Leuprolide adverse effects

Several randomized trials have demonstrated that leuprolide and goserelin are effective agents when used alone in patients with advanced prostate cancer.19 Response rates around 80% have been reported, with a lower incidence of adverse effects compared with estrogens.19 There are no direct comparative trials of the currently available LHRH agonists or the dosage formulations, but a recent meta-analysis reported that there is no difference in efficacy or toxicity between leuprolide and goserelin. Therefore, the choice between the two usually is made based on cost and patient and physician preference for a dosing schedule. 

In a randomized, placebo-controlled study in women who received leuprolide acetate depot 11.25 mg intramuscularly with tibolone 2.5 mg/day (n = 36), leuprolide acetate depot 11.25 mg with placebo (n = 37), or a placebo injection with placebo tablets (n = 39), irritable bowel syndrome related to the menstrual cycle improved in those who received leuprolide (5). There were hot flushes in those who took leuprolide compared with placebo no data were given about the frequency of hot flushes, but there were no withdrawals because of this symptom. Amenorrhea also occurred. Both flushing and amenorrhea are expected adverse effects of leuprolide. 

Intermittent courses of gonadotropin analogues for prostate cancer may reduce the frequency of adverse effects. In 95 patients who received 245 cycles of leuprolide acetate and nilutamide for 8 months, testosterone concentrations recovered during the rest periods (61% of cycles) and sexual function improved (47%) (23). 

Fraunfelder FT, Edwards R. Possible ocular adverse effects associated with leuprolide injections. JAMA 1995 273(10) 773 1. 

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