Any Problems Transitioning from Firmagon to Lupron

[TEBozo]

The 4 knots under the skin on my belly suggest I might try a 3 month Lupron shot in 24 days. The monthly Firmagon shots are seemingly scarring me. Any reason not to? Increased SEs?

[FCoffey]

I have no direct experience with Firmagon, so I can't speak to increased side effects.

I do know that Lupron has some pretty significant side effects, what my oncologist characterized as "multiple grade 3 toxicities." Those are graded 1 to 5, with one being a major annoyance that requires treatment, and 5 being dead.

She told me that I was unusual in that many men had some side effects from Lupron, but I got pretty much all of them. So I might not be a good example.

If the bumps from the subcutaneous injections are worrying you, know that they go away in time. I've been giving myself sub-Q injections for years. Sometimes my abdomen looked like I had been stung by a bunch of wasps. Now it is back to its washboard 6-pack. Seriously, no bumps.

If the firmagon is working for you and the bumps are your only complaint, consider sticking with it for a while. Changing drugs can help, but change can also be for the worse.

Good luck!

[Longterm101]

How long have you been on firmagon

[TEBozo in reply to Longterm101]

4th shot last week. 14 to go

[joeguy]

I have used both Firmagon and Eligard (Lupron) injections over the last 2.5 years. There are advantages and disadvantages to both. Your will have the bumps from both the injections....... it is supposed to form into what they call a "depot" under the skin, and then be slowly absorbed over a month or 2. For me the Firmagon works better at keeping my PSA down (somewhat), but the Firmagon injection causes a very painful reaction on my belly that leaves me red, swollen, and hurting for about 5 days after the injection (Eligard doesn't do that). But, Eligard can cause more cardio problems than Firmagon, so I deal with the monthly pain from the Firmagon.

[TEBozo in reply to joeguy]

I'll deal with it, too. Thanks men

[Hirsch in reply to TEBozo]

You want to switch as I did. One shot of firmagon 2 years ago still shows as a scar. Give me a call and we’ll talk. J

Hope the rads are going well

J

[efsculpt]

I have had both. When I researched both, two years ago, the Firmagon seemed a bit more effective as far as keeping PSA down. Yes I did have the hard, sausage areas on my stomach with Firmagon. Sore. I switched to Lupron/Zytiga.

Good luck,

Craig

[Tonyliv]

I switched from firmagon, which was leaving me sore and inflamed, to 12 weekly shots, which which I found better. A big plus is the psychological effect. I was obsessed every 4 weeks with micro psa movements; you regain more of your life back when its not dominating your time.

[EdinBmore]

Good questions.

My experience> I had one month of Firmagon and have had 3 Lupron injections; each of 3 mo duration. Same reaction to Firmagon as yours - very sore belly - redness, soreness size of my hand on each side of my navel. Ouch. Also "the lump." And, both produced numerous side effects; none of them pleasant. From a roller coaster of emotions, to physiological changes too numerous to list.

My docs recommended switching from Firmagon to Lupron as part of their normal protocol (it wasn't done to mitigate the side effects of Firmagon). Apparently, one drug is an agonist (Lupron) and the other is an antagonist (Firmagon). While they both reduce T, they do it differently (no MD here so I don't pretend to understand the chemical and physiological reactions occurring). And, with Lupron, apparently there is a greater occurrence of a testosterone "flare;" considered a bad thing. So, by beginning with Firmagon and then switching to Lupron, the goal was to reduce the likelihood of a flare. My understanding is that the drugs are given to accomplish the same goal - reduce T and thus starve the PC cells or slow their ability to replicate - but they work differently and can have different side effects. Btw, Firmagon is monthly; Lupron is available in 1, 3, 4 and 6 mo doses.

I had my last (god, I hope) Lupron 3 mo duration injection in May. I hope that, by the end of the year, I may begin to feel more "normal" as the testosterone production begins to occur. Whether it reverses the effects of ADT seems unknown (I've gotten various opinions from "yes, you'll return to your pre-ADT self" to "let's wait and see, everyone is different").

Unless there are good medical reasons to remain on Firmagon, I'd switch to Lupron; if, for no other reason than you can choose the dosage/duration of Lupron. I felt that a 3 mo duration was all that I could tolerate; it gave me a feeling of being in control. And, over time, I've gotten "use to" the drug's effects and can tell myself, "oh, that's just the drug making me react this way."

So, good luck to you and your decision.

EdinBaltimore

[gamemaster34]

I started with firmagon for 1 month and have been on lupron 2 months now. Will receive another 3 month shot of lupron at the end of July. Lupron was given in the hip and did not swell like di the firmagon shot . The only side effects I have had with lupron is fatigue at times and hot flashes. I am also on zytiga. I will start radiation on Monday. This is the path that I am on. We have had good results so far. Hope the good results continues. I have learned from this site that there are not many MOs that recommend the same path. That's not a bad thing. Everyones situation is different. Stay positive and keep on fighting.

[Joes-dad]

I'm at the same point in making a decision. I went from monthly Firmagon to 3-month Elligard when I was about to start my IGRT. My stomach has numerous bumps that cause a sharp stabbing pain for minutes when I bend over in a certain way or wrestle with my dog on the floor. Since the bumps do not seem to be going away, I can only see it getting worse as time goes on and I continue to get the injections. I'll be switching to Lupron injections in my hip area for my next injection. I'm not sure if it's a "out of the frying pan and into the fire" situation but I'm giving it a try.

Bob

[TEBozo in reply to Joes-dad]

Bob, keep me posted? Thx

[Hidden]

No problems for me!

[monte1111]

6 month Lupron injections from the beginning. Next one in a week. Over 2 years now. Hip is sore for a few days. Stay off of bikes etc for a few days after shot. One very uncomfortable experience and narrowed it down to that.

[GeorgesCalvez]

I have been on Firmagon since the end of March 2018 which is fifteen months.

The first injection caused a fairly strong reaction, I felt very tired that afternoon and there was quite a lot of inflammation.

Subsequent injections caused more inflammation and I took quite a lot of ibuprofen in the days after the injection to control it.

Now the inflammation is minimal.

I am thinking of stopping the Firmagon in September so that by the end of October I will have had nineteen months worth.

Is Firmagon better than Lupron?

Hard to say, Firmagon may suppress FSH and testosterone more than Lupron so it may be more effective as a drug taken in association with radiation but it may be harder to recover from the effects of Firmagon after a long period.

Experiences do vary, some men recover more than others after ADT.

Eighteen months can result in permanent castration as the hormonal systems just go into permanent hibernation.

Here's hoping that I will recover something!

[TEBozo]

Calvez, LA docs say they dont mind revving up testosterone after 18 months by providing supplementation