How soon after taking 4 month eligard shot can you switch to firmagon?

[skiingfiend]

I started my hormone treatment with firmagon + apalutamide beginning 2023.

The treatment worked fantastic and all my pain faded away and my psa dropped from 350 to .09 over 11 months. My life was as near normal as can be expected with cancer.

Almost immediately my MO was recomending to switch to 4 mo eligard. I resisted because firmagon was working so well and he could not provide any credible reason why I should switch.

In november I relented and agreed to switch to eligard. It has been an unmitigated disaster. I am now in constant pain and have resorted to a daily regime of hydromorphone (13+ mg) just to manage it.

I am not happy since there was never any compelling reason to make this switch that was communicated to me. I intend to push back and withdraw consent to be treated with eligard and I want to be reinstated on firmagon. This distresses me because I do not want to act as my own MO, I want to make collaborative decisions that I can see are in my personal best interest.

My eligard shot was nov 14, 2023 and my next one is due mar 5, 2024.

What is the earliest possible date I can resume firmagon?

[Tall_Allen]

Why can't you switch right away, since Eligard isn't working for you? Or maybe take Orgovyx tablets, which work the same way as Firmagon.

[skiingfiend in reply to Tall_Allen]

Are there any complications due to an agonist and antagonist acting on the pituary gland at the same time?

[Tall_Allen in reply to skiingfiend]

Not that I know of.

[skiingfiend in reply to Tall_Allen]

So I called my MO's office and left a message indicating I want to be reinstated on firmagon immediately.

Let's see how he responds.

Thanks

[Oatmeal2]

I’m not sure how long you would have to wait for the firmagon, but maybe if you inquire with the drug maker they may know. When the 4 month wears off you could definitely get the firmagon. I can give you an idea why the doctor may have wanted to change you over. One is cost; eligard is cheaper than Firmagon plus, unfortunately, a lot of doctors get “incentives” for pushing certain drugs. I’m not saying that happened but it’s a possibility. My husband is on Firmagon and the doctor wanted to switch to lupron for “convenience” but we requested he stay on firmagon and the doctor had no issue. We are battling with Aetna who wanted him to take eligard and we are on the final external denial review for Firmagon. Luckily, in May he gets Medicare and Aetna has to cover firmagon because it’s a part b drug. Stick to your guns and insist on getting firmagon because it work for you.

[Brians1020]

Sorry your MO is doing this...I am 5+ yrs out from DX, 5/18...., 15 mos. on eligard....Follow the money!!!!! Uro's and Mo's make huge sums of money on eligard (Lupron).I fired my whole cancer team over this issue...

[skiingfiend in reply to Brians1020]

Money is not the issue in this case, it's time. My MO is a lynchpin player in the entire BC healthcare system and is literally trying to perform 3 or 4 fulltime jobs all at the same time. It's not humanly possible and something has to slip and I see it in the clinic.

He is an exceptional and dedicated physcian, researcher, educator, administrator and a highly respected clinician, however, this is literally my life on the line and I will fight as hard as I have to - to get some attention and the quality of service I am entitled to.

[Lovinlife53 in reply to skiingfiend]

I am also in BC. Who is your Dr?