your doctor will make a small incision and place the histrelin implant under your skin. The incision is then closed with special surgical tape and covered with a bandage. You should leave the surgical tape in place while the incision heals, usually in a few days. Do not get the arm with the implant wet for 24 hours. Do not lift anything heavy or do strenuous work with the arm for 7 days after the implant has been placed.

The implant delivers histrelin to the body continuously over the course of 12 months. After that time, the implant should be removed and may be replaced by your doctor.

Precautions

Histrelin may briefly increase testosterone in men when first implanted. This causes the symptoms of prostate cancer to get worse for about a week and is called a "disease flare." To prevent this, most doctors give drugs that block testosterone for the first week of treatment. 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 during this time. They will help you get the right dose or drug for the time that the pain has increased.
  • If prostate cancer has spread to the bones of the spine, leg weakness may also occur. 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 flare symptoms that last longer than 2 weeks.

Call your doctor or nurse if you have fever, redness, pain, or swelling at the implant site.

Get help right away if you have sudden headache, vomiting, changes in vision, confusion, or collapse. Rarely, the drug can cause emergencies like 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.

This drug has not been studied in women or children and is not recommended for their use.

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
  • tiredness

Less common

  • problems urinating
  • breast swelling or soreness
  • worse symptoms or "flare" reaction when treatment first starts*
  • problems at the implant site, such as bruising, burning, soreness, redness, and swelling*
  • lack of energy
  • decreased sexual desire
  • impotence or erectile dysfunction
  • bone thinning (osteoporosis)

Rare

  • dwelling of the hands and feet
  • increased appetite
  • testicles getting smaller
  • trouble sleeping
  • constipation
  • headache
  • weight gain
  • diabetes*
  • blood vessel disease (heart disease or stroke)*

*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 2004.

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.

Last Medical Review: 12/08/2009
Last Revised: 10/22/2010