Hormone drug: Triptorelin (Brand names: Decapeptyl®SR, Gonapeptyl® Depot)

What is triptorelin?

Triptorelin is a form of hormone therapy called an LHRH (luteinizing hormone-releasing hormone) agonist. There are two brands of the same drug, which are called Decapeptyl® SR and Gonapeptyl® Depot. These are given at different stages of prostate cancer. Triptorelin and other LHRH agonists work by stopping the brain from telling your body to make testosterone. Without testosterone the prostate cancer cells are not able to grow. Triptorelin will not cure prostate cancer but it can keep the cancer under control for many months or years.

How do I take triptorelin?

Triptorelin is usually injected into the muscle in your buttock (bottom). The injection can be painful and your skin may darken or redden for a short time afterwards. You may be given the injection by your GP, practice nurse, district nurse or at your local hospital. You may have the injections every month or every three months depending on the type and dose of the drug and on the stage of your cancer. Each of these doses of triptorelin work equally well at controlling the cancer. The only difference between them is the length of time that the drug works for. Your doctor will help you decide which dose is best for you.

Decapeptyl® SR 3 mg Every 28 days For cancer that has spread just outside the gland (locally advanced) or to other parts of the body (advanced)

Decapeptyl® SR 11.25 mg Every three months For cancer that has spread just outside the gland (locally advanced) or to other parts of the body (advanced)

Gonapeptyl® Depot 3.75 mg Every four weeks For cancer that has spread to other parts of the body (advanced)

Flare

A few days before you start treatment with triptorelin, you may take a short course of another type of hormone therapy drug called an anti-androgen, such as bicalutamide, flutamide or cyproterone acetate. This is to prevent the body’s normal response to the first injection, which is to produce testosterone. This temporary rise in testosterone could cause the cancer to grow more quickly for a short time. This is known as flare. Taking an anti-androgen tablet can help to prevent this flare. You will start taking the tablets a week or so before the first injection and continue taking them for a week or two afterwards.

What happens if I miss an injection?

The prostate cancer will not spread if your injection is delayed by a few days. If you miss your treatment for longer than this, your body may start producing more testosterone and this could cause the cancer cells to grow. If this happens you will need to start hormone injections again with a short course of antiandrogen tablets to prevent flare.

What are the side effects?

Like all drugs, triptorelin can cause side effects in some men. The risk of side effects may vary depending on the dose you are taking. We have listed the most common ones here but you should tell your specialist team if you notice any other changes while you are having treatment. Some men get very few side effects and others get more. Many side effects will only last for as long as you are taking the drug. However, if you take triptorelin for a long period of time, it may take several months after you finish treatment for the side effects to stop. Before you take triptorelin, you should tell your doctor if you have any bone pain or problems passing urine.

Loss of sex drive and erectile dysfunction

Some men taking triptorelin may lose their desire for sex (libido). Some men may also have problems getting and keeping an erection. These side effects usually start within the first month of treatment. This will last for as long as you are taking triptorelin and may take a while to return to normal after you stop treatment.

Hot flushes

Hot flushes give you a sudden feeling of warmth in the upper body and can be similar to those experienced by women going through the menopause. Some men also find that they sweat more than they used to. Hot flushes can vary from a few seconds of feeling overheated to a few hours of sweating that can stop you from sleeping or cause discomfort.

Bone thinning

If you take triptorelin for more than a few months, it may cause your bones to become weaker (osteoporosis). If you already have osteoporosis, have a family history of osteoporosis or have had fractures in the past, talk to your doctor before you start treatment like triptorelin.

Tiredness

You may feel tired and have trouble sleeping whilst you are taking triptorelin. You may find that your tiredness improves over time but many men find that regular exercise gives them more energy and helps them to cope with treatment.

Anxiety and depression

Some men taking triptorelin may find that they feel depressed or have mood swings. Talking to your family, friends or doctor about how you feel may help

Feeling sick

Some men feel sick from time to time when they are taking triptorelin. If needed, your specialist team can give you medicine to ease the symptoms.

Sore joints

This is usually mild and settles when you stop taking triptorelin. It most often happens during the flare stage when you first start taking triptorelin. Your specialist team can offer you treatments such as pain relief and hot packs.

Breast swelling and tenderness

Some men may experience breast swelling (gynaecomastia) and tenderness in the breast area. This can affect one or both breasts and can range from mild sensitivity to ongoing pain. The amount of swelling can also vary from a small amount to a more noticeable enlarged area.

How long will I need to take triptorelin?

The length of time you take triptorelin for depends on why you are taking it and how well it is working.