Health Centres - Prostap 3
How does it work?
Prostap 3 injection contains the active ingredient leuprorelin acetate, which is a type of medicine known as a gonadorelin (LHRH) analogue. It acts on the pituitary gland in the brain.
The pituitary gland produces and stores various hormones, including the sex hormones, luteinising hormone (LH) and follicle-stimulating hormone (FSH). In men, LH released from the pituitary gland causes the testicles to produce testosterone. FSH and testosterone cause the production of sperm by the testicles. In women, FSH and LH cause the production of oestrogen by the ovaries and help control the menstrual cycle.
The amount of LH and FSH released from the pituitary gland is controlled by another hormone, called gonaderelin (LHRH). Gonadorelin acts on LHRH receptors in the pituitary gland, causing the release of LH and FSH and hence the subsequent production of testosterone in men and oestrogen in women.
Leuprorelin acetate is a synthetic form of gonaderelin. It acts on the LHRH receptors in the pituitary gland in the same way as natural gonadorelin.
Initially, leuprorelin causes an increase in the amount of FSH and LH released from the pituitary gland, with resulting increase in testosterone production in men, and oestrogen production in women. However, chronic administration of leuprorelin desensitises the pituitary gland. This means that it produces less and less FSH and LH, which in turn stops the production of oestrogens in women and testosterone in men. This reduction in the levels of sex hormones caused by leuprorelin is used to treat disorders that are linked to levels of oestrogen or testosterone.
In men, the growth of some prostate cancers is stimulated by testosterone. Reducing the body's levels of testosterone therefore deprives the tumour of testosterone and causes it to shrink.
Because the leuprorelin may at first increase testosterone levels, it may cause an initial temporary tumour 'flare' with symptoms such as urinary obstruction and bone pain, before the cancer begins to shrink. Some men may be particularly prone to these symptoms. If this applies to you, your doctor will also treat you with another type of anti-cancer medicine, known as an anti-androgen (eg cyproterone acetate or flutamide) to prevent this. The anti-androgen will be started three days before the leuprorelin and continued for the first two to three weeks of treatment.
In women, endometriosis is treated with leuprorelin. Endometriosis is a condition where tissue resembling the womb or uterus lining (endometrium) is found in other sites in the body. The growth of this tissue is stimulated by oestrogen, so decreasing oestrogen levels with leuprorelin will stop the growth of this tissue, thereby relieving symptoms.
As with the treatment of prostate cancer in men, administration of leuprorelin in women may cause a temporary increase in symptoms in the first few days of treatment, due to the initial rise in oestrogen levels. This improves with continued treatment as the oestrogen levels decrease.
What is it used for?
-
Advanced prostate cancer
-
Endometriosis
Warning!
- The site that the injection is given into should be varied periodically.
- This medicine may cause dizziness and visual disturbances. You should make sure you are aware of your reactions to this medicine before driving or operating machinery.
- People with diabetes should monitor their blood sugar carefully during treatment with this medicine.
- This medicine should cause womens' menstrual periods to stop. If you are still experiencing menstrual bleeds despite treatment, you should consult your doctor.
- Leuprorelin inhibits ovulation, but it is not a reliable contraceptive. Women should use non-hormonal methods of contraception to prevent pregnancy during treatment, as this medicine may be harmful to a developing baby. If you miss a dose of this medicine, breakthrough bleeding or ovulation may occur. Since this increases the risk of getting pregnant, you should continue using contraception if you miss a dose. Consult your doctor if you think you could be pregnant.
Use with caution in
-
Depression
-
Diabetes
- Men considered by their doctor to be at risk of an initial worsening of their tumour symptoms (tumour flare)
when starting treatment
- Men whose cancer has spread to the spine
- Men with urinary obstruction
-
Osteoporosis
- Women with a strong family history of osteoporosis
- Women who have had long-term treatment with corticosteroids, eg hydrocortisone, or antiepileptic medicines
- Women with a history of heavy drinking or smoking
Not to be used in
-
Pregnancy
-
Breastfeeding
- Vaginal bleeding of unknown cause
This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy.
Pregnancy and Breastfeeding
Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.
- This medicine should not be used during pregnancy as it may be harmful to a developing baby. Women should use non-hormonal methods of contraception to prevent pregnancy during treatment. Seek medical advice from your doctor.
- There is no information available about the safety of this medicine during breastfeeding. For this reason, the manufacturer states that it should not be used during breastfeeding. Seek medical advice from your doctor.
Side effects
Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.
General side effects:
- Pain and irritation at the injection site
- Headache
- Difficulty in sleeping (insomnia)
- Hot flushes
- Dizziness
- Swelling of the legs and ankles due to excess fluid retention (peripheral oedema)
- Weight changes
- Decreased sex drive
- Fatigue
- Disturbances of the gut such as nausea, vomiting, diarrhoea or abdominal pain
- Pain in the muscles and joints
- Visual disturbances
- Pins and needles (paraesthesia)
- Awareness of your heartbeat (palpitations)
- Changes in blood pressure
- Worsening of depression
- Decrease in the number of white blood cells in the blood (leucopenia)
- Blood clot in the lungs (pulmonary embolism)
Side effects in men:
- Impotence
- Abnormal enlargement of the breasts (gynaecomastia)
- Sweating
Side effects in women:
- Vaginal dryness
- Decreased bone density
- Hair loss
- Breast tenderness
- Change in breast size
The side effects listed above may not include all of the side effects reported by the drug's manufacturer.
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