Can i switch to Eligard from Firmagon ? - Advanced Prostate...

Advanced Prostate Cancer

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Can i switch to Eligard from Firmagon ?

mynacho profile image
23 Replies

I am 1 year since dx.I am metastatic PC so no surgery or RT was made.I have been on Firmagon monthly shots for a year and my PSA is less than <0.06 ( that is as far as Weill Cornell measures and they do a blood test every month ) I had my last shot yesterday and had a slight fever and muscle pains today. My real question is I will be traveling overseas in a few months and my onc told me they can do a 3 months Eligard shot instead of Firmagon so I can travel with no worry.Apparently they do it from buttocks.Has anybody switched from Firmagon to Eligard ?? Which one is less painful ? Also I read bad side effects for Lupron and Eligard such as depression ,bone fracture etc so I am a little skeptical .I would appreciate any input on this.Also I am on a low dose Erleada daily tablets and I give 1-2 week break every month with my onc's consent.It helps me with bone/joint pain ,rash and canker sores.I wanted to share that with other patients

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mynacho profile image
mynacho
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23 Replies
6357axbz profile image
6357axbz

Yes you can switch

tango65 profile image
tango65

You can switch. My experience is that Lupron in the buttocks is less painful than Firmagon in the abdomen. Firmagon can also cause the problems you described for Lupron.

Infor from the FDA:

accessdata.fda.gov/drugsatf...

accessdata.fda.gov/drugsatf...

Tall_Allen profile image
Tall_Allen

It's very common to switch. Most of the side effects are caused by low testosterone, so it doesn't matter which you take.

mynacho profile image
mynacho in reply toTall_Allen

Thank you Tall_Allen. What if I miss 1 month ?My MO strongly opposes but I read some trials some people take Firmagon shot every 3 months (120 mg vs 80 ) and also that the suppression actually lasts 45 days even with the single dose.Also I would like to get a PSMA but with the undetectable PSA they will not see anything so maybe I thought I would let it increase a little ( remember I still have a prostate ) My MO says why would you feed the cancer ?? What is your intake on that ?

Tall_Allen profile image
Tall_Allen in reply tomynacho

The only reason to have a PET scan is if it could possibly make a difference in your treatment. Why would you risk letting your cancer progress just to satisfy your curiosity?

Jac_J profile image
Jac_J

Some interesting responses here. Particularly in the method of administration.

Firmagon is often used initially to prevent Testosterone flare which would occur if you inject a Lupron (like Eligard) initially. Then (in Australia anyway) the patient (me) might switch to Eligard for subsequent T reduction.

Like others I did get an initial reaction from Firmagon. Nothing major. Skin irritation etc. Eligard still has a slight irritation effect for a few days. Its no big deal.

I personally injected myself with Eligard a few weeks ago because I was away from my Dr and it was just the most convenient thing to do. You have to mix the solution between 2 syringes for 40 seconds before injection. Its simple to do.

The instructions below detail that it is to be injected subcutaneously, NOT intramuscularly. It does say 'Australian Product Information' but I doubt this would be done differently in other regions. Correct me please if there is information to the contrary.

Eligard Instructions
dhccpa profile image
dhccpa in reply toJac_J

Yes, Eligard is injected more like Firmagon than like Lupron.

Seasid profile image
Seasid

Do you have hot flashes on Firmagon?

Dannyboy48 profile image
Dannyboy48 in reply toSeasid

Yes

Seasid profile image
Seasid in reply toDannyboy48

I don't have hot flashes now after being 4 years on it. Maybe I had some hot flashes at the start but not anymore. You could inject it yourself.

garyjp9 profile image
garyjp9

Hi, what doses of estrogen patches do you use? How long have you used?

My six month Eligard shot was in the fat over my belly. Not painful if the nurse is experienced and takes her time. I did have a bit of a reaction so I'm glad my wife was driving. I think it dropped my blood pressure. I was a little unsteady until the next day.

Seasid profile image
Seasid

Did you call Firmagon? Ferring?

Jac_J profile image
Jac_J

Yes from memory that lump was prominent and sore.

I’m not really supposed to self administer. My general practitioner Dr injects me after I purchase from a pharmacy. I was away on holiday so it was easiest that I do it myself.

Still thinking almost ever day about BAT. I think in a couple months I start.

binati profile image
binati

Taking a Firmagon or any other subcutaneous injection yourself is not a problem. I took them myself from Aug 21 to Feb 22. Had no problem really. The reaction - slight red bump, fever for 2 days and feeling of slight weakness was there as always.

Seasid profile image
Seasid in reply tobinati

From Firmagon I only have fever occasionally. I am getting the injection at 8 am and the fever could start at 5pm to 7pm, but next day morning I am always fever free. I hope that they are injecting it deep into the fat tissue. I went to the ER at the start and the doctor said that fever occasionally can happen with injections. Her concern was that my injection site was warm. Next morning I was fever free. I believe that if the injection of the Degarelix is very slow at 45° deep into the fat tissue than the injection site should not be warm. I am getting Firmagon four years long.

Seasid profile image
Seasid

Maybe. I am getting Firmagon injections four years long. They should change the injection site and should do it at 45 ° angle. It is a depot injection. If you have a real bump than they are not injecting it the proper way. You can find the educational video about how to inject Firmagon on the Ferring internet site. I hope that they are injecting it properly. Otherwise it is possible to get the bump. Check the video:

google.com/search?q=firmago...

binati profile image
binati

Yes I was on it for 30 months. Invariably got 36 hours of fever- low grade - some pain for 24 hours. I tried all permutations of 45 degrees to 90 degrees with slow injection and withdrawal after 30 secs of injecting. Always had the same side effects so I started injecting myself.

Seasid profile image
Seasid in reply tobinati

90 ° is not good. Than I get a bump.

binati profile image
binati in reply toSeasid

Got it with 45 deg as well. No clear conclusion. Now I'm off it for 4 months. Keeping my fingers crossed that EBRT plus ADT will give me a few years respite. Gleason 10, PSA-250, SVI, PNI but no spread ie. metastases - PSMA Pet CT.

Fightinghard profile image
Fightinghard

Either drug should work to hold down testeroneThey offer 1 month, 3 month and 6 month doses. The 3 month does seems to be preferred by my Drs

Lupron should be injected into muscle. Thats why the butt is preferred. Elegard usually into belly fat layer.

Get a shot and enjoy your trip.

I would think hard before to an ADT vacation. Why risk letting the sleeping monsters wake up angry??

Seasid profile image
Seasid

I feel you. With Firmagon injections it is always a problem, but they are very effective especially for me as I have lots of mets in my spine.

Seasid profile image
Seasid

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