Firmagon vs Lupron

[Cooolone]

So, the question is what are the up or downs if switching from Firmagon to Lupron.

I used Orgovyx until it didn't work, switched to Firmagon. Wanted either due to family history with heart issues. Dad, uncle's, brothers, all having issues. One brother recently having a major HA...

But the convenience of Lupron might be necessary as I'll be traveling for a bit and not near home base so I could get my Firmagon...

My only worries are twofold. One is, the Firmagon along with Darolutamide has worked and kept my PCa asleep so far (since late 2022), so why change something that's working right? The other worry is to introduce any issues heart wise long term if switching to Lupron.

I also haven't jumped back into the deep end of the pool to re-familiarize myself between the two drugs and their mechanism of action and differences between the two.

So... Thoughts are welcome to jump start my brain, and opinions appreciated! TIA

[StayingOptimistic]

I am not sure if I read this correctly but you said orgovyx didn’t work but Firmagon did work? I am wondering as both are the same.

[pe43 in reply to StayingOptimistic]

Firmagon is degarelix, but Orgovyx is relugolix.

[Tall_Allen]

"I used Orgovyx until it didn't work, switched to Firmagon. " What do you mean by "it didn't work"? All ADT, whether Orgovyx, Firmagon, or Lupron, has one job - to keep endogenous production of testosterone at castration level. If it is doing that, there is no need to change.

[Cooolone in reply to Tall_Allen]

The assumption is that our metabolism is perfect... that everything we consume will be processed accordingly. It's not always so...

It is a pill, it is taken orally. This along with other medications I was taking at the time (in all probability) contributed to my system going into evacuate mode! Let's say some 8-10 bowel movements per day... So this was about 10 months in using the Orgovyx. And the symptoms around 2-3 months along. The other prescription I was taking was Metformin for Diabetes... Both together for me wasn't a good thing.

A good thought though by my MO was the possibility that due to this, expanded evacuations, lol, the pills weren't being around long enough to do their work properly. Unfortunately, my T had recovered somewhat, my PSA was climbing like a rocket by then (for me), so we switched to the injectable. That stabilized the PSA movement and T, but did not lower it. A few (2) months later we decided to add Darolutamide and that put everything back on the bottom shelf nicely!

So when I say, it stopped working, the PILL stopped working for ME! I didn't imply, or mean to imply, Orgovyx doesn't work. Guess I'll be more exact in my finger frenzy when I post sorry about the confusion.

[JohnInTheMiddle]

I'm on Firmagon for almost two years (as part of Triplet for Stage 4 etc.) and decided not to switch to Lupron "for convenience".

Here's a write-up I did as a reply in the middle of a longer discussion (the auto-scroll to the reply doesn't always work - my 10-point comparison is quite aways down):

healthunlocked.com/advanced...

Also on the issue of travel, I did a lot of research - there are quite a few people who do their own Firmagon/Degarelix injections! (This seems to be more the case in Australia! Not what you might say common of course.) I have now a specialist nurse - it's tricky to get the depot right and not too shallow or deep and not all nurses get it right.

Here's another reply (you can ignore the change of topic part way through):

healthunlocked.com/advanced...

And another writeup reply - long item!

healthunlocked.com/advanced...

[Cooolone in reply to JohnInTheMiddle]

I actually told them I would do the injection myself, lol... They weren't so hot on that idea!

[JohnInTheMiddle in reply to Cooolone]

You have to read the instructions carefully and practice! My visit-at-home nurse does injections so perfectly - versus hospital nurses who sometimes were told how to do it "by a colleague". Also I'm getting much better results my injection in the side versus the stomach.

[skiingfiend]

In my opinion a big issue to consider is the difference in side effects. This difference may be positive or negative. You may not know until you switch.

I switched from firmagon to eligard for convience and now I'm switching back. I had an immediate and bad reaction upon starting eligard.

You are 100% right, don't screw with something that's working.

[Cyclingrealtor]

I guess I'll stir the water a bit. The Lupron kicked my ass with fatigue, muscle, joint and ligament aches and pains. This lasted 4 - 6 weeks.

The Oncology clinic stated that most men get Eligard and most women get Lupron.

So this last injection about two weeks ago with Eligard doesn't seem to have as drastic of impact as Lupron did for me. I hadn't wanted to switch from Lupron to Eligard but these first few weeks, I prefer it a lot better.

[London441 in reply to Cyclingrealtor]

Lupron and Eligard are the same thing.

[dhccpa in reply to Cyclingrealtor]

I have gone from Lupron to Eligard and back to Lupron a few years ago during a Lupron shortage. No difference for me except Eligard left a blister at injection site.

[HikerWife]

From Google: "Eligard is given as an injection under the skin. Lupron Depot is given as an injection in a muscle. Eligard is only FDA approved for prostate cancer. Lupron Depot is FDA approved for prostate cancer and other conditions, such as uterine fibroids, endometriosis, and early puberty in children."...."Lupron Depot and Eligard are brand names for drugs that both contain the active ingredient leuprolide acetate."

[Teacherdude72]

I was in monthly Lupron and Nubeqa for over 33 months before that in eligard until it failed. PSA tripped in one month to 3. PSA dropped to <0.02 for the past 29 months. Per MO recommendation I am now on Houkdy from both

[j-o-h-n]

One man's woman is another man's wife........or as the original saying goes, one man's food is another man's poison....

Good Luck, Good Health and Good Humor.

j-o-h-n

[Hailwood]

Lupron for me alongside Erleada has been a blessing. The fatigue is possibly difficult to differentiate from 68 yr old normal fatigue, but the muscle wasting is troublesome at times, but 4 years in with distant Mets, everything is stable