Leuprolide acetate

Definition

Leuprolide acetate is a synthetic (man-made) hormone that acts similarly to the naturally occurring gonadotropin releasing hormone (GnRH). It is available under the tradename Lupron.

Purpose

Leuprolide acetate is used primarily to counter the symptoms of advanced prostate cancer in men when surgery to remove the testes or estrogen therapy is not an option or is unacceptable to the patient. It is often used to ease the pain and discomfort of women suffering from endometrosis, advanced breast cancer , or advanced ovarian cancer .

Two less common uses of this drug are the treatment of anemia caused by bleeding uterine fibroids, and the treatment of early onset (precocious) puberty.

Description

Leuprolide acetate is a man-made protein that mimics many of the actions of gonadotropin releasing hormone. In men, it decreases blood levels of the male hormone testosterone . In women, it decreases blood levels of the female hormone estrogen.

Recommended dosage for prostate cancer

In men, there are three methods of dosing: daily injections, a monthly injection, or an annual implanted capsule. In the case of daily injections, 1 mg of leuprolide acetate is injected under the skin (subcutaneously). In the case of monthly injections, an implanted capsule that contains 7.5 mg of leuprolide acetate is injected into a muscle. In the case of an annual implanted capsule, the capsule contains 72 mg of leuprolide acetate. Both the monthly and the annual capsules are specially designed to slowly release the drug into the patient's bloodstream over the specified time. The monthly capsule dissolves completely over the course of the month. The annual capsule must be removed after 12 months.

In the case of self-administered daily injections, a patient who misses a dose should take that dose as soon as it is noticed. However, if he or she does not remember until the next day, the missed dose should be skipped. Dosages should not be doubled.

Precautions

People taking leuprolide acetate should not drive a car, cook, or engage in any activity that requires alertness until they have been taking the medication long enough to be sure how it affects them.

Leuprolide acetate may cause birth defects if taken during pregnancy, and may be passed to an infant via breast milk. Therefore, women who are pregnant or nursing should not take leuprolide acetate without first consulting their doctors.

Leuprolide acetate will also interfere with the chemical actions of birth control pills. For this reason, sexually active women who do not wish to become pregnant should use some form of birth control other than birth control pills.

Side effects

In patients of both sexes, common side effects of leuprolide acetate include:

• tumor flare, which is exhibited as bone pain (due to a temporary initial increase in testosterone/estrogen before its production is finally decreased)
• sweating accompanied by feelings of warmth (hot flashes)
• lack of energy (lethargy)
• depression , or other mood changes
• headache
• enlargement of the breasts
• decreased sex drive

Other common side effects in women include:

• light, irregular vaginal bleeding
• no menstrual period
• pelvic pain
• vaginal dryness and/or itching
• emotional instability
• increase in facial or body hair
• deepening of the voice

Less common side effects, in patients of either sex, include:

• burning or itching at the site of the injection
• nausea and vomiting
• insomnia
• weight gain
• swollen feet or lower legs
• constipation

Other side effects in men can include impotence and decreased testicle size.

A doctor should be consulted immediately if the patient experiences any of the above symptoms.

Interactions

There are no known interactions of leuprolide acetate with any food or beverage. People taking leuprolide acetate should consult their physician before taking any other prescription drug, over-the-counter drug, or herbal remedy. People currently taking any other hormone or steroid-based medications should not take leuprolide acetate without first consulting their physician.

See Also Endometrial cancer

Paul A. Johnson, Ed.M.

KEY TERMS

Endometrial tissue

—The tissue lining the uterus that is sloughed off during a woman's menstrual period.

Fibroid

—A benign smooth muscle tumor of the uterus.

Gonadotropin releasing hormone (GnRH)

—A hormone produced in the brain that controls the release of other hormones that are responsible for reproductive function.

Prostate gland

—A small gland in the male genitals that contributes to the production of seminal fluid.