There is an initial flare in testosterone levels with the Lupron type drugs (Eligard, Zoladex, etc) whereas there is no testosterone flare with Firmagon. The Lupron type drugs are agonists whereas Firmagon is the only FDA approved antagonist. An agonist produces an action whereas an antagonist opposes that action.
Common practice, at least where I live, is to give Casodex (bi-calutamide) pills prior to receiving Lupron injections to lessen the effect of the testosterone flare. Uncommon practice is to use Firmagon to reduce the flare and then switch to Lupron. You might want to ask your oncologist why you didn't remain on Firmagon until your testosterone reached its lowest nadir and then switch to Lupron. It takes two or three months to become completely castrate. Hope that helps.
Why were you switched to Lupron (Leuprolide) from Firmagon (Degarelix) ? Firmagon would seem to be better for long-term PSA and Testosterone control. See study below where people were switched the other way to their benefit.
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PSA on the rise
Slight PSA Rise
Still on Vacation
First PSA Three Months After Starting ADT Vacation
PSA rise from initial Pluvicto treatment
