+ -Text Size

Histrelin Implant

(hiss-trel-in)

Trade/other name(s): Vantas

Why would this drug be used?

Histrelin implant is used to treat 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 man-made version of the body’s luteinizing-hormone-releasing hormone (LHRH). This drug stops the release of testosterone from the testicles in men. This can slow or stop the growth of cells (including prostate cancer cells) that depend on testosterone.

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), gout, or infections. These conditions may require that your medicine dose, regimen, or timing be changed.
  • If you have ever been diagnosed with heart problems, especially long QT syndrome, an abnormal heart rhythm, congestive heart failure, or if you have been told you have low blood levels of potassium, calcium, or magnesium (which can affect the heart). This drug can affect the rhythm of the heart, which might lead to irregular heartbeats and can even lead to death.
  • If you have or 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 or heavy user of alcohol, or if you have taken steroids or medicines to prevent seizures, which can cause bone loss. Triptorelin can speed up loss of bone minerals, so your doctor may need to watch you for this.
  • If you have trouble passing your urine due to enlarged prostate or other blockage.
  • 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. (See “Precautions” section.)
  • If you think you want to have children in the next year or so. This drug can reduce fertility while you are on it and for some time afterwards. .
  • If you are breast-feeding. This drug can interfere with milk production. Also, it is not known whether this drug passes into breast milk. If it does, it could harm the baby.
  • 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

Because histrelin can affect the rhythm of the heart, be sure your doctor is aware of any drugs you take that affect heart rhythm. Examples of these drugs include:

  • Amiodorone (Cordarone, Pacerone)
  • Disopyramide (Norpace)
  • Dofetilide (Tikosyn)
  • Flecainide (Rhythmol)
  • Ibutilide (Corvert)
  • Mexiletine (Mexitil)
  • Moricizine (Ethmozine)
  • Procainamide (Procan, Pronestyl)
  • Propafenone (Tambocor)
  • Quinidine (Quinidex, Cardioquin)
  • Tocainide (Tonocard)

Beta blocker drugs slow the heart rate and can worsen effects on the heart. This class includes drugs like acebutolol (Sectral), atenolol (Tenormin), bisoprolol (Zebeta), esmolol (Brevibloc), metoprolol (Lopressor, Lopressor LA, Toprol XL), nadolol (Corgard), propranolol (Inderal), sotalol (Betapace), and timolol (Blocadren).

Clonidine (Catapres), digoxin (Lanoxin, Cardoxin, Digitek), and the calcium channel blockers diltiazem (Cardizem) and verapamil (Covera, Calan, Verelan) can also slow the heart and might cause problems while you are on histrelin.

These drugs can affect the rhythm of the heart in the same way as histrelin and so can increase your risk of abnormal heart rhythm if you take them during the same times you are on histrelin.

  • Anti-psychotic drugs such as thioridazine (Mellaril), haloperidol (Haldol), mesoridazine (Serentil)
  • Antidepressants such as venlafaxine (Effexor) and amitriptyline (Elavil)
  • Certain antibiotics (e.g., erythromycin, clarithromycin, levofloxacin, ofloxacin, moxifloxacin, sparfloxacin, pentamidine)
  • Nausea medicines such as ondansetron (Zofran), dolasetron (Anzemet), granisetron (Kytril), droperidol (Inapsine), promethazine (Phenergan), and chlorpromazine (Thorazine)

This is not a complete list. Other drugs that can slow the heart rate or prolong the QT interval of the heart can increase the increase the danger of an abnormal rhythm. Check with your doctor or pharmacist to find out if other drugs you’re taking have this effect.

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

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 or tumor “flare.” To prevent this, doctors can 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. If the flow of urine is blocked completely, this can lead to kidney failure.
  • 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, the flare can cause the cancer to press on the spinal cord and cause spinal cord compression. Early symptoms include numbness in the legs or feet, trouble urinating or moving your bowels, back pain, and weakness in the legs. If left untreated it can lead to paralysis (loss of movement). Call your doctor right away if you have any of these symptoms.
  • Tell your doctor right away if you have flare symptoms that last longer than 2 weeks.

Your doctor will check your blood during treatment to see the drugs effect on your cancer and look for side effects. It’s important to keep all your appointments, even those just for blood tests.

This drug may raise your blood sugar (glucose) levels or even lead to diabetes. Tell your doctor if you have ever had diabetes or high blood sugar, or if you have symptoms that can be caused by high blood sugar, such as feeling thirsty all the time or having to urinate more often than normal. Your doctor may check your blood sugar levels while you are taking this drug.

Patients on histrelin have an increased risk of heart attack and stroke. Call your doctor right away if you have pain in the chest, neck, pain, jaw or arm, shortness of breath, headache, numbness or weakness on one side of your body, or trouble talking,

Androgen deprivation therapy (such as histrelin) can cause a change in heart rhythm called prolonged QT interval. Tell your doctor if you have ever been diagnosed with any type of heart disease, especially an abnormal heart rhythm or long QT syndrome. Your doctor may need to test your heart rhythm with an EKG and test your blood levels of certain minerals that could affect heart rhythm during treatment. Tell your doctor or nurse right away if you notice a fast or irregular heartbeat, very slow heartbeat, chest pain, lightheadedness, dizziness, fainting, or shortness of breath to your doctor right away. Tell your doctor if you start to take or have any changes in heart or blood pressure medicines.

Histrelin implant should be removed after 12 months. Sometimes there are problems finding the implant after 12 months and it cannot be removed as scheduled.

This drug has not been studied in women or children and is not recommended for their use. If this drug is used during pregnancy, it may cause fetal harm. Check with your doctor about what kinds of birth control can be used with this medicine.

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. (Note: some side effects listed as less common or rare become more common the longer you are on the drug.)

Common

  • Hot flashes

Less common

  • Tiredness
  • Testicles getting smaller
  • Worse symptoms or “flare” reaction when treatment first starts*
  • Problems at the implant site, such as bruising, burning, soreness, redness, and swelling*
  • Severe bone thinning or weakness (osteoporosis), which increases the risk of having a bone break

Rare

  • Decreased sexual desire
  • Loss of ability to have sex (impotence or erectile dysfunction)
  • Problems urinating and kidney problems*
  • Breast swelling or soreness
  • Problems with heart rhythm, which may be serious*
  • Trouble sleeping
  • Constipation
  • Headache
  • Weight gain
  • Increased blood sugar levels (including diabetes)*
  • Trouble removing the implant*
  • Allergic reactions
  • Blood vessel disease (which can cause heart attack or stroke)*
  • Liver problems
  • Pressure or bleeding in the pituitary gland, causing vomiting, headache, changes in vision, confusion, collapse, or other serious symptoms (this can occur in people who had a tumor in the pituitary, but didn’t know it before treatment)
  • Death due to diabetes, heart problems, stroke, or some other cause*

*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: 09/17/2014
Last Revised: 09/17/2014