Names and pronunciation
(loo-proe′lide) Camcevia, Eligard, Fensolvi, Lupron Depot, Lupron Depot-Ped, Lupron
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Individual generic drug information
Extracted information for leuprolide only.
(loo-proe′lide) Camcevia, Eligard, Fensolvi, Lupron Depot, Lupron Depot-Ped, Lupron
Source page 767
Func. class.: Antineoplastic hormone
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Chem. class.: Gonadotropin-releasing hormone
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ACTION: Causes initial increase in circulating levels of LH, FSH; continuous administration results in decreased LH, FSH; in men, testosterone is reduced to castrate levels; in premenopausal women, estrogen is reduced to meno- pausal levels
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USES: Metastatic prostate cancer (inj implant), management of endometriosis, central precocious puberty, uterine leio- myomata (fibroids)
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Unlabeled uses: Breast cancer, hormone therapy for transgender females (male-to- female), paraphilia
Source page 768
Extracted information for leuprolide only.
CONTRAINDICATIONS: Preg- nancy, breastfeeding, hypersensitivity to GnRH or analogs, thromboembolic disor- ders, undiagnosed vaginal bleeding; Eligard should not be used in women, children Precautions: Edema, hepatic disease, CVA, MI, seizures, hypertension, diabetes mellitus, HF, depression, osteoporosis, spinal cord compression, urinary tract obstruction
Source page 768
SIDE EFFECTS CNS: Memory impairment, depression, seizures CV: MI, PE, dysrhythmias, peripheral edema GI: Nausea, vomiting, anorexia, diarrhea, GI bleeding GU: Edema, hot flashes, impotence, decreased libido, amenorrhea, vaginal dryness, gynecomastia, profuse vaginal bleeding INTEG: Alopecia MS: Bone pain RESP: Dyspnea, pulmonary fibrosis, interstitial lung disease
Source page 768
INTERACTIONS Increase: antineoplastic action—flu- tamide, megestrol Increase: seizure risk—SSRIs Drug/Herb • Do not use with black cohosh or chaste tree fruit; may interfere with treatment
Source page 769
Extracted information for leuprolide only.
DOSAGE AND ROUTES Advanced prostate cancer • Adult: SUBCUT 1 mg/day; IM 7.5 mg/ depot dose monthly; IM 22.5 mg depot q3mo; or IM 30 mg depot q4mo; or IM 45 mg depot q6mo; SUBCUT (Eligard) 7.5 mg monthly; SUBCUT 22.5 mg (Eligard) q3mo; SUBCUT 45 mg (Eligard) q mo every 6 months Endometriosis • Adult: IM 3.75 mg depot monthly for 6 mo or 11.25 mg q3mo for 6 mo or 30 mg q4mo Anemia related to uterine fibroids • Adult: IM 3.75 mg depot monthly × 3 mo or 11.25 mg depot as a single dose Central precocious puberty • Child: SUBCUT 50 mcg/kg/day; may increase by 10 mcg/kg/day as needed • Child >37.5 kg: IM Lepron Depot-Ped 15 mg q4wk • Child 25-37.5 kg: IM Lepron Depot- Ped 11.25 mg q4wk • Child ≤25 kg: IM Lepron Depot-Ped 7.5 mg q4wk Benign prostatic hyperplasia (BPH) (unlabeled) • Adult: SUBCUT (sol for inj) 1 mg/day, IM(injection susp) 3.75 mg q28day × 24 wk
Source page 768
Available forms: Depot inj: 3.75, 7.5, 11.25, 15, 22.5, 30, 45 mg; Solution for Subcut Inj: 5 mg/mL (2.8-mL multidose vials); emulsion for injection 42 mg injection kit
Source page 768
Administer: • Never give IV • Store in tight container at room tem- perature • SUBCUT: No dilution needed if patient self-administering; make sure patient is using syringes provided by manufacturer • SUBCUT Eligard bring to room tem- perature, once mixed, give within 30 min, prepare the 2 syringes for mixing, join the 2 syringes together by pushing in and twisting until secure; mix the prod- uct by pushing the contents of both sy- ringes back and forth between syringes until uniform; should be light tan to tan, draw entire mixed product into syringe B (short, wide syringe) by depressing the syringe A plunger and slightly withdraw- ing syringe B plunger, uncouple syringe A, while pushing down on syringe A plunger, small air bubbles will remain, hold syringe B upright, remove pink cap, attach needle cartridge to the end of sy- ringe B, remove needle cover, give by subcut IM route • Monthly: reconstitute single-use vial with 1 mL of diluent; if multiple vials used, withdraw 0.5 mL, inject into each vial (1 mL); withdraw all, inject at 90- degree angle (3.75 mg) • 3-mo: reconstitute microspheres using 1.5 mL of diluent, inject into vial; shake, withdraw, inject
Source page 768
Extracted information for leuprolide only.
Assess: • Prostate cancer: increased bone pain for first 4 wk of treatment; those with metastases in spinal column may exhibit severe back pain • Symptoms of endometriosis (lower abdominal pain)/fibroids (pelvic pain, excessive vaginal bleeding, bloating) be- fore, during, after treatment • Central precocious puberty (CPP) di- agnosis should have been confirmed by secondary S4 characteristics in children <9 yr, estradiol/testosterone levels, GnRH test, tomography of head, adrenal steroids, chorionic gonadotropin, wrist x-ray, height, weight • Hepatic studies (bilirubin, AST, ALT, LDH) before, during therapy monthly, as needed; PSA, calcium, testosterone with prostate cancer; bone mineral density; blood glucose, HbA1c • Pituitary gonadotropic and gonadal function during therapy and 4-8 wk after therapy is discontinued • QT prolongation (depot): ECG in CV patients using depot route • Tumor flare: worsening of signs and symptoms; normal during beginning therapy • Fatigue, increased pulse, pallor, leth- argy; edema in feet, joints; stomach pain • Severe allergic reaction: rash, pruri tus, urticaria, purpuric skin lesions, itch ing, flushing
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Evaluate: • Therapeutic response: decreased tu- mor size and spread of malignancy; de- crease in lesions, pain with endometriosis, fibroids, correction of CPP; increased fol- licle maturation
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CLINICAL CONSIDERATIONS
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Patient and caregiver information: • To notify prescriber if menstruation continues; menstruation should stop • That bone pain will disappear after 1 wk • To report any complaints, side effects to nurse, prescriber; that hot flashes may occur; to record weight, report gain of >2 lb/day • How to prepare, give; to rotate sites for SUBCUT/IM inj; to use only syringes pro- vided by manufacturer; to store depot at room temperature, to refrigerate un- opened vials, to protect all from heat • To keep accurate records of dose • That tumor flare may occur: increase in size of tumor, increased bone pain, will subside rapidly; may take analgesics for pain, usually in prostate cancer or central precocious puberty • That ongoing treatment is needed in L central precocious puberty • That voiding problems may increase during beginning of therapy but will de- crease in several weeks • Pregnancy: to notify prescriber if preg nancy is planned or suspected; not to breastfeed; to use nonhormonal form of contraception (women of childbearing age)
Source page 769
Extracted information for leuprolide only.
PHARMACOKINETICS IM/SUBCUT: Peak 1-2 mo, duration 1-3 mo; absorbed rapidly (SUBCUT), slowly (IM depot); half-life 3 hr
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Filter the extracted dose blocks for this individual drug.
Advanced prostate cancer
• Adult: SUBCUT 1 mg/day; IM 7.5 mg/ depot dose monthly; IM 22.5 mg depot q3mo; or IM 30 mg depot q4mo; or IM 45 mg depot q6mo; SUBCUT (Eligard) 7.5 mg monthly; SUBCUT 22.5 mg (Eligard) q3mo; SUBCUT 45 mg (Eligard) q mo every 6 months Endometriosis
Candidate age grouping · source page 768
Advanced prostate cancer
• Adult: IM 3.75 mg depot monthly for 6 mo or 11.25 mg q3mo for 6 mo or 30 mg q4mo Anemia related to uterine fibroids
Candidate age grouping · source page 768
Advanced prostate cancer
• Adult: IM 3.75 mg depot monthly × 3 mo or 11.25 mg depot as a single dose Central precocious puberty
Candidate age grouping · source page 768
Advanced prostate cancer
• Adult: SUBCUT (sol for inj) 1 mg/day, IM(injection susp) 3.75 mg q28day × 24 wk
Candidate age grouping · source page 768