Drug reference
Administration of gonadorelin analogues produces an initial phase of stimulation; continued administration is followed by down-regulation of gonadotrophin-releasing hormone receptors, thereby reducing the release of gonadotrophins (follicle stimulating hormone and luteinising hormone) which in turn leads to inhibition of androgen and oestrogen production.
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DECAPEPTYL ® SR 11.25MG Advanced prostate cancer (specialist use only) ▶BY INTRAMUSCULAR INJECTION ▶Adult: 11.25 mg every 3 months Endometriosis ▶BY INTRAMUSCULAR INJECTION ▶Adult: 11.25 mg every 3 months for maximum 6 months (not to be repeated), to be started during first continued → 5 days of menstrual cycle DECAPEPTYL ® SR 22.5MG Advanced prostate cancer (specialist use only) ▶BY INTRAMUSCULAR INJECTION ▶Adult: 22.5 mg every 6 months DECAPEPTYL ® SR 3MG Advanced prostate cancer (specialist use only) ▶BY INTRAMUSCULAR INJECTION ▶Adult: 3 mg every 4 weeks Endometriosis Endocrine system ▶BY INTRAMUSCULAR INJECTION ▶Adult: 3 mg every 4 weeks maximum duration of 6 months (not to be repeated), to be started during first 5 days of menstrual cycle Reduction in size of uterine fibroids ▶BY INTRAMUSCULAR INJECTION ▶Adult: 3 mg every 4 weeks for at least 3 months, maximum duration of treatment 6 months (not to be repeated), to be started during first 5 days of menstrual cycle Premenopausal breast cancer [as combination therapy] (specialist use only) ▶BY INTRAMUSCULAR INJECTION ▶Adult: 3 mg every 4 weeks for up to 5 years, initiated 6–8 weeks before starting aromatase inhibitor—for further information, consult product literature GONAPEPTYL DEPOT ® Advanced prostate cancer ▶BY SUBCUTANEOUS INJECTION, OR BY DEEP INTRAMUSCULAR INJECTION ▶Adult: 3.75 mg every 4 weeks Endometriosis| Reduction in size of uterine fibroids ▶BY SUBCUTANEOUS INJECTION, OR BY DEEP INTRAMUSCULAR INJECTION ▶Adult: 3.75 mg every 4 weeks maximum duration of 6 months (not to be repeated), to be started during first 5 days of menstrual cycle SALVACYL ® Male hypersexuality with severe sexual deviation ▶BY INTRAMUSCULAR INJECTION ▶Adult: 11.25 mg every 12 weeks
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In endometriosis do not use for longer than 6 months (do not repeat). undiagnosed vaginal bleeding SALVACYL ® Severe osteoporosis
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GENERAL CAUTIONS History of depression. patients with metabolic bone disease (decrease in bone mineral density can occur) SPECIFIC CAUTIONS ▶When used for breast cancer Risk factors for osteoporosis ▶When used for prostate cancer Risk factors for osteoporosis. risk of spinal cord compression in men. risk of ureteric obstruction in men SALVACYL ® Increased risk of sensitivity to restored testosterone if treatment interrupted—consider administration of an antiandrogen before stopping treatment. transient increase in serum testosterone occurs on initiation—consider administration of an anti- androgen
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DECAPEPTYL ® SR 22.5MG Each vial includes an overage to allow accurate administration of a 22.5 mg dose. DECAPEPTYL ® SR 3MG Each vial includes an overage to allow accurate administration of 3 mg dose. DECAPEPTYL ® SR 11.25MG Each vial includes an overage to allow accurate administration of an 11.25 mg dose.
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Scottish Medicines Consortium (SMC) decisions SMC No. SMC2186 The Scottish Medicines Consortium has advised (October 2019) that triptorelin (Decapeptyl SR 3mg ®) is accepted for use within NHS Scotland as adjuvant treatment, in combination with tamoxifen or an aromatase inhibitor, of endocrine responsive early stage breast cancer in women at high risk of recurrence who are confirmed as premenopausal after completion of chemotherapy. The advice is contingent upon the continuing availability of the patient access scheme in NHS Scotland or a list price that is equivalent or lower. All Wales Medicines Strategy Group (AWMSG) decisions The All Wales Medicines Strategy Group has advised (March 2017) that triptorelin (Decapeptyl ® SR) is recommended as an option for use within NHS Wales as an adjuvant treatment to radiotherapy and as a neoadjuvant treatment prior to radiotherapy, in patients with high-risk localised or locally advanced prostate cancer.
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GENERAL SIDE-EFFECTS ▶Common or very common Anxiety. asthenia. depression. diabetes mellitus. dizziness. dry mouth. embolism. gastrointestinal discomfort. gynaecomastia. haemorrhage . headache. hot flush. hyperhidrosis. hypersensitivity. hypertension. joint disorders. menstrual cycle irregularities. mood altered. muscle complaints. nausea. oedema. ovarian and fallopian tube disorders. pain. painful sexual intercourse. pelvic pain. sexual dysfunction . skin reactions. sleep disorders. weight changes ▶Uncommon Alopecia. appetite abnormal. asthma exacerbated. chills. confusion. constipation. diarrhoea. drowsiness. dyspnoea. flatulence. gout. muscle weakness . taste altered. testicular disorders. tinnitus. vertigo. vision disorders. vomiting ▶Rare or very rare Abnormal sensation in eye. chest pain. difficulty standing. fever. hypotension. influenza like illness. musculoskeletal stiffness. nasopharyngitis. orthopnoea. osteoarthritis. QT interval prolongation ▶Frequency not known Angioedema. malaise SPECIFIC SIDE-EFFECTS ▶Common or very common ▶With intramuscular use Bone disorders. bone fracture. breast abnormalities. glucose tolerance impaired. hyperglycaemia. musculoskeletal disorder. seborrhoea. sensation abnormal. urinary disorders. vulvovaginal disorders ▶With subcutaneous use Dysuria. vulvovaginal dryness ▶Uncommon ▶With intramuscular use Broken nails. central nervous system haemorrhage. cerebral ischaemia. concentration impaired . cystocele. dry eye. fluid retention. hirsutism. hyperlipidaemia. memory impairment. myocardial ischaemia. oral ulceration. palpitations. syncope. thrombocytosis. tremor ▶With subcutaneous use Paraesthesia ▶Frequency not known ▶With subcutaneous use Bone disorder. breast pain. memory loss SIDE-EFFECTS, FURTHER INFORMATION During the initial stage increased production of testosterone may be associated with progression of prostate cancer. In susceptible patients this tumour ‘flare’ may cause spinal cord compression, ureteric obstruction or increased pain.
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Non-hormonal, barrier methods of contraception should be used during entire treatment period. Pregnancy should be excluded before treatment, the first injection should be given during menstruation or shortly afterwards or use barrier contraception for 1 month beforehand.
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Avoid.
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Avoid.
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▶When used for Prostate cancer Men at risk of tumour ‘flare’ should be monitored closely during the first month of therapy.
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Rotate injection site to prevent atrophy and nodule formation.
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There can be variation in the licensing of different medicines containing the same drug. Powder and solvent for suspension for injection ▶Decapeptyl SR (Ipsen Ltd) Triptorelin (as Triptorelin acetate) 3 mg Decapeptyl SR 3mg powder and solvent for suspension for injection vials | 1 vial P £69.00 DT = £69.00 Triptorelin 11.25 mg Decapeptyl SR 11.25mg powder and solvent for suspension for injection vials | 1 vial P £207.00 DT = £207.00 Triptorelin (as Triptorelin embonate) 22.5 mg Decapeptyl SR 22.5mg powder and solvent for suspension for injection vials | 1 vial P £414.00 DT = £414.00 ▶Gonapeptyl Depot (Ferring Pharmaceuticals Ltd) Triptorelin (as Triptorelin acetate) 3.75 mg Gonapeptyl Depot 3.75mg powder and solvent for suspension for injection pre-filled syringes | 1 pre-filled disposable injection P £81.69 DT = £81.69 6.1 Hereditary angioedema PITUITARY AND HYPOTHALAMIC HORMONES AND ANALOGUES › ANTI-GONADOTROPHIN- RELEASING HORMONES
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11.25 mg every 3 months
First-line fragment. Read the complete Indications and Dose section above.
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11.25 mg every 3 months for maximum
First-line fragment. Read the complete Indications and Dose section above.
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22.5 mg every 6 months
First-line fragment. Read the complete Indications and Dose section above.
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3 mg every 4 weeks
First-line fragment. Read the complete Indications and Dose section above.
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3 mg every 4 weeks maximum duration of
First-line fragment. Read the complete Indications and Dose section above.
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3 mg every 4 weeks for at least 3 months,
First-line fragment. Read the complete Indications and Dose section above.
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3 mg every 4 weeks for up to 5 years, initiated
First-line fragment. Read the complete Indications and Dose section above.
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3.75 mg every 4 weeks
First-line fragment. Read the complete Indications and Dose section above.
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3.75 mg every 4 weeks maximum duration of
First-line fragment. Read the complete Indications and Dose section above.
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11.25 mg every 12 weeks
First-line fragment. Read the complete Indications and Dose section above.
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