What Is Supprelin LA Used For?

Supprelin LA is a sterile, non-biodegradable, diffusion-controlled hydrogel polymer reservoir. It contains histrelin acetate, a synthetic nonapeptide analog of naturally occurring gonadotropin-releasing hormone, which has more potency than the natural sequence hormone. 

Supprelin LA is designed to deliver approximately 65 mcg of histrelin acetate daily for 12 months.

Supprelin LA is a gonadotropin-releasing hormone (GnRH) agonist prescribed to treat children with central precocious puberty. Supprelin LA will not be considered for coverage unless all the conditions outlined below are met and are supported by legal and medical documentation.

The following are the criteria for initial approval:

• At the time of treatment, the person must be at least two years old and younger than 13 years.
• Supprelin LA should be administered by a pediatric endocrinologist or after consultation with one.
• The clinical diagnosis must be confirmed with all the following:
  • Pubertal response to a GnRH stimulation test or a random level of luteinizing hormone (LH) in the pubertal range (third generation basal LH assay).
  • Their bone age is older (by one year or more) than their chronological age.
  • Baseline laboratory, physical exam, and imaging have been performed, including:
    • Height and weight
    • Pelvic/adrenal/testicular ultrasound to rule out a steroid-secreting tumor
    • Diagnostic imaging of the brain to rule out an intracranial tumor
    • Beta human chorionic gonadotropin to rule out chorionic gonadotropin-secreting tumors
    • Adrenal steroid level to exclude congenital adrenal hyperplasia
• The person has attempted depot leuprorelin acetate therapy and failed (failure is defined as the inability to suppress physical symptoms of puberty), unless the therapy is contraindicated, or the person is intolerant to it.
• Women who can get pregnant have received pregnancy risk counseling.

Criteria for continuing therapy

• All the criteria for initial therapy must be met.
• The provider must attest to a successful clinical outcome.
• LH must be lowered to levels associated with prepuberty.
• The age at which therapy should be stopped is 11 years for girls and 12 years for boys.

This medicine is injected under the skin of your upper arm by a medical professional in a hospital or office.

• After placing the implant, keep the insertion site dry and clean for 24 hours.
• Avoid strenuous activities for seven days following implant insertion.
• The surgical strips covering the wound should gradually fall off during the next few days. 
• A year after implantation, the implant must be removed, and the therapy may be continued by inserting a new implant.

Consult your pediatrician on the use of this drug in children. Although there are precautions, this drug may be prescribed to children as young as two years old for specific conditions.

The following side effects should be reported as soon as possible to your physician or other healthcare providers:

• Allergic symptoms such as skin rash, hives, itching, or swelling of the face, lips, or tongue
• Visual changes
• Low mood
• Discomfort at the insertion site 
• Convulsions
• Terrible headache
• Suicidal ideas or other behavioral changes
• Vomiting
• Discomfort or redness at the insertion site

Some side effects may not necessitate medical attention; however, if they persist or are unpleasant, inform your doctor or any other qualified healthcare provider.