Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.
Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
DRUG CLASS AND MECHANISM: Leuprolide is an injectable, man-made hormone that is used for treating prostate cancer, endometriosis, central precocious puberty, and
fibroids. It is similar to but stronger than human gonadotropin releasing hormone (GnRH).
GnRH is made in the hypothalamus (a part of the brain) and travels to the pituitary gland where it causes the production of luteinizing hormone (LH) and follicle stimulating hormone (FSH). LH and FSH are released by the pituitary into the blood and stimulate the production of testosterone by the testes in men and estrogens by the ovaries in women. The release of GnRH, LH and FSH is governed by negative feedback which means that when there is too much testosterone or estrogen being produced, the body sends a signal to the pituitary gland to reduce the production of GnRH which, in turn reduces the production of LH and FSH. This results in reduced production of testosterone and estrogen. When given continuously, leuprolide initially increases the production of LH and FSH as well as testosterone and estrogen; however, after a few weeks of continuous leuprolide, the levels of LH and FSH drop because the pituitary gland stops responding to GnRH and leuprolide. This leads to a decrease in the production of estrogen and testosterone.
Testosterone promotes the growth of prostate cancer. Therefore, leuprolide is used in treating prostate cancer to slow the growth of the cancer. In children with central precocious puberty (puberty caused at an early age because of too much LH and FSH) leuprolide, by suppressing LH and FSH, reduces the levels of estrogen and testosterone and allows for more normal timing of puberty. Estrogens promote the growth of fibroids (benign tumors of the uterus) and areas of endometriosis (abnormal uterine tissue that exists outside of the uterus). Leuprolide is used to reduce the production of estrogen and treat both fibroids and endometriosis.
PRESCRIPTION: Yes.
GENERIC AVAILABLE: Yes.
PREPARATIONS: Leuprolide injection: 5 mg/ml. Lupron Depot microspheres for injection: 3.75, 7.5, 11.25, 15, 22.5 and 30 mg.
STORAGE: Leuprolide should be stored at room temperature between 15-30 C (59-86 F).
PRESCRIBED FOR: Leuprolide is used for the treatment of advanced prostatic cancer, endometriosis, fibroids and central precocious puberty.
DOSING: Leuprolide is injected under the skin (subcutaneously). Lupron Depot is injected into muscle (intramuscularly).
For prostate cancer, leuprolide can be given daily or Lupron Depot can be given monthly or at 3 to 4 month intervals. The daily dose of leuprolide is 1 mg. The 3.5 and 7.5 mg doses of Lupron Depot are injected monthly, the 11.25 and 22.5 mg doses every three months, and the 30 mg dose every four months.
For endometriosis, the recommended dose of Lupron Depot is 3.75 mg monthly or 11.5 mg every 3 months.
Fibroids are treated with either a single 11.5 mg dose of Lupron Depot or 3.75 mg doses given monthly.
The recommended starting dose of leuprolide for treating central precocious puberty is 50 mcg/kg/day. This dose can be increased by 10 mcg/kg/day depending on the response of the patient.
Alternatively, Lupron Depot can be given. The dose of Lupron Depot is 0.3 mg/kg/week given as one injection. The dose can be increased by 3.75 mg every 4 weeks depending on the response of the patient.
DRUG INTERACTIONS: No drug interaction studies have been done for leuprolide.
PREGNANCY: Leuprolide should not be administered to
pregnant women because there is a high chance of harm to the fetus.
NURSING MOTHERS: The effects of leuprolide on the infant have not been studied in women who are breastfeeding.
SIDE EFFECTS: The most common side effects of leuprolide are aches and pain,
headaches, hot flashes and irritation at the injection site. Leuprolide also may cause impotence, shrinking of the testes and breast enlargement in men. Depression, rare cases of
suicidal behavior, low blood pressure, convulsions, joint pain and muscle aches have been reported in post-marketing surveillance.
Endometriosis is the growth of cells similar to those that form the inside of the uterus, but in a location outside of the uterus. Endometriosis implants are most commonly found on the ovaries, the Fallopian tubes, outer surfaces of the uterus or intestines, and on the surface lining of the pelvic cavity. They can also be found in the vagina, cervix, and bladder. Treatment of endometriosis can be with medication or surgery.
Uterine fibroids are benign tumors that originate in the uterus and are usually round or semi-round in shape. The most common symptom of a uterine fibroid is abnormal vaginal bleeding. Other symptoms include pressure, pelvic pain, pressure on the bladder, or pain during a bowel movement. Treatment options vary from surgery to medication.
Prostate cancer is an uncontrolled (malignant) growth of cells in the prostate gland. Prostate cancer is the second
leading cause of death of males in the U.S. Prostate cancer is often initially
suspected because of an abnormal PSA blood test or a hard nodule (lump) felt on
the prostate gland during a routine rectal examination.
Benign uterine growths are tissue enlargements of the female womb (uterus). Three types of benign uterine growths are uterine fibroids, adenomyosis, and uterine polyps. Symptoms include: abdominal pressure, pelvic pain, and pain during intercourse. Diagnosis and treatment of benign uterine growths depends upon the type of growth.
The time when boys and girls begin the process of sexual maturation is called puberty. During this time, both sexes undergo a series of biological changes that include a rapid increase in height, bone growth, weight increase, the growth of pubic hair, breast development and the onset of menstruation in girls, and testicle, penis, and muscle enlargement in boys.
Premenstrual dysphoric disorder (PMDD) is considered to be a severe form of premenstrual syndrome (PMS). PMDD has also been referred to as late luteal phase dysphoric disorder. The cause of PMDD is unknown. Some of the common symptoms of PMDD (not an inclusive list) include: mood swings, bloating, fatigue, headache, irritability, headache, breast tenderness, acne, hot flashes and more. Treatment for PMDD is with medication to treat the symptoms of PMDD.
Teenagers recognize that they are developmentally between child and adult. Teen health prevention includes maintaining a healthy diet, exercising regularly, preventing injuries and screening annually for potential health conditions that could adversely affect teenage health.
Premenstrual dysphoric disorder (PMDD) can be considered to be a severe form
of premenstrual syndrome (PMS). Both PMS and PMDD are characterized by
unpleasant physical and psychological symptoms that occur in the second half of
a woman's menstrual cycle,
most commonly in the days preceding the menstrual period. Fatigue, mood changes, irritability, and abdominal bloating are among the most common symptoms of PMS and PMDD, but numerous other symptoms have been reported. Whereas the symptoms of PMS may be troubling and unpleasant, PMDD may cause severe, debilitating symptoms that interfere with a woman's ability to function.
PMS is much more common than PMDD. PMS may affect to 30% of women with regular menstrual cycles, while only 3% to 8% of these women have true PMDD.
PMDD has been previously medically referred to as late luteal phase dysph...
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