Generic Name: Leuprolide

Brand Name: Eligard, Lupron, Lupron Depot, Lupron Depot-Ped

Classification: PHARMACOTHERAPEUTIC: Gonadotrophin-releasing hormone

(GnRH) analogue. CLINICAL: Antineoplastic.

Mode of Action: Leuprorelin is an agonist analogue of luteinizing hormone-releasing

hormone (LHRH). When administered continuously, it will decrease in LH and FSH
levels followed by suppression of ovarian and testicular steroidogenesis then
testosterone levels will reduce below castrated levels in males.

Dose and Routes: ADVANCED PROSTATIC CARCINOMA: (IM) Lupron Depot: Adults,
Elderly: 7.5 mg q1mo, 22.5 mg q3months, 30 mg q4months, or 45 mg q6months. (SQ)
Eligard: Adults, Elderly: 7.5 mg every months, 22.5 mg q3months, 30 mg q4months, or
45 mg q6months. (SQ) Lupron: Adults, Elderly: 1 mg/day.

ENDOMETRIOSIS: (IM) Lupron Depot: Adults, Elderly: 3.75 mg/month for up to 6 months
or 11.25 mg q3months for up to 2 doses.

UTERINE LEIOMYOMATA: (IM) with Iron, Lupron Depot: Adults, Elderly: 3.75 mg/month
for up to 3 months or 11.25 mg as single injection.

PRECOCIOUS PUBERTY: (IM) Lupron Depot-Ped: Children greater than 37.5 kg: 15 mg
q1month. Greater than 25 kg to 37.5 kg: 11.25 mg q1month. 25 kg or less: 7.5 mg
q1month. Titrate dose upward by 3.75 mg/month if down regulation not achieved. Lupron
Depot-Ped: 3 months: 11.25 mg or 30 mg q12weeks. (SQ) Lupron: Children: Initially, 50
mcg/kg/day. Titrate upward by 10 mcg/kg/day if down regulation is not achieved.

DOSAGE IN RENAL/ HEPATIC IMPAIRMENT: No dose adjustment.

Indications: Advanced Prostatic Carcinoma in patients who are unable to tolerate

orchiectomy or estrogen therapy. Endometriosis. Uterine Leiomyomata (with iron
therapy). Central Precocious Puberty.
Contraindications: Hypersensitivity to leuprolide, GnRH, GnRH-agonist analogue.
Pregnancy or women who may become pregnant, breastfeeding (Lupron Depot 3.75 mg
and 11.25 mg), abnormal, undiagnosed vaginal bleeding (Lupron Depot 3.75 mg and
11.25 mg). 22.5 mg, 30 mg, 45 mg Lupron Depot contraindicated in women.

Side effects: FREQUENT: Hot flashes (ranging from mild to diaphoresis), migraines,
hyperhidrosis. Females: Amenorrhea, spotting. OCCASIONAL: Arrhythmias, palpitations,
blurred vision, dizziness, edema, headache, burning, pruritus, swelling at injection site,
nausea, insomnia, weight gain. Females: Deepening voice, hirsutism, decreased libido,
increased breast tenderness, vaginitis, altered mood. Males: Constipation, decreased
testicle size, gynecomastia, impotence, decreased appetite, angina. RARE: Males:
Thrombophlebitis.

Adverse effects: Occasionally, signs/symptoms of prostatic carcinoma worsen 1-2

weeks after initial dosing (subsided during continued therapy) Increased bone pain and,
less frequently, dysuria. Hematuria, weakness, paresthesia of lower extremities may be
noted. MI, pulmonary embolism occur rarely.

Drug Interactions: DRUG: QT interval-prolonging medications (e.g., amiodarone,

azithromycin, ceritinib, haloperidol, moxifloxacin) may increase risk of QT interval
prolongation, cardiac arrythmias. HERBAL: None significant. FOOD: None known. LAB
VALUES: May increase serum prostatic acid phosphatase (PAP). Initially increases, then
decreases serum testosterone. May Increase serum ALT, AST, alkaline phosphatase,
glucose, LDH, LDL, cholesterol, triglycerides. May increase platelets, WBC.

Nursing Responsibilities:

- Question the patient for medical history and for possibility of pregnancy before
initiating the therapy.
- Monitor for arrythmias, palpitations.
- Assess for peripheral edema.
- Assist patient with ambulation if dizziness occurs.
- Monitor blood sugar and glycosylated hemoglobin periodically during therapy.
- Explain to the Patient/Family that there is temporary exacerbation of
signs/symptoms of disease that may occur during first few weeks of therapy.
- Tell the patient to avoid tasks that require alertness, motor skills until response drug
is established (potential for dizziness).