Classification: Luteinizing Hormone Releasing Hormone (LHRH) Agonist
Most prostate cancers need supplies of the male hormone testosterone to grow. Testosterone is an androgen produced by the testes and adrenal glands. The production of testosterone can be stopped by surgically removing the testicles or through medication therapy. A hormone called luteinizing hormone (LH), which is produced by the pituitary gland, stimulates production of testosterone by the testicles. Agonists of the LH releasing hormone (i.e. LHRH agonists) stop the production of luteinizing hormone by the pituitary gland. This reduces the production of testosterone in men. The cancer cells may then grow more slowly or stop growing altogether. Leuprolide acetate is a type of LHRH agonist.
Leuprolide acetate is given as an injection under the skin every 4 weeks. There is also a long acting formulation (called depot), which is given every 3 or 4 months. Leuprolide acetate can also be administered as an implant (Viadur) that is inserted under the skin in the upper arm and lasts for 12 months.
There are a number of things you can do to manage the side effects of Leuprolide Acetate. Talk to your doctor or nurse about these recommendations. They can help you decide what will work best for you. These are some of the most common side effects:
Most men find that hot flashes decrease after a period of time on the medication. There are a few things you can do to help with hot flashes. Several medications have been studied, including some low doses of antidepressants (such as venlafaxine and Paxil), and certain hormone therapies (medroxyprogesterone acetate and cyproterone acetate). Non-medical recommendations include: keeping well-hydrated with eight glasses of water daily, wearing cotton or lightweight, breathable fabrics, dressing in layers, exercising on a regular basis (generally walking exercise is best), practicing relaxation exercises, and avoiding triggers such as warm rooms, spicy foods, caffeinated beverages, nicotine and alcohol.
This drug can affect your reproductive system, resulting in sperm production becoming irregular or stopping permanently. In addition, you may experience erectile dysfunction or a decreased desire for sex during treatment. Talk to your urologist about options for treating erectile dysfunction.
Exposure of an unborn child to this medication could cause birth defects, so you should not father a child while on this medication. Effective birth control is necessary during treatment, even if you believe your sperm is affected. See OncoLink's section on sexuality for helpful tips for dealing with these side effects.
An increase in breast tissue (gynecomastia) or breast tenderness may develop. Your healthcare team can suggest medications to relieve the tenderness. In rare cases, radiation can be given to relieve severe tenderness.
Men who take hormone therapy for extended periods of time are at risk for bone thinning (osteoporosis). You may be advised to take calcium and vitamin D supplements to help prevent bone loss. You may have a bone density scan (DEXA scan) to assess your bone health. If your physician determines that you are at high risk of developing osteoporosis, they may recommend additional treatment with a type of medication called a bisphosphonate to help strengthen the bones. Learn more about bone health after cancer therapy.
Your doctor or nurse can recommend medication and other strategies to relieve bone pain or headaches.
While on cancer treatment you may need to adjust your schedule to manage fatigue. Plan times to rest during the day and conserve energy for more important activities. Exercise can help combat fatigue; a simple daily walk with a friend can help. Talk to your healthcare team and see OncoLink's section on fatigue for helpful tips on dealing with this side effect.
Some men experience weight gain, for which exercise and dietary changes may be helpful. There have been reports of heart problems, including heart failure and blood clots. If you develop any swelling or pain in your leg, ankles, feet or calves, any shortness of breath or unexplained weight gain, notify your healthcare team right away.