Trade Names:Eligard- Injection 22.5 (3-month depot)- Injection 30 mg (4-month depot)- Injection 45 mg (6-month depot)- Powder for injection, lyophilized 7.5 mg
Trade Names:Lupron- Injection 5 mg/mL
Trade Names:Lupron Depot- Microspheres for injection, lyophilized 3.75 mg- Microspheres for injection, lyophilized 7.5 mg/mL
Trade Names:Lupron Depot-3 Month- Microspheres for injection, lyophilized 11.25 mg- Microspheres for injection, lyophilized 22.5 mg
Trade Names:Lupron Depot-4 Month- Microspheres for injection, lyophilized 30 mg
Trade Names:Lupron Depot-Ped- Microspheres for injection, lyophilized 7.5 mg- Microspheres for injection, lyophilized 11.25 mg- Microspheres for injection, lyophilized 15 mg
Trade Names:Lupron for Pediatric Use- Injection 5 mg/mLLupron Depot 3.75 mg/11.25 mg (Canada)Lupron/Lupron Depot 3.75 mg/7.5 mg (Canada)Lupron/Lupron Depot 7.5 mg/22.5 mg/30 mg (Canada)
A synthetic luteinizing hormone-releasing hormone (LHRH) agonist that acts as a potent inhibitor of gonadotropin secretion when given continuously and in therapeutic doses. After initial stimulation, chronic administration results in suppression of ovarian and testicular steroidogenesis.
Not active orally.Injection Daily
Bioavailability subcutaneous is comparable with IV.Monthly
C max is 4.6 to 25.3 ng/mL. T max is 4 to 5 h.Every 3 mo
C max is 36.3 to 127 ng/mL. T max is 4 to 5 h.Every 4 mo
C max is 59.3 to 150 ng/mL. T max is 3.3 to 4 h.Every 6 mo
C max is 82 to 102 ng/mL. T max is 4.5 h.
Protein binding is 43% to 49%. Mean Vd ss is 27 L.
Inactive metabolites are pentapeptide (metabolite Ι), tripeptides (metabolite ΙΙ and ΙΙΙ), and dipeptide (metabolite ΙV).
Plasma t ½ is 3 h.
Pharmacokinetics have not been determined.Hepatic Function Impairment
Pharmacokinetics have not been determined.Elderly
Majority of patients studied were 65 yr of age and older.
Palliative treatment of advanced prostatic cancer; management of endometriosis in women older than 18 yr of age (depot preparation); treatment of children with central precocious puberty (CPP [pediatric injection or depot pediatric]); uterine leiomyomata (depot preparation).
Pregnancy; lactation; hypersensitivity to GnRH, GnRH agonist analogs, or product components; undiagnosed vaginal bleeding. Eligard is contraindicated in children.
Injection; subcutaneous 1 mg/day. Depot; subcutaneous ( Eligard only) 7.5 mg/mo, 22.5 mg every 3 mo, 30 mg every 4 mo, or 45 mg every 6 mo. IM ( Lupron only) 7.5 mg/mo, 22.5 mg every 3 mo, 30 mg every 4 mo.CPPChildren
Injection; subcutaneous Starting dose: 50 mcg/kg/day as single injection. If total downregulation not achieved, titrate upward by 10 mcg/kg/day, which will be considered the maintenance dose. Depot; IM Starting dose: 25 kg or less, 7.5 mg every 4 wk; 26 to 37.5 kg, 11.25 mg every 4 wk; greater than 37.5 kg, 15 mg every 4 wk. If total downregulation not achieved, titrate upward in 3.75 mg increments every 4 wk, which will be considered the maintenance dose.EndometriosisAdults
IM 3.75 mg as single monthly injection or 11.25 mg every 3 mo (depot preparation).Uterine LeiomyomataAdults
IM 3.75 mg/mo or one 11.25 mg injection with concomitant iron therapy. Recommended duration of therapy is 3 mo or less.
Store injection below 77°F. Protect from freezing and light; store vial in carton until use.
Store Lupron Depot at controlled room temperature (59° to 86°F). Does not contain a preservative; discard if not used immediately after reconstitution.
Refrigerate Eligard at 35.6° to 46.4°F. Administer within 30 min of mixing.
None well documented.
Diagnostic tests of pituitary gonadotropic and gonadal functions during treatment and up to 12 wk after discontinuing depot preparation may be misleading.
Vasodilation (68%); ECG changes/ischemia, heart failure, hypertension, murmur, phlebitis/thrombosis (at least 5%); angina, arrhythmia, atrial fibrillation, bradycardia, deep thrombophlebitis, hypotension, MI, tachycardia, varicose vein (less than 5%); syncope, (less than 2%); pulmonary embolism (postmarketing).
Headache/Migraine (65%); depression, insomnia/sleep disorders (31%); asthenia (18%); dizziness/vertigo (16%); decreased libido (11%); neuromuscular disorders (10%); nervousness, paresthesia (8%); anxiety, memory disorder/amnesia (6%); abnormal thinking, confusion, convulsion, delusions, dementia, fatigue, hypesthesia, lethargy, malaise, mood swings, numbness, paralysis, peripheral nephropathy, personality disorder, syncope/blackouts (less than 5%); emotional lability, personality disorder, somnolence (less than 2%); paralysis, spinal fracture (postmarketing).
Hot flashes/sweats (98%); skin reaction (12%); acne/seborrhea (10%); dermatitis (at least 5%); carcinoma of the skin/ear, clamminess, dry skin, ecchymosis, hair loss, herpes zoster, itching, local skin reactions, nail disorders, night sweats, pigmentation/melanosis, skin lesions (less than 5%); rash including erythema multiforme (2%); hirsutism, skin striae (less than 2%); hair growth, photosensitivity, rash, urticaria (postmarketing).
Abnormal vision, amblyopia, blurred vision, carcinoma of the ear, conjunctivitis, dry eyes, epistaxis, pharyngitis, tinnitus (less than 5%).
Nausea, vomiting (25%); GI disorder (16%); altered bowel function (14%); anorexia, constipation (at least 5%); colitis, diarrhea, duodenal ulcer, dysphagia, enlarged abdomen, eructation, GI bleeding, gastroenteritis, gingivitis, gum hemorrhage, hepatomegaly, hernia, increased appetite, increased sputum, intestinal obstruction, peptic ulcer, periodontal abscess, rectal polyps, taste disorders, thirst/dry mouth (less than 5%); abdominal pain, dysphagia, gingivitis (less than 2%).
Vaginitis (28%); testicular atrophy (20%); urinary disorders (17%); breast enlargement, gynecomastia (7%); urinary retention, urinary frequency (5%); breast pain/tenderness, impotence (at least 5%); vaginal bleeding/discharge (2%); balanitis, bladder carcinoma, bladder spasms, dysuria, epididymitis, incontinence, lactation, menstrual disorders, nocturia, penis disorders, testicular pain, testis disorders, UTI (less than 5%); cervix disorder, prostate disorder (less than 2%); prostate pain (postmarketing).
Anemia (at least 5%); leukopenia, lymphedema, lymphadenopathy (less than 5%).
Increased triglycerides (12%); increased total cholesterol (7%); abnormal LFTs, decreased albumin, decreased bicarbonate, decreased and increased platelets, decreased and increased prostatic acid phosphatase, decreased and increased urine specific gravity, decreased HDL, decreased Hgb/Hct/RBC, decreased potassium, decreased total protein, eosinophilia, hyperglycemia, hyperlipidemia, hyperphosphatemia, hyperuricemia, increased BUN, increased calcium, increased creatinine, increased PT, increased PTT, increased WBC, thrombocytopenia, uricaciduria (at least 5%).
Injection site reaction (38%); abscess at injection site (5%).
Edema (21%); weight gain/loss (13%); dehydration (8%); peripheral edema (at least 5%); abnormal healing, diabetes, hypoglycemia, hypoxia, thyroid enlargement (less than 5%).
Joint disorder (16%); myalgia (8%); bone pain (at least 5%); joint pain, leg cramps, neck pain (less than 5%); extremity pain (3%); arthritis (less than 2%); decreased bone density, fibromyalgia, tenosynovitis-like symptoms (postmarketing).
Respiratory disorders (11%); dyspnea, sinus congestion (at least 5%); asthma, bronchitis, cough, emphysema, epitaxis, hemoptysis, lung edema, pharyngitis, pleural effusion, pleural rub, pneumonia, pulmonary fibrosis, rhinitis (less than 5%).
Pain (33%); fatigue/malaise (21%); edema (14%); flu syndrome (12%); allergic reaction, androgen-like effects, cellulitis, chills, cyst, enlarged abdomen, enlarged thyroid, fever, infection/inflammation, hiccup, lung disorder, neoplasm, sinusitis, temporal bone swelling, voice alteration, weakness (less than 5%); accelerated muscle maturity, body odor, dry mucous membranes, rigors (less than 2%); anaphylactoid reactions, asthma, pituitary apoplexy (postmarketing).
Closely observe prostatic cancer patients with metastatic vertebral lesions or with urinary tract obstruction during first few weeks of therapy. Monitor therapeutic response by measuring testosterone serum levels, prostate-specific antigen (PSA), and prostatic acid phosphatase. After 1 to 2 mo of initiating CPP therapy or changing doses, monitor GnRH stimulation test, sex steroids, and Tanner staging to confirm downregulation. Verify downregulation in patients whose weight has increased significantly while on therapy. Monitor measurements of bone age for advancement every 6 to 12 mo.
Category X . Exclude pregnancy before initiating therapy in women of childbearing potential; use nonhormonal method of contraception during treatment.
The safety and efficacy of leuprolide, apart from the pediatric formulations for treatment of CPP, have not been established.
Injection contains benzyl alcohol, which can cause local hypersensitivity reactions. Depot preparation is preservative-free.
Use of depot preparation may result in decreased bone density. Decreased bone mineral content risk factors may cause additional bone loss with long-term use.
Consider discontinuation of CPP therapy before 11 yr of age in women and before 12 yr of age in men.
Has occurred in prostatic cancer patients treated with LHRH agonists.
Increase in clinical signs and symptoms of CPP, prostatic cancer, endometriosis, and uterine leiomyomata may occur during early phase of therapy because of transient increases in gonadotropins and sex steroids.
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