Triptorelin is a hormone therapy used to treat prostate cancer.

HOW DOES TRIPTORELIN WORK?

Hormones are substances produced naturally in the body. These act as chemical messengers and help control the activity of cells and organs. Hormone therapies interfere with the way hormones are made or formed in the body.

Most prostate cancers need the hormone testosterone to grow. Almost all of the testosterone in men is made by the testicles. A small amount is made by the adrenal glands, which are located above the kidneys. Triptorelin stops the testicles from producing testosterone. This lowers testosterone levels and may shrink the prostate cancer or stop its growth.

WHEN IS TRIPTORELIN GIVEN?

Triptorelin can be used alone or with other types of treatment. It can be used before or after surgery or radiotherapy. It can also be used to control prostate cancer that has spread to other parts of the body (advanced or metastatic prostate cancer).

Triptorelin can be given over months or years depending on the patient's situation. Some men with advanced prostate cancer may receive intermittent therapy with triptorelin. This means having triptorelin treatment over a number of months until the cancer is at a very low level (measures by a blood test called a PSA test). Following this, you have a rest from the treatment and resume triptorelin when it is necessary.

HOW IS TRIPTORELIN ADMINISTERED?

Triptorelin is given as an injection. It can be given under the skin (subcutaneously) or it can be administered into a muscle (intramuscular) in the buttocks. The injections can be monthly or as a longer-acting preparation every three or six months.

Tell your doctor or nurse if you are taking any drugs to thin your blood out, as these can increase bruising and may have implications in the way the injection can be given.

Some people may find the injection to be a bit uncomfortable and notice reddening or a dark discoloration around the area. You may have a local anesthetic cream applied before the injection to reduce any discomfort.

POSSIBLE SIDE EFFECTS OF TRIPTORELIN

You may experience some of the side effects mentioned here, though it is rare for a patient to have all of them. If you are taking other drugs, you may have certain side effects that are not listed here.

Always inform your doctor or nurse of the side effects you experience. They can prescribe drugs to help control them and can also give you advice on managing side effects.

TUMOR FLARE

You may have a temporary increase in your levels of testosterone in the first days or weeks after starting on triptorelin. This may worsen the symptoms caused by the cancer. Doctors cause this tumor flare. Your doctor may describe a hormone treatment to prevent or reduce tumor flare. You usually begin to take the tablets before starting treatment with triptorelin and continue taking them for a few weeks afterward.

If you notice any increase in symptoms in the first month after starting on triptorelin, let your doctor know. In particular, if you have blood in your urine, back pain, or numbness or ticking of the legs, let your doctor know immediately.

HOT FLASHES AND SWEATING

These are common and can be mild or more severe. While having a hot flash, you feel warmth in the neck and face, and your skin may turn red. Mild hot flashes last from a few seconds to a couple of minutes. More severe hot flashes can last 10 minutes or more. You may have sweats and then feel chills and clamminess. Some people feel anxious or irritable during a hot flash.

There are things you can do to treat or reduce hot flashes. These include lowering your intake of nicotine, alcohol, and hot beverages containing caffeine such as tea and coffee.

If the hot flashes are bothersome, your doctor can prescribe medication to help lessen them.

Hot flashes and sweating reduce as your body adapts to the hormone treatment. They usually stop completely a few months after the treatment ends.

SEXUAL EFFECTS

Most men can lose their sex drive and have erection difficulties during the hormone therapy. These often return to normal after they stop taking the medication, though some keep having difficulties after the treatment is over. Your doctor can prescribe treatments to help with erection problems, though these do not influence sex drive.

If you need support in coping with sexual difficulties, your nurse or doctor can give you information and refer you to specialized support services.

TIREDNESS

Tiredness is a common side effect. Evidence indicates that exercise and resistance training (such as lifting weights) at least twice a week can reduce tiredness in men taking hormone therapy. It is important to get medical advice before starting to exercise.

HEADACHES

Headaches can usually be alleviated with painkillers such as paracetamol. Tell your doctor or nurse if your headaches are bothersome.

SKIN CHANGES

You may find that your skin dries out. Some men develop a skin rash, though this is normally mild and often gets better without treatment. Tell your doctor if you notice any changes to your skin.

DIZZINESS, BLURRINESS OF VISION, DROWSINESS

Triptorelin can sometimes cause dizziness, blurriness of vision, or drowsiness. Do not drive or operate heavy machinery if you have these side effects.

NAUSEA

Triptorelin can make you feel nauseous, though this tends to be mild. If this does not get better, your doctor may prescribe antiemetic drugs.

POSSIBLE SIDE EFFECTS OF LONG-TERM USE OF TRIPTORELIN

WEIGHT GAIN AND LOSS OF MUSCLE STRENGTH

You may gain weight—especially in the waist—and you may lose some muscle strength. Eating a healthy diet and getting regular exercise can help you control your weight. Resistance exercises such as lifting weights can help reduce loss of muscle strength. Talk to your doctor or nurse for advice.

MOOD CHANGES

You may have changes in your mood. Some men feel down or depressed for a few months or longer after taking triptorelin. Talk to your doctor if you notice changes in your mood.

MEMORY AND CONCENTRATION

You may notice changes in your memory or ability to concentrate. Try to use a notebook, post-it notes, and a calendar to help keep a log of things. Talk to your doctor if you are having problems.

CHEST SWELLING OR SENSITIVITY

You may notice swelling or sensitivity in your chest. This is called gynecomastia. Your doctor can give you advice on how to prevent or treat this.

BONE THINNING (OSTEOPOROSIS)

Taking triptorelin for a number of years increases the risk of bone thinning (osteoporosis), which may make it more likely to have bone fractures. Your doctor can give you advice on controlling and treating this. Exercise such as walking and resistance exercises such as lifting weights can help keep your bones strong. Eating a healthy diet, not smoking, and keeping alcohol intake within recommended limits can also help protect your bones. Tell your doctor if you have any discomfort in the bones or joints.

RISK OF DIABETES AND CHANGES TO THE HEART

When taking triptorelin, there may be a higher risk of developing diseases of the heart, changes in heart rate, or diabetes. Overall, however, the benefits of the treatment outweigh its possible risks. You can talk to a specialist about the possible risks and benefits of your situation. It is important that you notify your doctors if you have ever had problems with your heart rate or if you are taking any medication for this.

Eating a healthy diet, not smoking, keeping alcohol consumption within recommended limits, maintaining a healthy weight, and physical activity can help reduce the risk of heart disease and diabetes.

MORE INFORMATION ABOUT TRIPTORELIN

DELAYS IN INJECTIONS

If an injection is delayed for 2 to 3 days, it should not make much of a difference. However, you should try to have your injections as regularly as possible.

OTHER DRUGS

Triptorelin can interact with other drugs. This includes medications that can be purchased in a store or pharmacy. Tell your doctor if you are taking any drugs, including complementary therapies, vitamins, and herbal remedies.

MEDICAL TREATMENT

If you have to go to the hospital for whatever reason other than cancer, always tell the doctors and nurses that you are taking triptorelin. Explain to them that you are undergoing hormone therapy that no one should stop or restart if it is not done under the advice of a cancer doctor.