different ADT medications

[mediocra]

Is there any known difference between the various ADT injection meds in terms of efficacy and side effects? My dad's new oncologist is switching him from Lupron to Trelstar, not sure why. Just haven't seen that name come up too often on this site. Thanks

[Tall_Allen]

He is probably switching your father because there is currently a Lupron shortage. Trelstar (triptorelin) and Lupron (leuprolide) do the same thing (as does Zoladex (Goserelin) and a few others). They belong to a class of medications called Gonadotropin-Releasing Hormone (GnRH) agonists. They work by hyperactivating the gonadotropin receptor in the pituitary. That causes the testes to secrete a lot of testosterone. The testosterone surge then causes the GnRH receptors to down-regulate, shutting off all further secretion of testosterone. This is called "negative feedback." The nice thing about Trelstar and Lupron is that the shots can be made to last for several months.

Firmagon (degarelix) is a direct GnRH antagonist, so there is no testosterone surge at the start of therapy that could aggravate metastases. The downside is that it is only available in monthly injections. Sometime next year there may be daily GnRH antagonist pills called Relugolix.

[mediocra in reply to Tall_Allen]

Thanks for the clarification!

[Haniff in reply to Tall_Allen]

👍🙌

[VictoryPC in reply to Tall_Allen]

Well said...

[Hidden]

Here's a head to head comparison of the two drugs.

pubmed.ncbi.nlm.nih.gov/128...

Bottom line: check testosterone and make sure it is at castrate level.

[mediocra in reply to Hidden]

Thanks for the citation

[depotdoug]

I got switched to ELIGARD on my Sept 18th 90 day injection. No choice. Lupron depot is short supply still is.

Tgey my oncologist assured me it does the same is the same as lupron.

Said tgey inject it in your stomach.

I opted for injection in buttocks. They said it will hurt the same. Id prefer a sore but to a jab in stomach.

So far same exact SE’s with Eligard...

[leo2634 in reply to depotdoug]

I've been getting jabbed in the stomach for almost three years now with Eligard and Xgeva its not as bad as it sounds. They administered the shots just like an inch or so under the skin. I found its who gives you the shot that matters. Leo

[treedown in reply to depotdoug]

I just got switched to Eligard but was assured it was fine at the same site on my backside as Lupron. I switched cheeks each time.

[depotdoug in reply to treedown]

Yes sir. Thats what my infusion injection med oncolgist RN told me. Butt or stomach it does sting for a while. Try driving back home 120 miles with a sore butt.

[treedown in reply to depotdoug]

I agree, a definite heat, sting, but I rode 21 miles on my bike after the shot and by the time I was done nothing. Lupron was achy until the next morning but none of that on Eligard. I did feel off for a couple days unlike Lupron but am fine now.

[monte1111 in reply to treedown]

A new meaning for turning the other cheek. I was told I was going to get an injection into my stomach. I'm sure I turned a little green. But it's just into the belly fat. Subcutaneous. By far the easiest of all the injections, infusions, jabbing and harpooning that I've gone through. Prostate biopsy belongs in one of the circles of hell. For now my blood test and Xgeva shot are every 3 months. Lupron shot every 6 months. My lower back pain is seeming to go away for some reason. The best of times, and the worst of times. I wish everyone the best of times. Enjoy.

[treedown in reply to monte1111]

Funny and correct. For some reason the idea of getting it in the stomach was not appealing to me at all, not sure why. I agree prostate biopsy by far the most invasive thing ever endured. The upside, everything that came after as a breeze. I had a slight lower back pain on the right side for many years, I could stretch it out so never worried. I also could not drive long distances because of a thrombosis like pain in my legs. Both are gone now. Could equally have to do with the weight I lost but I am counting it as a win to treatment either way because I doubt I would have lost the weight w/o the dx.

[Pianodude]

I am on Firmagon which is doing the job. My MO wanted to switch me to Lupron, I declined. Call me superstitious, but if something isn't broke, why fix it.

[Rocketman1960]

Last visit Sept 22. They switched me to 6 mo Eligard due to Lupron not being available in 6 month injections. They gave the injection on the back side of my upper arm in the soft tissue area not muscle as would be the case with Lupron. It leaves a Ben size bump under the skin which releases the medication over time. The first few days were very different than the usual Lupron injection but things have calmed down.

[depotdoug in reply to Rocketman1960]

That sounds like the way to go. Upper arm muscle. What was different for a few days with Eligard release over time??

[Rocketman1960 in reply to depotdoug]

A flush feeling. A bit disoriented. Like needed to sleep badly. I was fortunate to be able to drive home. It cleared up after a few days.

[j-o-h-n]

I keep getting mine in my earlobe... but still no pierced ear....damn it.........

Good Luck, Good Health and Good Humor.

j-o-h-n Wednesday 09/30/2020 4:53 PM DST

[depotdoug]

Agree prostate biopsies are not an enjoyable day on your side. Getting probed and specimen tissue grabbed.

Worst pain in the Urology organ area was not one but two DVIU’s ( direct vision internal urethra reamming. DVIU’s were a futile attempt to unblock my IMRT urethral stricture. Good news i was put to sleep. Thank goodness for anethesiologist...