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Is the Lupron injection the same as DEGARELIX?

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Posted 6/30/2019 10:49 PM (GMT 0)
Is the Lupron injection the same as the DEGARELIX injection?

Shots to the stomach with injection site soreness and pain?

How about the side effects?

Has anyone had both and can speak to the differences?

Thanks
Posted 7/1/2019 1:38 AM (GMT 0)
Lupron and Degarelix (also known as Firmagon) do the same thing. They both drive Testosterone, which feeds prostate cancer, down to castrate levels. But, without getting into the weeds with a lot of detail, they do it in different ways.
Firmagon/Degarelix On average gets testosterone below castrate levels in three days. Lupron does the same thing but on average it takes about 28 days. Some doctors think that Degarelix Is superior, for that reason and generally in controlling disease. That is opinion not scientific fact as far as I know

With Lupron you can get a shot every month every three months every six months. Firmagon is only offered in a one month dose so you have to have a shot each month. And with Firmagon there is more chance of a Reaction at the injection site that could last a few days to a week. Shot is given in the stomach. With Lupron those reactions or less common. And the shot is given in the butt.
Reaction at the injection site that could last a few days to a week. Shot is given in the stomach. With Lupron those reactions are less common. And the shot is given in the butt.

Also I’ve been told at least by my radiation oncologist, That Lupron tends to have more rest of cardiac issues than Firmagon.

Side effects of the two treatments are pretty much the same they are interchangeable

What’s your situation?
Posted 7/1/2019 8:48 PM (GMT 0)

Pratoman said...


What’s your situation?

In two days I get a 3 month shot of Lupron. I had the one month (two injections to the stomach) shot of the high does Degarelix June 5th.

I was wondering if I should expect the same reactions.
Also,
Do the side effects increase the longer you are on these drugs?
Posted 7/2/2019 12:44 AM (GMT 0)
Mentor, i think longer term ADT probably does result in increase in the side effects for many, but i cant say for sure, maybe others will chime in, i was only on it for 6 months.

Just my humble opinion, if i were you, i would ask the doc if you could stay on Degarelix, unless you are switching because you got a really bad reaction. to the first shot.
Posted 7/2/2019 1:40 AM (GMT 0)
I have had experience with both. The first 2 shots of Firmagon are the worse. The monthly shot after that are bearable.

Lupron shot hurts in the butt for a few days and then it goes away.

If you have more specific questions...let me know.
Posted 7/2/2019 4:06 AM (GMT 0)
I get the lupron every six months, Shot in the left arm....
No problem and no soreness....
Posted 7/2/2019 4:54 AM (GMT 0)
I get my Lupron shot in the right hip every 6 months. I've never had any more than a few hours soreness.
Posted 7/2/2019 11:48 AM (GMT 0)
Firmagon does not result in a testosterone "flair" (a sudden initial increase in the amount of testosterone in your blood) while Lupron and Eligard both produce a testosterone "flair". If you have a serious/borderline cancer your doc will likely give you Firmagon, at least at first. Mine had to fight with my insurance and show cause. He did that. sad

I did 3 - 1 month Firmagon injections before radiation followed by 2 - 6 month Lupron/Eligard injections a year for a total of 2 & 1/2 years on this chemo. All of my injections were into the abdominal wall muscle (you would call it the 'stomach'). The first Firmagon injection hit a vein and killed it. All of the injections hurt at first.

As soon as the blood levels of leuprolide chemical hit the target level, they stop the hypothalamus gland from producing any biologic factors (jam it up completely) which shuts off your pituitary gland. One of the many side effects of this process is a lack of a hormone that tells your testicles to produce testosterone so they quit that, which is the desired effect.
Posted 7/2/2019 2:09 PM (GMT 0)
I just finished a year on Degarelix (Firmagon). I had almost no side effects, which I know is unusual. I believe the usual side effects - hot flashes, fatigue etc. are caused by the lack of testosterone, so I don't think it should matter whether the drop in T was caused by Degarelix or by Lupron. But, given my good experience with the first round I'd rather not mess with a good thing. I will ask my MO to put me back of Degarelix, not Lupron when the time comes for the next round. The monthly shots and monthly trip to the hospital are a nuisance. But other than the first shot, which is a triple dose, the pain is no big deal. It stings the next day, but quite a bit less than the first shot, and then the sting fades over the next few days. It's a trade-off I'll happily take if I have minimal SEs.
Jim
Posted 7/2/2019 5:13 PM (GMT 0)
I get Eligard injections every 6 months in the right hip. I had the second one just two weeks ago and had no issues with either one of them
Posted 7/3/2019 12:27 AM (GMT 0)

Pratoman said...


Just my humble opinion, if i were you, i would ask the doc if you could stay on Degarelix, unless you are switching because you got a really bad reaction. to the first shot.

This is what I was thinking.... I was fishing around for why the change might be taking place.
To late now though, my shot is tomorrow. I have handled the Degarelix very well.

My guess is that the doctor prefers the Lupron for treatment but wanted to avoid the flare as my cancer is borderline.
They even got a PET scan OKed for me which is not generally covered.
Posted 7/3/2019 12:31 AM (GMT 0)
Another question.... do they do monthly blood work? If so, do they do lipids or just testosterone and PSA?

Does anyone ever call to check on you? or once they write the prescriptions you pretty much don't see the doctor again? Who watches your lipids? Should I ask my GP to test them monthly????? I am pretty concerned about cholesterol shooting up as I am already nearly 300 and can't tolerate the meds.
Posted 7/3/2019 2:01 AM (GMT 0)
I imagine that every Dr/facility has a different approach.
At MSKCC my RO did monthly blood tests for T and PSA. i tested lipids every 3 months on my own. It wasnt pretty
Posted 7/3/2019 11:24 AM (GMT 0)

Pratoman said...
I imagine that every Dr/facility has a different approach.
At MSKCC my RO did monthly blood tests for T and PSA. i tested lipids every 3 months on my own. It wasnt pretty

Can you share some detail on the lipids? How high were they to start, how much did they go up each 3 month interval.

I believe we have the same RO.
Posted 7/3/2019 12:55 PM (GMT 0)
Mentor,
If you are being seen by an RO at MSK, ask them to run whatever test you are concerned about. I saw my MO a few weeks ago and had basically the same question. I told her I was getting fed up with all my different doctors wanting me to get blood draws. She said that whatever they want tested, to let her know and she will include it when MSK does my blood draw. Ask your MO. Or RO in your case.
Posted 7/3/2019 1:16 PM (GMT 0)

mentor5959 said...

Pratoman said...
I imagine that every Dr/facility has a different approach.
At MSKCC my RO did monthly blood tests for T and PSA. i tested lipids every 3 months on my own. It wasnt pretty

Can you share some detail on the lipids? How high were they to start, how much did they go up each 3 month interval.

I believe we have the same RO.

RO was Zelefsky.

My cholesterol was ok, never went above 120 (I’m on low dose Crestor), ldl never above 40. But Triglycerides hung around the 200’s for most of the time, then about. Month after treatment ended (February was end of Lupron), about 290, then April, 501😱. Now down to 385 as of a month ago, because pcp put me on meds. Very careful with diet and I’m sure you exercise I did not do that in the beginning
And remember that everyone is different
Posted 7/3/2019 4:11 PM (GMT 0)

Pratoman said...


My cholesterol was ok, never went above 120 (I’m on low dose Crestor), ldl never above 40. But Triglycerides hung around the 200’s for most of the time, then about. Month after treatment ended (February was end of Lupron), about 290, then April, 501😱. Now down to 385 as of a month ago, because pcp put me on meds. Very careful with diet and I’m sure you exercise I did not do that in the beginning
And remember that everyone is different

Yes my RO is Zelefsky too.
My Triglycerides are 80, total cholesterol is 275, LDL 192 ... these are my base numbers.

I lost 8 pounds the first month under DEGARELIX . I'll ask my GP to order a monthly lipid as I won't see my RO until my surgery.... if he does it himself as he said he would. They took blood today before the Lupron but no lipid test had been ordered.

Post Edited (mentor5959) : 7/3/2019 12:00:59 PM (GMT-6)

Posted 7/3/2019 6:00 PM (GMT 0)

mentor5959 said...
Another question.... do they do monthly blood work? If so, do they do lipids or just testosterone and PSA?

I'm in a clinical trial at Dana-Farber but was randomized into the group getting standard treatment with Degarelix. For the past year while was on monthly Degarelix shots I had monthly blood tests including CBC (Complete Blood Count), TSH (Thyroid), and Comprehensive Metabolic Panel including the usual liver function tests, Creatinine test for kidney function, plus sodium, potassium, calcium, etc. However they have not tested for lipids. Now that I'm on break from Degarelix I have monthly PSA and T tests. I'm probably getting more testing than most patients because I'm a lab rat in a study.
Jim
Posted 7/4/2019 12:26 AM (GMT 0)

Hello!

I was on LUPRON initially --- over time, my oncologist saw "spikes and flares" in my PSA, and then began testing testosterone.

In my case, he felt that trying other forms of ADT shots could result in a better stabilization of testosterone, which would then result, hopefully, in better PSA control.

I tried FIRMAGON next --- I experienced site injection reactions --- I would have stayed on FIRMAGON, but we didn't see improvement in the spikes and flares in testosterone, which feeds the PSA.

From there, we tried ZOLADEX --- perhaps not as commonly used as LUPRON and FIRMAGON.

However, it resulted in consistent, low testosterone --- and it has helped me better maintain my health goals in keep PSA suppressed.

No matter which form of ADT shot you might be on, my comrades and brothers, PLEASE simply do one thing --- the next time your doctor places orders for lab work for you, please ask your doctor to add a testosterone level test, to ENSURE that your ADT shot is keeping your testosterone LOW, to help suppress your P.S.A. to the greatest extent possible.

There was a study that I read, indication that doctors OFTEN overlook the testosterone reading, for their ADT shot patients --- many of them are fixated on P.S.A. levels ---

In my case, suppressing the testosterone, by trying various forms of A.D.T. shots, resulted in finding the one that worked best for me, and my testosterone levels CONSISTENTLY have stayed below 7 for a few years now --- which was not happening with Lupron or Firmagon, in my particular case.

Make certain your doctor, along the way, is tracking testosterone levels --- in my case, it made a crucial difference in finding the ADT shot which seemed to work best for me. I have no pain or tenderness following my ZOLADEX injection, thankfully --- it is injected into the abdomen.

I'm thankful for an oncologist who was willing to think "outside the box" --- my original urologist REFUSED to try anything except Lupron --- my oncologist is now the lead "quarterback" on my medical "team" --- he has seen windows, where others saw only closed doors. That's the doctor that I needed, in my case.

We're all in this together, and the sharing of experiences is exceedingly valuable here!

With my best,
CYCLONE ~ Iowa State University
Posted 7/22/2019 9:51 PM (GMT 0)
Just thought I'd update. This Lupron is no fun. I did much better on DEGARELIX.

With Lupron I have
hot Flashes all day long. In ice cold rooms with the vents blowing on me.
My legs ache. My teeth hurt. I have had pain in stomach, pain in testicles.
And the dizziness is no joke. I just went down.
I had to go to the ground (I did not pass out, I never have from anything) because I became so light headed. I could bearly sit through church, standing was hell.
I am exhausted but can't sleep!

And my eyes. All kinds of flashes and terrible retained vision. Heavy duty floaters.

also, heart flutters.

I have not gone into full blown tachycardia yet but it's right around the corner...


I did so much better with DEGARELIX.

Is it just that ADT gets worse and worse as time goes on or is Lupron just so much worse?

Post Edited (mentor5959) : 7/22/2019 4:17:55 PM (GMT-6)

Posted 7/23/2019 1:16 AM (GMT 0)
Have you mentioned this to your Dr? Those side effects don’t sound like the typical Lupron experience to me. The hot flashes yes. And they are probably more intense now because it’s a while now that your T is depressed, rather than the switch to Lupron.
But the heart flutters, dizziness, achy legs, and teeth...that’s a severe reaction. Ask your Dr, there may be supplements or prescription meds that could help
Posted 7/23/2019 2:51 PM (GMT 0)

Pratoman said...
Have you mentioned this to your Dr? Those side effects don’t sound like the typical Lupron experience to me. The hot flashes yes. And they are probably more intense now because it’s a while now that your T is depressed, rather than the switch to Lupron.
But the heart flutters, dizziness, achy legs, and teeth...that’s a severe reaction. Ask your Dr, there may be supplements or prescription meds that could help

Who is my doctor? The RO is way to busy to bother... last time we spoke he did not even know what he was treating me with. Twice we have talked and both times he forgot we already spoke.

I have kind of enlisted the help of my nephrologist, (as a result of a dangerous test result at the end of teh first month ADT) and my primary care guy because of what I have read about the effects on cholesterol but in the end, no one knows anything out of their field. I just feel like no one is leading my team. It's like I was plugged into the system and away I went.

BTW, most of what I am experiencing I have seen attributed to ADT therapy in post market studies. (except for eyes)

The horrific eyes problems I had prior, the ADT therapy is simply inflaming the problem. But as I said, it did not until I was changed to teh Lupron.

I take it that no one has seen a continued increase in problems arising from ADT therapy so it's more likely the Lupron does not agree with me as well?????
Posted 7/23/2019 3:01 PM (GMT 0)

Bohemond said...
I just finished a year on Degarelix (Firmagon). I had almost no side effects, which I know is unusual. I believe the usual side effects - hot flashes, fatigue etc. are caused by the lack of testosterone, so I don't think it should matter whether the drop in T was caused by Degarelix or by Lupron. But, given my good experience with the first round I'd rather not mess with a good thing. I will ask my MO to put me back of Degarelix, not Lupron when the time comes for the next round. The monthly shots and monthly trip to the hospital are a nuisance. But other than the first shot, which is a triple dose, the pain is no big deal. It stings the next day, but quite a bit less than the first shot, and then the sting fades over the next few days. It's a trade-off I'll happily take if I have minimal SEs.
Jim

When did you actually talk to your doctor?
Let me explain. I went in, my protocol was set and that was it. I have been rather surprised at the lack of follow up and I have no appointments to see my actural RO.I have surgery tomorrow and I am wondering who will actually perform it.

Did anyone ever ask you how you felt after the first month? (I did have blood tests but no LIPIDS)
I did great the first month on Degarelix but protocol had already been set that I would be changed to Lurpon (which is horrible). And I got a 3 month shot so I am stuck on it.
Posted 7/23/2019 3:21 PM (GMT 0)
“last time we spoke he did not even know what he was treating me with. Twice we have talked and both times he forgot we already spoke.“

Back in March I got my first Lupron shot and I started Xtandi two weeks later. My MO scheduled a PSA test at five weeks to guage my early response to the drugs. At the office visit he noted how pleased he was with the strong drop in PSA and suggested I also start on an oral medication called Xtandi and he began explaining the medication. His assistant and I looked at each other and I interrupted...um... we've had this conversation and I'm already taking Xtandi. The MO smiled and said he was smarter than he thought (by already having me on Xtandi).
Posted 7/23/2019 3:33 PM (GMT 0)

mattam said...
“last time we spoke he did not even know what he was treating me with. Twice we have talked and both times he forgot we already spoke.“

Back in March I got my first Lupron shot and I started Xtandi two weeks later. My MO scheduled a PSA test at five weeks to guage my early response to the drugs. At the office visit he noted how pleased he was with the strong drop in PSA and suggested I also start on an oral medication called Xtandi and he began explaining the medication. His assistant and I looked at each other and I interrupted...um... we've had this conversation and I'm already taking Xtandi. The MO smiled and said he was smarter than he thought (by already having me on Xtandi).

Well, you did better than I. You had an office visit!
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