Firmagon doseage

[Spyder54]

Hi guys. Now 7 months on Firmagon injections monthly. Start at 240mg, then 80mg each month thereafter. Also on Zytiga+Prednisone. Having hard time getting PSA much below 4.0 (from 47 last Oct). Tried Xtandi at month 2&3=failed. Now Zytiga months 4,5,6,7. Question: if I am 6’0” 228lbs can we up the doseage to 100mg to kick down the PCa into Sennescence? Why would one size fit all? A160lb 5’6” man gets 80mg. Why wouldn’t I need/handle more?

[Tall_Allen]

While some medications are size-dependent (e.g., chemo), others aren't. Firmagon is a GnRH antagonist. GnRH is produced by the GnRH-producing neurons in the hypothalamus. Those neurons do not increase with body size.

[tango65]

If your testosterones is less than 20, Firmagon is doing what is supposed to do. If that is the case, I believe a higher dose will not make a difference in the treatment of the cancer.

[Spyder54 in reply to tango65]

My T is a strange paradox. Here in St Pete. It was down to Zero% late Dec 2020. Then up tp 14.1 in Jan, 15.5 in Feb, then at MD Anderson <3 In March. 10 days later, 26.2 in St Pete. Mid April 2021 back to <3! 2 days in a row (retested for error=accurate). Then on May 5th (10 days later, 24.2 here in St Pete. My guess is a difference in testing method between MD Anderson and St Pete URo?

[MateoBeach]

That is very strange. Differences in testing methods might give mildly different results at different labs, and their reference ranges should reflect that. But not produce such wild swings in testosterone (total, not calculated free). Should not be that variable. Make sure there is not an exogenous spurious source (lotion, gel or some concoction). Then perhaps have two test vials drawn at once and send to both labs to test.Firmagon effect should be very steady. It does not wear off in just one month.

[Spyder54 in reply to MateoBeach]

Firmagon was working great 1st 2 months then added Xtandi for month 3&4. Switched to Zytiga+Prednisone month 5 to present. Almost wish I’d stayed on Firmagon only. As TA says, fight the PCa, not PSA. Somewhat better but not great. That is when T shot up, and PSA flattened off.

[MateoBeach]

You could also test for gonadotropins from the pituitary FSH and LH, which should be near zero. If not consider a pituitary adenoma? not that rare.

[tmfo]

Because nothing is ever simple, as with the 2 different names for each drug, there are 2 different measures of T. My husband was aiming to get his below 0.7 but in many of the articles I read they also say it needs to get below 20. Obviously, these measures cannot be the same. Can anyone explain the difference? is it free and total or just a different type of measure.

[Seasid in reply to tmfo]

In Australia up to 1.7 is considered castrate level. In USA 50 is the same as in Australia 1.7. different units. My testosterone is between 0.3 to 1.35 in Australia.

Testosterone 20 in USA is equal 20/50x 1.7= 0.68 in Australia

50 in USA is equal 1.7 in Australia.

Hopefully it helps a bit.