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Eligard

(leuprolide acetate (Eligard))

How does this medication work? What will it do for me?

Leuprolide is a medication that has been designed to mimic the actions of gonadotropin releasing hormone (GnRH or luteinizing hormone releasing hormone, LHRH), the hormone released from the hypothalamus gland in the brain. The hypothalamus uses GnRH to send messages to the pituitary gland in the brain, which then sends messages to the ovaries in women and the testicles in men, telling these organs to produce the sex hormones estrogen (in women) and testosterone (in men). Normally, GnRH comes from the hypothalamus in pulses, leading to the production of estrogen or testosterone. If GnRH came from the hypothalamus all of the time (rather than in "pulses"), it would have the opposite effect and "turn off" hormone production.

Leuprolide works by acting in place of LHRH and causes hormone production to be “turned off.” As a result, the production of testosterone by the body is reduced.

Leuprolide is used to treat advanced prostate cancer. For some cases of prostate cancer, testosterone causes the cancer to grow. This medication helps treat prostate cancer by reducing the amount of testosterone in the blood.

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are receiving this medication, speak to your doctor. Do not stop receiving this medication without consulting your doctor.

How should I use this medication?

Leuprolide is given as an injection under the skin by your doctor. Depending on the dosage form used, it may be given once every 1, 3, 4, or 6 months.

Many things can affect the dose of a medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are receiving the medication without consulting your doctor.

It is very important to receive this medication exactly as recommended by your doctor. If you miss an appointment to receive leuprolide, contact your doctor as soon as possible to reschedule your appointment.

Leuprolide vials or kits should be stored in the refrigerator (between 2°C and 8°C) and protected from light. Leuprolide may be stored at room temperature in the original packaging for up to 8 weeks before it is used. Keep out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

What form(s) does this medication come in?

7.5 mg vial
Eligard 7.5 mg (1-month) is supplied in two separate prefilled, sterile syringes whose contents are mixed immediately prior to administration. The two syringes are joined and the single dose product is mixed until it is homogenous. One syringe contains the Atrigel Delivery System, and the other contains leuprolide acetate. The Atrigel Delivery System is a polymeric (non-gelatin containing) delivery system consisting of a biodegradable, 34% poly (DL-Lactide-co-glycolide; PLG) polymer formulation dissolved in a biocompatible solvent, 66% N-methyl-2-pyrrolidone (NMP). PLG is a copolymer with a 50:50 molar ratio of DL-lactide to glycolide containing carboxyl end groups. The second syringe contains 10.2 mg lyophilized leuprolide acetate and is designed to deliver 7.5 mg of leuprolide acetate at the time of subcutaneous injection. Eligard 7.5 mg (1-month) is available in a single use pouch packaging. The pouch packaging contains the two-syringe mixing system, a 20-gauge half-inch needle, and a silicone desiccant pouch to control moisture uptake.

22.5 mg vial
Eligard 22.5 mg (3-month) is supplied in two separate prefilled, sterile syringes whose contents are mixed immediately prior to administration. The two syringes are joined and the single dose product is mixed until it is homogenous. One syringe contains the Atrigel Delivery System, and the other contains leuprolide acetate. The Atrigel Delivery System is a polymeric (non-gelatin containing) delivery system consisting of a biodegradable, 45% poly (DL-Lactide-co-glycolide; PLG) polymer formulation dissolved in a biocompatible solvent, 55% N-methyl-2-pyrrolidone (NMP). PLG is a copolymer with a 75:25 molar ratio of DL-lactide to glycolide with hexanediol. The second syringe contains 28.2 mg lyophylized leuprolide acetate and is designed to deliver 22.5 mg of leuprolide acetate at the time of SC injection. Eligard 22.5 mg (3-month) is available in a single use pouch or tray packaging. The pouch and the tray packaging contain the two-syringe mixing system, a 20-gauge half-inch needle, and a silicone desiccant pouch (two for the tray packaging) to control moisture uptake.

30 mg vial
Eligard 30 mg (4-month) is supplied in two separate prefilled, sterile syringes whose contents are mixed immediately prior to administration. The two syringes are joined and the single dose product is mixed until it is homogenous. One syringe contains the Atrigel Delivery System, and the other contains leuprolide acetate. The Atrigel Delivery System is a polymeric (non-gelatin containing) delivery system consisting of a biodegradable, 45% poly (DL-Lactide-co-glycolide; PLG) polymer formulation dissolved in a biocompatible solvent, 55% N-methyl-2-pyrrolidone (NMP). PLG is a copolymer with a 75:25 molar ratio of DL-lactide to glycolide with hexanediol. The second syringe contains 35.8 mg lyophilized leuprolide acetate and is designed to deliver 30 mg of leuprolide acetate at the time of subcutaneous injection. Eligard 30 mg (4-month) is available in a single use pouch or tray packaging. The pouch and the tray packaging contain the two-syringe mixing system, a 20-gauge 5/8-inch needle, and a silicone desiccant pouch (two for the tray packaging) to control moisture uptake.

45 mg vial
Eligard 45 mg (6-month) is supplied in two separate prefilled, sterile syringes whose contents are mixed immediately prior to administration. The two syringes are joined and the single dose product is mixed until it is homogenous. One syringe contains the Atrigel Delivery System, and the other contains leuprolide acetate. The Atrigel Delivery System is a polymeric (non-gelatin containing) delivery system consisting of a biodegradable, 50% poly (DL-Lactide-co-glycolide; PLG) polymer formulation dissolved in a biocompatible solvent, 50% N-methyl-2-pyrrolidone (NMP). PLG is a copolymer with a 85:15 molar ratio of DL-lactide to glycolide with hexanediol. The second syringe contains 58.2 mg lyophilized leuprolide acetate and is designed to deliver 45 mg of leuprolide acetate at the time of subcutaneous injection. Eligard 45 mg (6-month) is available in a single use tray packaging. The tray packaging contains the two-syringe mixing system, a 18-gauge 5/8-inch needle, and two silicone desiccant pouches to control moisture uptake.

Who should NOT take this medication?

Do not use leuprolide if you:

  • are allergic to leuprolide or any ingredients of this medication
  • are allergic to medications called GnRH agonists or LHRH agonists (e.g., buserelin, goserelin)
  • are breast-feeding
  • are pregnant or may become pregnant while receiving the medication

What side effects are possible with this medication?

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.
The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.
The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.
Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

  • blurred vision
  • dizziness
  • hot flashes (sudden sweating and feeling of warmth)
  • nausea
  • sleeping problems
  • swelling, itching, burning, or redness at the place of injection
  • swelling of feet or legs
  • vomiting

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not check with your doctor or seek medical attention.
Check with your doctor as soon as possible if any of the following side effects occur:

  • bone pain
  • decreased level of consciousness
  • difficult or painful urination
  • fast heartbeat
  • heavy sweating
  • nervousness
  • numbness or tingling of hands or feet
  • persistent nausea or vomiting
  • severe hot flashes
  • signs of depression (e.g., poor concentration, changes in weight, changes in sleep, decreased interest in activities, thoughts of suicide)
  • sudden headache
  • vision changes
  •  

Stop taking the medication and seek immediate medical attention if any of the following occur:

  • seizures
  • signs of a heart attack (e.g., chest pain or pressure, pain extending through shoulder and arm, nausea and vomiting, sweating)
  • signs of stroke (e.g., sudden or severe headache; sudden loss of coordination; vision changes; sudden slurring of speech; or unexplained weakness, numbness, or pain in arm or leg)
  • symptoms of a severe allergic reaction (e.g., hives; difficulty breathing; difficulty swallowing; or swelling of the face, mouth, tongue, or throat)
  • symptoms of severely increased blood pressure (e.g., chest pain, blurred vision, dizziness, excessive tiredness, headache, stronger or faster heart beat)

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Are there any other precautions or warnings for this medication?

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Anemia: Reduced testosterone levels contribute to low levels of red blood cells. If you experience symptoms of reduced red blood cell count (anemia) such as shortness of breath, pale skin, or feeling unusually tired, contact your doctor as soon as possible.

Your doctor will do blood tests regularly to monitor the number of specific types of blood cells, including red blood cells, in your blood.

Depression: Changed levels of hormones in the body have been known to cause mood swings and symptoms of depression. If you have depression or a history of depression, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

If you experience symptoms of depression such as poor concentration, changes in weight, changes in sleep, or decreased interest in activities, or notice them in a family member who is taking this medication,contact your doctor as soon as possible.

Diabetes: Leuprolide may cause a loss of blood glucose control, and glucose tolerance may change. People with diabetes may find it necessary to monitor their blood sugar more frequently while using this medication.

If you have diabetes or are at risk for developing diabetes, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Heart problems: This medication may increase the risk of heart problems such as changes in heart rhythm. You may be more at risk of experiencing heart problems if you have congenital long QT syndrome, electrolyte (e.g., potassium) abnormalities, or congestive heart failure, or you are taking medications that affect heart rhythm (e.g., quinidine, procainamide, amiodarone, sotalol, flecainide). Discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Medical conditions: If you have urinary tract obstruction (a blockage in the urinary tract), reduced kidney or liver function, spinal cord compression, or cancer that has spread to the bones of the spine, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Men and the heart: There may be an increased risk of heart-related events (e.g., heart attacks, stroke, heart-related death) in men being treated for prostate cancer with GnRH medications. Before you start treatment, tell your doctor if you have diabetes, heart disease, had a previous heart attack or stroke, or have cardiovascular risk factors (e.g., high blood pressure, smoking, or cholesterol). If you have any of these conditions, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Osteoporosis: Leuprolide can cause the bones to lose thickness. Your doctor will monitor you for this while you are using this medication. If you have osteoporosis or are at risk for it (e.g., have been smoking or drinking excessive amounts of alcohol for a long time, have a family history of osteoporosis, or are taking medications such as prednisone or anti-seizure medications), discuss with your doctor how this medication may affect your medical condition and whether any special monitoring is needed.

Starting treatment: During the first week of treatment with leuprolide, you may notice that your signs and symptoms temporarily get worse. This is due to a sudden increase in hormones that will normalize once the right dose for you has been found.

Pregnancy: Leuprolide should not be used during pregnancy. Leuprolide is not recommended for use by women.

Breast-feeding: It is not known if leuprolide passes into breast milk. Leuprolide is not recommended for use by women.

Children: The safety and effectiveness of using this medication have not been established for children under 12 years of age.

What other drugs could interact with this medication?

There may be an interaction between leuprolide and any of the following:

  • alfuzosin
  • amantadine
  • amiodarone
  • androgens (e.g., methyltestosterone, nandrolone, testosterone)
  • antihistamines (e.g., cetirizine, doxylamine, diphenhydramine, hydroxyzine, loratadine)
  • antipsychotics (e.g., chlorpromazine, clozapine, haloperidol, olanzapine, quetiapine, risperidone)
  • apomorphine
  • “azole” antifungals (e.g., itraconazole, ketoconazole, voriconazole)
  • buprenorphine
  • chloral hydrate
  • chloroquine
  • diabetes medications (e.g., chlorpropamide, glipizide, glyburide, insulin, metformin, nateglinide, rosiglitazone)
  • disopyramide
  • domperidone
  • dronedarone
  • estrogens (e.g., conjugated estrogen, estradiol, ethinyl estradiol)
  • fingolimod
  • flecainide
  • formoterol
  • galantamine
  • HIV protease inhibitors (e.g., darunavir, indinavir, lopinavir, saquinavir, tipranavir)
  • indapamide
  • lithium
  • macrolide antibiotics (e.g., clarithromycin, erythromycin)
  • maprotiline
  • mefloquine
  • methadone
  • metoclopramide
  • metronidazole
  • mifepristone
  • nilotinib
  • octreotide
  • pentamidine
  • pimozide
  • primaquine
  • procainamide
  • propafenone
  • romidepsin
  • quinidine
  • quinine
  • quinolone antibiotics (e.g., ciprofloxacin, norfloxacin, ofloxacin)
  • salbutamol
  • saquinavir
  • selective serotonin reuptake inhibitors (SSRIs, e.g., citalopram, fluoxetine, paroxetine, sertraline)
  • serotonin antagonists (anti-emetic medications; e.g., granisetron, ondansetron)
  • solifenacin
  • sotalol
  • sulfamethoxazole
  • tacrolimus
  • tamoxifen
  • tetrabenazine
  • thioridazine
  • trazodone
  • trimethoprim
  • tricyclic antidepressasnts (e.g., amitriptyline, clomipramine, desipramine, trimipramine)
  • tyrosine kinase inhibitors (e.g., dasatinib, imatinib, nilotinib)
  • vardenafil
  • venlafaxine
  • vilanterol

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

  • stop taking one of the medications,
  • change one of the medications to another,
  • change how you are taking one or both of the medications, or
  • leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

All material copyright MediResource Inc. 1996 – 2017. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source: www.medbroadcast.com/drug/getdrug/Eligard

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