Triptorelin (GnRH)

Introduction

Triptorelin works by reducing the amount of testosterone that the body makes. This effect helps slow or stop the growth of cancer cells and helps relieve symptoms such as painful/difficult urination. This medication is similar to a natural substance made by the body (luteinizing hormone releasing hormone-LHRH).

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How it works?

Hormones are chemical substances that are produced by glands in the body, which enter the bloodstream and cause effects in other tissues. For example, the hormone testosterone, made in the testicles and is responsible for male characteristics such as deepening voice and increased body hair. The use of hormone therapy to treat cancer is based on the observation that receptors for specific hormones that are needed for cell growth are on the surface of some tumour cells. Hormone therapy can work by stopping the production of a certain hormone, blocking hormone receptors, or substituting chemically similar agents for the active hormone, which cannot be used by the tumour cell. Different types of hormone therapies are categorized by their function and/or the type of hormone that is affected. Triptorelin pamoate is classified as a Gonadotropin-Releasing Hormone (GnRH) agonist. In general, a GnRH agonist is used when the desired end result is to reduce the number of reproductive hormones circulating in the body. Medications in this class typically work by forcing the body’s pituitary gland to first overproduce follicle-stimulating hormone (FSH) and luteinizing hormone (LH), which both play a role in the body’s production of estrogen and testosterone. Over time, this causes the pituitary to exhaust its normal supply of FSH and LH, which then results in lowered levels of these hormones, as well as estrogen and testosterone, in the body. In adult men with advanced prostate cancer, a GnRH agonist can also be used to help lower testosterone levels, which can be beneficial in stopping or slowing the growth of abnormal prostate tissue. The drug does not have a direct effect on cancer, only on the testicles or ovaries. The resulting lack of testosterone (in men) and estrogen (in women) interferes with stimulating cell growth in testosterone or estrogen-dependent cancer cells. Cancer of the prostate depends on the male hormone testosterone for its growth. If the amount of testosterone is reduced it is possible to slow down or shrink cancer.

Side Effects

Triptorelin can cause a temporary increase in certain hormones, especially when you first start using triptorelin. This may cause side effects that are similar to the condition being treated. Call your doctor at once if you have:
● painful or difficult urination, burning when you urinate, blood in the urine;
● bone pain;
● (in children) new or worsening signs of puberty;
● a seizure;
● chest pain or pressure, pain spreading to your jaw or shoulder;
● sudden numbness or weakness, slurred speech;
● loss of movement in any part of your body;
● high blood sugar–increased thirst, increased urination, hunger, dry mouth, fruity breath odor; or
● nerve problems–back pain, muscle weakness, problems with balance or coordination, severe numbness or tingling in your legs or feet, loss of bladder or bowel control.
Common side effects may include:
● pain, swelling, itching, or redness where an injection was given;
● hot flashes;
● decreased interest in sex, impotence, trouble having an orgasm;
● headache, bone pain, pain or swelling in your legs;
● nausea, vomiting, diarrhea, upset stomach;
● vaginal bleeding; or
● cold or flu symptoms (stuffy nose, sneezing, cough, sore throat, ear pain).

More information

Do not use if you are pregnant. Use effective birth control, and tell your doctor if you become pregnant during treatment.

Some people using triptorelin have had new or worsening mental problems or seizures (convulsions). Call your doctor right away if you have a seizure, or any unusual changes in mood or behavior (anger, aggression, crying, feeling restless or irritable).

Triptorelin can cause a temporary increase in certain hormones, especially when you first start using triptorelin. This may cause side effects that are similar to the condition being treated.

Dosages

Triptorelin is usually given once every 4, 12, or 24 weeks. Your dose schedule will depend on the strength and brand of triptorelin you are using.

Triptorelin must be mixed with a liquid (diluent) before using it. When using injections by yourself, be sure you understand how to properly mix and store the medicine.

Conclusion

For patients with locally advanced or metastatic prostate cancer, hormonal therapy has long been a mainstay of palliative treatment. Additionally, physicians frequently integrate androgen deprivation with radiotherapy in certain intermediate and high-risk patients with localized disease.8 In use for more than two decades, GnRH agonists represent the most frequently chosen hormonal therapy for achieving androgen deprivation in patients with prostate cancer.

Depot formulations of GnRH agonists have proven preferable to earlier options including daily injections and bilateral orchiectomy for several reasons. These include the reversibility of chemical castration58 and, for patients, the ability that injectable GnRH agonists provide to avoid psychological and other comorbidities associated with orchiectomy.

User reviews

Reviews 1

“I’m 62 years old and my general health is very good. Not a smoker, not a drinker but I’m no gym rat and I have done very well. That said, Gleason score was 8, PSA was 27 however, by the grace of god, my cancer was localized. After 43 Radiation treatments and Triptorelin every six months I’m thankful to say that my PSA is now 0.03 and doctor says because radiation has a residual for up to two years he expects my PSA to drop to 0.003. .yes, hot flashes however, nothing I can’t deal with. Because Triptorelin can increase one’s chance of cardiovascular issues , My dr put me on aspirin therapy. ”

Review 2
Trelstar (triptorelin) for Prostate Cancer: “Dr. ordered Trelstar for one year beginning at end of radiation. PSA has been undetectable since! Was it the treatment, medicine or both? Many side effects! Hot flashes can be VERY bad where I feel like throwing up, passing out etc. Some are very minor, average about 15 a day. Monthly dose has been much better than larger dose of a similar medicine taken two years ago! Other side effects are too numerous to mention, but are generally mild.”

Review 3
“My Local Primary Care Trust summarily decreed that LHRH Treatments were to be changed from Zoladex LA to Triptorelin – this is, without even seeming to give a thought to the possible effects of the change-over. (No relevant trials had ever been recorded for such a change) However after my ‘mandatory’ injection of Triptorelin – I immediately began to suffer from as many as 20 Hot Flushes every day. I began to record these Flushes and after only 2 weeks into the 3-month cycle, I complained to both my GP AND to the PCT direct. From my careful records, I produced an Excel graph in final support of my appeal. It was literally only 1 week before my new Injection/Implant was due, that I was allowed to return to Zoladex.”