What you need to know about drugs

Lupron Depot 7.5 mg

Lupron Depot (Oncology)(leuprolide acetate) – Abbott

THERAPEUTIC CLASS

Synthetic gonadotropin-releasing hormone analog

INDICATIONS

Palliative treatment of advanced prostatic cancer.

ADULT DOSAGE

Adults: IM: (1-Month) 7.5mg every 4 weeks, (3-Month) 22.5mg every 12 weeks, (4-Month) 30mg every 16 weeks, or (6-Month) 45mg every 24 weeks.

HOW SUPPLIED

Inj: (1-Month) 7.5mg, (3-Month) 22.5mg, (4-Month) 30mg, (6-Month) 45mg

CONTRAINDICATIONS

Women who are or may become pregnant.

WARNINGS/PRECAUTIONS

May increase serum levels of testosterone during 1st week of treatment; transient worsening of or occurrence of additional signs/symptoms of prostate cancer may develop. Ureteral obstruction and spinal cord compression reported; may contribute to paralysis with or without fatal complications. May experience temporary increase in bone pain; manage symptomatically. Closely observe patients with metastatic vertebral lesions and/or urinary tract obstruction during the 1st few weeks of therapy. Hyperglycemia, increased risk of developing diabetes, myocardial infarction [MI], sudden cardiac death, and stroke reported. May affect diagnostic tests for pituitary gonadotropic and gonadal functions during treatment and up to 3 months after d/c. May prolong the QT interval; consider risks and benefits in patients with congenital long QT syndrome, electrolyte abnormalities, or congestive heart failure (CHF), and in patients taking Class 1A (eg, quinidine, procainamide) or Class III (eg, amiodarone, sotalol) antiarrhythmic medications.

ADVERSE REACTIONS

Inj-site reactions, general pain, respiratory disorders, headache, hot flashes, sweating, edema, urinary disorders, asthenia, GI disorders, impotence, testicular atrophy.

PREGNANCY

Category X, not for use in nursing.

MECHANISM OF ACTION

Synthetic GnRH analog; inhibitor of gonadotropin secretion, resulting in suppression of testicular and ovarian steroidogenesis.

PHARMACOKINETICS

Absorption: Administration of various doses resulted in different parameters. Distribution: Plasma protein binding (43-49%), Vd=27L (IV). Metabolism: M-I (major metabolite). Elimination: (3.75mg) Urine (<5% as parent and M-I), T1/2=3 hrs (1mg IV).

ASSESSMENT

Assess for previous hypersensitivity to the drug, metastatic vertebral lesions, urinary tract obstruction, diabetes mellitus, congenital long QT syndrome, electrolyte abnormalities, CHF, and possible drug interactions. Obtain baseline serum testosterone levels, prostate specific antigen (PSA) levels, and blood glucose levels.

MONITORING

Monitor response to drug and for signs/symptoms of worsening prostate cancer, ureteral obstruction, spinal cord compression, renal impairment, MI, stroke, and other adverse reactions. Periodically monitor serum testosterone levels, PSA levels, blood glucose and/or HbA1c levels, and bone mineral density.

PATIENT COUNSELING

Inform of risks/benefits of therapy. Counsel on the possibility of development or worsening of depression during treatment. Advise not to use if experiencing allergic reaction to other similar drugs. Inform of most common side effects (eg, hot flashes, pain, inj-site pain, fatigue). Inform that drug may cause impotence and increase in urinary symptoms or pain. Advise to notify physician if new or worsening symptoms or adverse events occur.

ADMINISTRATION/STORAGE

Administration: IM route. Must be administered under physician's supervision. Inj- site should be varied periodically. Refer to PI for administration instructions. Storage: 25°C (77°F); excursions permitted to 15-30°C (59-86°F). Stable for up to 2 hours after reconstitution.


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