Leuprolide (Intradermal)

Overview

Leuprolide injection is a man-made (or synthetic) hormone that is very similar to a natural hormone that your brain produces. This can then be given to patients to help treat a range of medical problems, such as the following:

  • Advanced or late-stage prostate cancer

When Leuprolide is given regularly to men it can decrease their testosterone levels. In turn, this can help to treat prostate cancer.

If given regularly to women, this injection can help decrease their estrogen levels. By doing so, it can help to treat endometriosis. It can also have the effects of shrinking tumors in a patient's uterus. In turn, this decreases the amount of vaginal bleeding which helps to prevent anemia.

When Leuprolide injection is given regularly to girls and boys with early puberty, it slows the development of their genital areas. It can also help slow a girl's breast development. Be aware that Leuprolide is only effective in slowing puberty as long as the patient keeps receiving it.

Leuprolide injection is only available via a prescription from your doctor.

Condition(s) treated

  • Advanced or late-stage prostate cancer

Type of medicine

  • 4-month powder for suspension

Side effects

As well as having its intended effect, it is possible that Leuprolide will cause you to experience a range of unwanted side effects as well. Be aware that some patients may suffer from multiple side effects, whereas others will experience none. These side effects can also range in their severity and their need for medical assistance. Below is a list of the more serious side effects that Leuprolide injection can cause. If you experience any of these, then you should contact your doctor immediately.

For adults

Less common

  • Irregular or fast heartbeat

Rare

  • Irregular or fast breathing

For males only (adults)

More common

  • Pale skin

Rare

  • Pain in the legs or groin (especially in the calves)

Incidence not known

  • Vomiting

For females only (adults)

Rare

  • Increased hair growth

For children

Rare

  • Skin rash

For females only (children)'expected in first few weeks

Rare

  • Continuing white vaginal discharge

As well as more serious side effects, you may experience less severe ones that do not necessarily require medical assistance. Below is a list of such side effects. You may find that they will pass over time as your treatment progresses and your body adjusts to the medicines. However, if you do experience any of the following and find them bothersome or lingering, then you can contact your doctor. They may be able to advise on ways to help reduce the unwanted effects.

For adults

More common

  • Sudden feelings of warmth and sweating (also known as hot flashes)

Less common

  • Increased tenderness or swelling of the breasts

For females only (adults)

More common

  • Stopping of menstrual periods

Less common

  • Pelvic pain

For males only (adults)

More common

  • A sore throat

Less common

  • Decreased size of the testicles

Though these lists are extensive, they are not necessarily all-inclusive. This means you may experience other side effects not mentioned here. If that is the case then you can still discuss them with your doctor.

Dosage

Below you can find the typical doses of Leuprolide injection that are given to patients suffering from different conditions. Be aware that the exact dose you have been prescribed may differ greatly from what is below. That is because every patient is different in their needs and the dose will be based on a number of factors. These factors include things such as the extent of your condition, other medical problems you have, and other drugs you are currently taking. You should follow the exact prescription given to you by your doctor. You should never alter these doses unless you have been told to do so by your doctor.

For patients suffering from anemia that has been caused by tumors of the endometriosis or uterus:

  • Adults. The exact dose given will depend on the specific product that is used. An example dose is 3.75 mg injected into your muscle once a month for up to 3 months. Alternatively, it could be 11.25mg that is injected into a muscle as one injection that lasts up to 3 months.

For patients suffering from prostate cancer:

  • The exact dose given will depend on the specific product that is used. An example dose is 7.5 mg injected under the skin or into your muscle one time a month. Alternatively, it could be 22.5mg that is injected under the skin or into a muscle as one injection that lasts up to 3 months. Or it could be 30 mg injected under your skin as one injection that lasts for up to 4 months. Finally, it may be 45 mg injected under your skin as one injection that lasts for 6 months.

For patients suffering from central precocious puberty:

  • Children aged 2 and above. The exact dose is based on body weight and will need to be calculated by a doctor. However, the starting dose for the once-daily product is 50 mcg per kg of a patient's body weight. This is injected under the skin once a day. For the once monthly product, the starting dose is 0.3mg per kg of body weight. Or it may be 7.5mg, 11.25mg, or 15 mg that is injected into one of your muscles every 4 weeks. For the 3 month product dose, you will have 11.25mg or 30mg injected into one of your muscles in one injection every 12 weeks. Your dose may then be adjusted by your doctor if necessary.
  • Children aged younger than 2 years old: Using Leuprolide injection is not recommended.

You will be required to receive this medicine on a fixed schedule. If you do miss a dose for any reason then you should call your doctor or pharmacist for advice on how to proceed.

Here is some further guidance for the Leuprolide injections (including Lupron Depot®-4 month, or Lupron Depot®-6 month, Eligard®, Lupron® injection, Lupron Depot®-Ped 1-month or 3-month, Lupron Depot®-3 month, and Lupron Depot®):

  • You will likely receive this injection from a nurse, doctor, or another trained medical professional. It is administered by a shot into one of your muscles or under your skin.

If you have any further questions about this, you should address these to your doctor.

Upon receiving this medicine, you will find patient instructions. You should read these carefully and address any questions to your doctor. In particular, ensure you understand:

  • How to give yourself the injection

If you receive Viadur®, which is the Leuprolide implant, here is some further guidance:

  • The implant Viadur® will be surgically implanted under the skin of your upper arm. Before cutting the skin and inserting the implant with a special tool, your doctor will first numb the area. This incision will then be closed using surgical strips. After this, a surgical bandage will be wrapped over your arm, which should then be left for 24 hours.

You should only use the brand of Leuprolide that you have been prescribed. Other brands will not necessarily work in the same manner.

Interactions

It is possible that this injection will interact with other drugs you are currently taking. You should, therefore, inform your doctor of all other drugs you take. This includes both prescription and nonprescription ones. In many cases, your doctor will want to take steps to avoid interactions, but in other cases, they may be necessary. Either way, your doctor is best placed to make this decision. It is not recommended that you receive the Leuprolide injection whilst taking any of the following medicines. To avoid the unwanted interaction, your doctor will need to change either one or both of the interacting drugs.

  • Dronedarone

It is usually not recommended that you receive the Leuprolide injection at the same time as any of the following drugs. However, in some cases, it is still necessary for you to have both as it is best for your treatment. In this case, your doctor will take steps to minimize the possible interaction. This may mean altering one or both doses of the interacting medicines.

  • Norfloxacin

It is possible that The Leuprolide injection will interact with certain parts of your dietary intake. Your doctor may, therefore, need to make adjustments to what you eat, drink, or smoke. This may mean consuming such things in smaller quantities or less frequently. For example, it may be necessary for you to drink less alcohol or smoke less tobacco after receiving the Leuprolide injection.

Finally, it is possible that this injection will interact with other medical problems you suffer from. You should advise your doctor of your complete medical history and be careful in highlighting any of the following if applicable:

  • A history of heart attacks

Warnings

Before your doctor prescribes you with this medicine, they will first need to fully assess you to ensure it is the best course of treatment for you. As a part of this process, they will need to be aware of any allergies you suffer from. This includes allergies to animals, dyes preservatives, and to food.

The studies that have so far been performed to date on children have not indicated any signs that this drug would be less useful for pediatric patients to receive. However, it is not recommended that children younger than 2 receive this injection. Soon after children stop taking the injection for central precocious puberty, the effect will wear off and puberty will once again continue as normal.

As of writing, no efficacy and safety have been established for the use of the following forms of this drug in children. This is because no suitable studies have taken place on the relationship between age and the medicine.

  • Lupron Depot®

The studies that have taken place in elderly patients have not demonstrated any signs that would make the following drugs any less effective in older patients.

  • Lupron Depot®-6 month

However, be aware that there is no available information on the effects of Viadur® in geriatric patients.

Be aware that studies have indicated harmful effects to the fetus if this medicine is given to pregnant women. This drug should not be taken by any women who are currently pregnant or are looking to become pregnant whilst taking it. If you do become pregnant at all after receiving this medicine, inform your doctor immediately.

Similarly, studies have shown that the Leuprolide injection can lead to harmful effects for infants who are being breastfed. If a patient is currently breastfeeding then an alternative form should be prescribed.

You will be required to attend regular appointments whilst you are receiving this medicine. You should keep all scheduled appointments as they are a chance for your doctor to check your condition and see your treatment is progressing suitably. It may be necessary to have urine and blood tests to look for unwanted effects.

It is possible that this medicine will cause you to experience a severe allergic reaction called anaphylaxis. This is life-threatening and requires you to find emergency medical attention. If you display any of the following symptoms after having received Leuprolide injection, you should inform your doctor right away.

  • Any swelling of your face, or mouth, or hands

You should not take this medicine if you are thinking of becoming pregnant soon or are currently pregnant. Doing so can cause serious harm to your unborn child. If you do become pregnant whilst receiving this medicine, inform your doctor right away.

Here is some further guidance for patients who receive this medicine for central precocious puberty:

  • If you are female, then you may experience occasional vaginal spotting or bleeding after receiving this medicine. If, after 2 months, you continue to have a regular period or heavy bleeding, you should call your doctor right away.

If you are receiving this medicine because of anemia that has been caused by tumors of your uterus, then here is some more guidance:

  • You may find that your symptoms get worse for the first few days after your treatment. This is perfectly normal. You should not stop taking the medicine, but should instead discuss your concerns with your doctor.

For patients receiving this injection for advanced cancer of the prostate here is some further guidance:

  • You may find that, at first, your symptoms get worse. You may even find that you develop new symptoms after receiving this injection. This includes trouble urinating, back pain, a tingling or numbness in the body, bone pain, or blood in the urine. If this is the case and you have new symptoms or find your existing symptoms getting worse, then tell your doctor.
  • Discomfort or pain in the back, neck, arms, or jaw
  • You may find that this medicine causes changes in your heart rhythm, such as a condition that is known as QT prolongation. It could cause your heart to beat differently or lead to fainting and other serious side effects. If you experience any symptoms of a heart rhythm problem after taking this drug, tell your doctor. This includes things like an irregular, fast, or pounding heartbeat.
  • It is possible that the Leuprolide injection will cause your bone density to decrease. This can lead to osteoporosis or weakened bones. You can discuss how this might affect you with your doctor.

If you have any other medical tests whilst receiving this injection, you should tell the doctor in charge that you receive Leuprolide Injection. This is because it may affect the results of some tests.

Storage

You should store this medicine safely away from children at all times. Once you no longer need the medicine, or if any of it goes out of date at all, it should be disposed of safely and sensibly. Your pharmacist or doctor can advise on how to do so. You should keep it stored in a sealed container and kept at room temperature. It should never be allowed to freeze and should be kept away from heat, direct light, and moisture.

Once the injection is prepared, it should be administered right away and not be stored. Within 30 minutes of mixing Eligard®, it must be used. Similarly, Lupron Depot® should be administered within 2 hours of mixing.

You should dispose of any used needles inside of a closed and hard container that does not allow needles to poke through. You should then keep that container away from pets and children.

Summary

As a man-made brain hormone, this medicine can be particularly helpful for treating a range of conditions in patients of all ages. Just be aware that it does have some very specific uses and can lead to a number of unwanted side effects and interactions. For this reason, it is only available via a doctor's prescription. If you are prescribed it then you should be careful in following your doctor's instructions as closely as possible.

This means only using the brand of medicine you were prescribed, and only taking it as much and as frequently as advised. Failure to follow these steps could lead to unwanted side effects and a worsening of your condition. Also, you should closely follow any other lifestyle or dietary changes that are advised to you. If you have any other questions about the use of this medicine or about your condition in general, then these questions are best addressed to your doctor.