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Leuprolide

(loo-proh-lide)

Trade/other name(s): Lupron, Lupron Depot, Eligard, 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 is a member of the group 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 and the release of estrogen from the ovaries in women. This slows or stops the growth of cancer cells (and other cells) that depend on these hormones. If the medicine is stopped, hormone levels are expected to return to normal.

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 or 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 strength, which can lead to bones breaking easily, even with only slight trauma.. If you have any of these conditions, you may not be able to be treated with this drug. .
  • If you are pregnant, trying to get pregnant, or if there is any chance of pregnancy. This drug is not safe to take during pregnancy (see “Precautions”).
  • If you are breastfeeding. This drug could interfere with breastfeeding. It is also not known whether it passes into breast milk. If it does, it could harm the baby (see “Precautions”).
  • If you think you might want to have children in the future. This drug could affect fertility. Talk with your doctor about the possible risk with this drug and options that might save 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 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 injected into a muscle (intramuscular injection) or under the skin (subcutaneous injection). Depending on the dose of the drug and what form is used, the injection can be given each month or every 3, 4, or 6 months. The actual amount given per month is the same for all patients.

Precautions

In men

Leuprolide may briefly increase testosterone levels 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. To help prevent this, most doctors give drugs that block testosterone for the first week or so of treatment. These symptoms usually improve after a week or two, but sometimes extra treatment is needed:

  • The prostate gland may enlarge, and you might have blood in your urine, painful urination, or trouble passing urine. Call your doctor if you have these symptoms.
  • If prostate cancer has spread to the bones, bone pain may 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 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 any of the above flare symptoms lasting longer than 2 weeks.

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

In women

Leuprolide could briefly increase estrogen levels when the drug is first started. This can cause breast tenderness, vaginal spotting, and worsening of cancer symptoms that usually get better without treatment after a week or two.

Menstrual periods usually stop while you are on this drug. If you keep having periods, there may be a problem, and so you should talk to your doctor.

Although menstrual periods usually stop, it does not mean you cannot get pregnant. Taking this drug at the time of conception or during pregnancy can increase the risk of miscarriage or other harm to the fetus. Women who are taking this drug should use effective birth control during treatment. Ask your doctor what kinds of birth control can be used with this medicine. If you get pregnant while taking this drug, tell your doctor right away so that the drug can be stopped.

This drug should not be used by someone who is breastfeeding. It may affect milk production. It is not known if it passes into breast milk, but if it does, it could harm the baby.

By lowering estrogen levels, this drug can affect emotions and worsen problems with depression. Let your doctor know if you have a depressed mood, crying spells, trouble sleeping, loss of appetite, or suicidal thoughts.

For men and women

Call your doctor right away if you develop skin welts (hives), itching, swelling in your face, mouth, or throat, or have 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.

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 do have any, talk to your doctor or nurse. They can help you understand the side effects and cope with them. This drug can have different side effects in men and women.

Common

  • Hot flashes and sweats
  • Headache
  • Dizziness (in men)
  • “Flare” reaction at the start of treatment for prostate cancer (in men)*
  • Testicles getting smaller (in men)
  • Menstrual periods can stop in women, but may resume after drug is stopped*
  • Depression or feeling emotional (in women)*
  • Vaginal dryness or irritation (in women)
  • Nausea and vomiting (rarely seen in men)
  • Pain, including muscle and joint pain

Less common

  • Breast tenderness or swelling (in men)
  • Decreased sexual desire
  • Decreased sexual ability in men (impotence or erectile dysfunction)
  • Low energy (seen less often in women)
  • Abnormal lab tests, including increased cholesterol or triglyceride levels and liver function tests
  • Bruising or irritation at the injection site
  • Burning when passing urine (in women)

Rare

  • Swelling of the hands and feet
  • Increased breast size (in men)
  • Reduction in breast size (in women)
  • Loss of appetite
  • High blood sugar or diabetes (in men)
  • Seizures (convulsions) (in men)
  • Serious liver injury
  • Blood vessel disease, which can cause heart attacks and strokes (in men)*

*See “Precautions” section for more detailed information.

Other side effects not listed above 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.


Last Medical Review: 03/08/2011
Last Revised: 01/04/2013