How critical is the 6 months for a Lupron Depot infusion?

[Papa1]

I am scheduled for a 6 month Lupron infusion on Monday and my wife just tested positive for Covid-19. I presume I’ll be unwelcome at the Hospital. How critical is the timing?

[Tall_Allen]

Very critical.

[Papa1 in reply to Tall_Allen]

Thanks.

[6x942 in reply to Tall_Allen]

I don't get it. Cancer feeds on T and lupron inhibits production or utilization of T. I have read that T takes months to recover from ADT so why is it so time sensitive to get a shot exactly on time?

[Tall_Allen in reply to 6x942]

(1) Because Lupron is a GnRH agonist. It forces a surge of testosterone at first - it's not a problem if the Hypothalamic-Pituitary-Gonadal axis is shut down, but if not, it can cause problems. (2) And also, we have learned that keeping T < 20 ng/dl is optimal, so even if a delay allows it to rise over 50 ng/dl, it is not as good.

[Atdabeach]

Surprised to hear TA's response. I have no real knowledge here, other than my MO, in scheduling my next 3-month Eligard, was unconcerned about doing it a few days later than the 3-month window. I've always been a bit skeptical about the precision of a "time release" medication lasting 3 or 6 months. Bear in mind that a week late on a 6-month injection is less than 4%. But obviously, call the doctor/hospital and see what they say to do.

[StePeteMN in reply to Atdabeach]

Timing of a first shot is way more critical than subsequent shots

[rsgdmd]

My MO also didn't have a problem with my 3 mo. Lupron shot being a week late.

[StePeteMN in reply to rsgdmd]

Timing of a first shot is way more critical than subsequent shots.

[swwags]

I'm not a doctor and I'm not offering clinical advice. Follow your doctors direction.

If you have covid, wait, unless your doctor says don't wait. Get the injection as soon as you can.

It helps you if you understand what Lupron is doing in your body.

When Lupron is inject into your body, it initially stimulates the pituitary gland to release hormones that stimulate the gonads (tested in males) to produce sex hormones (Testosterone). However, this initial stimulation is followed by a prolonged suppression of pituitary gonadotropins, which ultimately leads to decreased secretion of gonadal steroids (testosterone). As a result, the tissues and functions in the body that rely on these hormones become "quiescent" or inactive.

OK so then what you ask?

The drug is released from the injection site at a constant rate, leading to steady-state levels in the third week after dosing. The average plasma concentration of Lupron declines gradually over the following weeks, and by 12 weeks, it falls to near the lower limit of detection in the body.

So what does this mean for me does my body start making testosterone EXACTLY on the 121st day after my shot?

Seems silly to say yes. We all have different metabolism. The point is regular injections allow Lupron to do its job and avoid that initial stimulation of testosterone that you get with a shot. The timed release stays constant.

[chefjlu]

There is an importance to getting things underway. However, talk to your doctor about possibly having a Firmagon shot first for an initial month. Unlike Lupron, Firmagon does not cause a flare up or rise in Testosterone after the initial shot. A little uncomfortable for a couple days, but T will drop immediately.

[j-o-h-n]

Get a covid test..... if negative I don't think the hospital will care if you kiss all the nurses (only good looking ones).............

Good Luck, Good Health and Good Humor.

j-o-h-n Monday 05/01/2023 12:27 AM DST

[Papa1]

Bottom line.

New hospital guidelines per CDC: Mask required only if positive test or symptomatic. On call doc I spoke to yesterday said feel free to come in today for my appointment following that guideline. Negative test yesterday and this am. Went in with NIOSH certified N95 mask. Did blood work, Lupron infusion and saw MO.

BTW, PSA still <0.1. 😀

[Derf4223]

If you are due to get a shot, go to the hospital and advise them up front you might have been exposed to Covid. You will see caregivers with KN95 masks, maybe gloved. Don't assume you'd be unwelcome.