Orgovyx vs. Lupron?

[CocoTheAlphaCat]

Saw a 2021 article about Orgovyx being potentially superior (more effective, potentially fewer heart issues, and pill form instead of a shot) to Lupron, and wondering if any advanced PC patients here have been on that instead of Lupron.

[KocoPr]

I was on lupron for 3 1 month shots then did a 3 month shot and I couldn’t walk straight for a few weeks till my chiropractor straightened me out. Been on Orgo for a year now and started darolutamide at same time as well as 10mg each of Osterine and Cardarine so I really can’t quantify if Orgo is superior to lupron except no more doctor visits and no more back pain.

[rfgaus in reply to KocoPr]

Same results. The 1 month Lupron Injections were tolerable but the 3 month knocked me out. Debilitating back pain, significant hot flashes, and energy level plummeted to near zero for about a week or two. Fortunately, my Urologist has a well-staffed "Health Navigator" program and with documented reaction to Lupron was able to get Orgovix approved by my insurance. No week + of back pain and energy levels and hot flashes definitely seem to be more manageable on O for me.

[GSDF]

I've been on Orgovyx for one year, prior to that was Firmagon... Orgovyx is essentially the same as Firmagon but in pill form. What a convenience! Firmagon and Orgovyx are LHRH antagonists where as lupron, eligard are LHRH agonists. They basically do the same but by different mechanics....

Firmagon and Orgovyx lower testosterone levels more quickly and don’t cause tumor flare like the LHRH agonists and are less stressful on cardiac system... Also, testosterone recovery is reported to be much quicker with the cessation of antagonists than the alternative agonist LHRH drugs too.

[Bret5]

One of the issues with Orgovyx is that it’s newer and more expensive therefore my United Healthcare / CVS private insurance would not approve it and I ended up with Eligard (similar to Lupron). I’m definitely planning to ask my Doctor to evaluate a change once I hit Medicare on Nov 1.

[Concerned-wife in reply to Bret5]

Expensive on Medicare too but covered. You can go to medicare.gov and input your drugs to see what it will cost you.

BTWHave you studied which Medicare plan you will buy? If not, this is a good time to do so

[Bret5 in reply to Concerned-wife]

Yes, I’ve been studying this topic for awhile. I’ve already done a contract for supplement plan G. Also, good news is that under the inflation reduction act, part D drugs will have an out of pocket cap in 2024 of around $3500 and for 2025 and beyond of around $2400. Under old / current law would have been around $7500 for my Nubeqa alone.

[jackwfrench in reply to Bret5]

My MO says Orgo/Nubeqa have not been examined to be useable together, although my Rad Onc says he would prescribe if I want -

[SimMartin]

U.K. NHS can’t supply it as NICE refuse to approve its use in PCa due to cost/ benefit equation - I understood that Europe and US Do

[Amadeus71]

I started treatment in January 2022 with Lupron. SE's such as hot flashes were very noticeable. Oddly, it was an RO that strongly suggested I change to Orgovyx. Made the change in May 2022 and still taking it. When I made the change, I noticed that hot flashes became fewer and less intense.

[jackwfrench in reply to Amadeus71]

It does seem the ROs are more likely to prescribe Orgo though Hopkins and Sloan MOs say the long term performance is not yet proven and won't prescribe it.

[Tigger2022]

My husband has been on both and vastly prefers the Orgovyx. He feels less achy & less depression with it.

[Lewellen]

After close to 2 years on lupron I'll be switching to Orgovyx later this year. I'm setting myself up for what I hope will be a nice long vacation 👍I'm in the US and on Medicare, but since I'm also on Medical Assistance, my costs are zero.

The first time I asked my MA about Orgovyx, he looked puzzled and had to look it up! But that's only because it's referred to as

[jackwfrench in reply to Lewellen]

About to start Lupron w Abi- My med onc wont prescribe Orgo because track record not ling like lupron- hoping after this first 3 mo shot he or someone else will consider letting me switch. Gathering any and all info I can about this to improve QOL for what I have left- input welcome!

[Lewellen]

Relugolix over here!

[Explorer08]

I was on Orgovyx for 55 weeks. Worked very well. Side effects virtually non-existent except for some residual weakness toward the end of the course of medication. I will have to resume Orgovyx early next year. My co-pay was $72.30 per month under United Healthcare/OptumRx drug plan - - delivered by mail each month.

[dhccpa]

I decided to stick with Lupron, almost 5 years now. On Medicare with supplement, Lupron is much cheaper than pills through the Pharmacy plan ripoff.

[SeattleDan]

I’ve been on both and for all the reasons named above, I like the O far better. If persistent and not earning much of an income, one can get it free from the manufacturer.

[CocoTheAlphaCat]

Wow--thanks for all the useful feedback, brothers!

[JRPnSD]

Yep...did 18 months of Orgovyx. Worked well for me. Less cardiac issues per mfg.

[TMcgee]

Love your post! I have never heard of Orgovyx; which isn’t a surprise, I had never heard of Lupron until a year ago. Now, your post raises a whole lot of questions to include:

I am mCSPC and am always wondering what’s next. Since Lupron and Orgovyx work differently, I’m wondering if Orgovyx would be a viable option as a next step to Lupron?

Is there any discussion about Orgovyx being offered as an injectable? The issue being an injectable is covered by Medicare, while pills have separate co-pays.

I read that (in women) one of the side-effects is bone density loss, which limits use to 2 years. Is bone loss applicable here?

That’s enough. Thanks again for post!

[KocoPr in reply to TMcgee]

Never heard of O as an injectable.

Any ADT that blocks testosterone and or aromatase will lead to bone loss by way of less or non existent estrogen. You should get your E2 tested quarterly when they test your T and PSA. Your E2 for PCa warrior’s ideally should be between 20-30pg/ml. Below that you will feel bitchy, skin malodies, and unknown to you feeling it till it is to late is lower bone density. Get a low dose estradiol patch for E2add back.

There is plenty of info on this sight and pubmed

[jackwfrench in reply to TMcgee]

I am in your camp! I have mult spots and likely will be on HT forever and so one concern is how long can stay on orgo vs lupron which is known to often work many years. Eager to continue to build my case w my med onc w any useful information!

[Teacherdude72]

I have been on monthly Luoron for several years and Nubeqa for over two years. No pains other than my arthritis in joints. I choose monthly because I feel longer months wear out. One of my medicals agrees.Diagnosed 2015, G9, aggressive, radiation & HDR only.

Only issue is energy sucks. Gym time or hard work in yard of carpentry.

[jackwfrench in reply to Teacherdude72]

Hello - by "longer months wear out" what exactly do you mean? Thanks

[Teacherdude72 in reply to jackwfrench]

The few times I had the longer month shot I stopped having hot flushes and gained some energy. When I mentioned this to a PA she agreed that the monthly shot seemed more effective.

[jackwfrench in reply to Teacherdude72]

So longer month means "more months than 1" -I guess and your PA agrees that the efficacy of it drops off since the hot flashes are down and energy up (which is other than efficacy maybe a good thing? - seems tough to quantify.

Some people complain that they are listless and painful in the first two weeks after the shot - I surmise you do not experience that? My MO cant get the 1 month and wants to start me with the 3 month. (thanks)

[Avanat]

My husband (Stevana on this site) has been on Orgovyx since March, 2021, when the FDA approved it. The makers of Orgovyx will help offset the cost. There was some paperwork that had to be filled out but he pays a very nominal fee. He has to get reapproved every year but it’s not a very cumbersome process and well worth it! It’s so much easier and convenient taking pills than getting shots. As far as side effects, to him it’s the same as the shots.

[conchjoe in reply to Avanat]

I assume this is income dependent? What types of financial statements are needed?

[Avanat in reply to conchjoe]

He did not have to provide any financial statements. The assistance from the makers of Orgovyx is for anyone with commercial insurance, not Medicare. Even though my husband has Medicare, he does not have Part D for prescription coverage. Instead he kept his insurance from when he worked (Blue Cross/Blue Shield). His copay with Orgovyx assistance is only $10 a month. If he didn’t have the assistance it would be $100 a month. The cost of the drug on his BC/BS statement is $3,129.56 per month. Hope this info helps.

[Maxone73]

I have not had bad side effects from LHRH (yet), but once I am done with the triplet therapy I am doing now (January 2024) I could start talking to my MO about switching to Orgovyx, especially since I would not need injections any more!