Leuprorelin For Prostate Cancer: Side Effects & How To Manage Them

Leuprorelin is classified as a type of LHRH (luteinizing hormone-releasing hormone) agonist used in the treatment of prostate cancer in men.

It is a kind of hormone therapy.

Luteinizing hormone-releasing hormone occurs naturally in the body and stimulates the secretion of testosterone hormone from the testes. 

Leuprolide blocks LHRH and reduces the testosterone levels in the body.

In this article, we will find out the various side effects of Leuprorelin for prostate cancer patients, how to reduce them, and what precautions you should take during Leuprolide treatment.

Common Side Effects Of Leuprorelin

Like any other medicine, Leuprorelin may cause various side effects ranging from mild to severe.

1) Testosterone Flares

When you start taking Leuprorelin, your testosterone levels become high during the initial few days or weeks before they become very low.

In some people, especially those who have an advanced stage of prostate cancer, your prostate cancer symptoms may worsen temporarily due to a testosterone flare.

Some of the symptoms and signs of a testosterone flare are:

  • Bone pain
  • Compression of the spinal cord
  • Urinary problems
  • Obstruction of the ureters (the tubes that transfer urine from the kidneys to the urinary bladder)
  • Aggravation of the nerve symptoms

Your doctor may prescribe a medicine (usually an anti-androgen) during the initial few weeks, along with Leuprorelin, to prevent testosterone flares.

2) Injection Site Reactions

Your Leuprorelin injection site may become:

  • Swollen
  • Painful
  • Bruised
  • Red
  • Itchy

These reactions may last for a couple of days. You may talk to your healthcare professional about how to manage injection site reactions from Leuprorelin.

3) Hot Flashes

A hot flash is a very common side effect of taking Leuprorelin, during which you may develop a sudden feeling of warmth over your face, neck, and chest, along with sweating and redness of your face. 

You may do the following to reduce hot flashes:

  • Wear cotton clothes
  • Wear clothes in layers so that you can remove a layer when you get a hot flash
  • Keep the temperature of your room cool
  • Drink cold beverages and avoid caffeinated beverages

4) Fatigue

It is very common to feel fatigued during treatment with the Leuprolide shot. The following measures may help manage fatigue:

  • Get enough sleep
  • Eat healthy foods
  • Do regular exercise

5) Loss Of Sexual Drive Or Erectile Dysfunction

A loss in sex drive and libido may occur very commonly as a side effect of Leuprorelin treatment. You may also develop erection problems.

You should talk to your healthcare professional about your sexual side effects. They may prescribe treatments, such as drugs, implants, creams, etc., to deal with your erection problems.

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6) Breast Tenderness Or Swelling

Some men may develop breast tenderness or swelling after taking Leuprolide. 

You should talk to your healthcare professional if you develop this side effect of Leuprorelin, and they may guide you on how to manage the condition.

7) Joint Or Muscle Pain

You may also develop joint or muscle pain as one of the side effects of taking Leuprorelin. Your doctor may prescribe painkillers to relieve the pain. 

You may also take the following measures to manage joint or muscle pain:

  • Do regular exercise such as gentle stretching exercise
  • Maintain a healthy weight
  • Get lots of sleep

8) Weight Gain

Weight gain is also a common Leuprorelin side effect. You may also lose your muscle mass and strength along with gaining weight.

To manage weight gain:

  • Eat healthy
  • Do regular physical activity

To maintain muscle mass

  • Do resistance exercises (for example, lifting weights) along with aerobic exercises

Before starting any new exercise regimen during prostate cancer treatment, always consult your healthcare provider.

9) Mood Changes

You may develop symptoms of:

  • Depression
  • Nervousness
  • Inability to control your emotions
  • Frequent changes in mood

Talk to your physician if you develop these symptoms, and they will guide you on ways to manage them.

10) Memory Problems

You may develop:

  • Difficulty with memory
  • Concentration problems

Talk to your healthcare provider to find out ways to manage this Leuprorelin side effect.

11) Osteoporosis

Taking Leuprolide for a long duration may cause bone thinning, a condition referred to as osteoporosis. This may also raise your risk of bone fracture. 

Ways to manage osteoporosis:

  • Do regular physical activity such as walking
  • Eat a healthy and well-balanced diet
  • Your physician may prescribe medicines such as bisphosphonates to increase bone density
  • Your doctor may also recommend taking vitamin D and calcium supplements

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Serious side effects of Leuprolide

Leuprolide may cause some serious side effects, though less commonly. If you develop any of the following symptoms or signs, contact your healthcare professional immediately.

1) Allergic Reaction

Signs of an allergic reaction are:

  • Skin rash
  • Shivering
  • Dizziness
  • Headache
  • Difficulty breathing

2) Cardiovascular Effects

Signs that warrant immediate medical help are:

  • Chest pain
  • Tightness in chest
  • Dizziness
  • Difficulty breathing
  • Irregular heartbeat

3) Nervous System Effects

Signs that warrant emergency medical help are:

  • Recurring or severe headache
  • Vision changes
  • Seizures (fits)
  • Tinnitus (ringing in ears)
  • Reduced consciousness
  • Drooping eyelids
  • Difficulty in moving eyes
  • Confusion

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Precautions To Take During Leuprorelin Treatment

Allergy to Leuprorelin

Tell your healthcare provider if you have an allergy to Leuprorelin, Zoladex, any other medicine, or any ingredients present in the Leuprorelin injection.

Medication Interactions

Tell your healthcare provider about the other nonprescription and prescription medicines, herbal products, nutritional supplements, and vitamins you are currently taking or are planning to take.

Your physician may adjust medication dosages or monitor you for potential side effects.

Ensure that you mention the following:

  • Medicines for irregular heartbeat include amiodarone, disopyramide, procainamide, sotalol, and quinidine
  • Medicines for seizures
  • Oral steroids, including dexamethasone, methylprednisolone, and prednisone
  • Selective serotonin reuptake inhibitors (SSRIs), including citalopram, escitalopram, fluoxetine, fluvoxamine, paroxetine, and sertraline

Medical History

Tell your doctor if you have any of the following:

  • Personal or family history of osteoporosis (thinning of bones)
  • Personal history of using tobacco or drinking alcohol for a long duration
  • If you have had seizures (fits), depression, brain tumors, diabetes, cancer spreading to the backbone, urinary obstruction, presence of blood in the urine, cerebrovascular disease, a prolonged QT interval (heart rhythm problem), and heart disease

Conclusion

Leuprorelin is a type of hormonal therapy prescribed for the treatment of prostate cancer in men. It is believed to work by reducing testosterone levels, potentially slowing the growth of prostate cancer cells.

Healthcare professionals often prescribe Leuprolide along with radiotherapy or after surgery.

Leuprorelin is administered as a small implant injected under the skin, as part of the treatment plan prescribed by healthcare professionals.

The frequency of Leuprorelin shots is determined by your diagnosis and individual circumstances. It may range from one injection every month to one injection every six months.

Leuprorelin, used in prostate cancer treatment, is associated with various side effects, ranging from mild to serious.

Individual responses to Leuprorelin can vary. If you experience severe side effects after receiving the drug, it is advisable to contact your physician immediately.

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Sources

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  6. Chrisp P, Sorkin EM. Leuprorelin. A review of its pharmacology and therapeutic use in prostatic disorders. Drugs Aging. 1991 Nov-Dec;1(6):487-509. doi: 10.2165/00002512-199101060-00008. PMID: 1794035.
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  8. Merseburger AS, Roesch MC. Advanced delivery of leuprorelin acetate for the treatment of prostatic cancer. Expert Rev Anticancer Ther. 2022 Jul;22(7):703-715. doi: 10.1080/14737140.2022.2082947. Epub 2022 Jun 3. PMID: 35612551.

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