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GnRH analogue

Leuprorelin acetate

Brand names: Prostap, Lutrate, Lupron

Adult dose

Dose: Depot: 3.75mg every 4 weeks, 11.25mg every 12 weeks, 22.5mg every 12 weeks, or 30mg every 24 weeks
Route: SC/IM (depot)
Frequency: every 4–24 weeks

Clinical pearls

  • Prostate cancer (with antiandrogen cover), endometriosis, fibroids, central precocious puberty
  • Co-prescribe bicalutamide/cyproterone for first 2 weeks in metastatic prostate cancer

Contraindications

  • Pregnancy
  • Hypersensitivity
  • Undiagnosed vaginal bleeding

Side effects

  • Hot flushes
  • Loss of libido
  • Erectile dysfunction
  • Bone loss
  • Tumour flare (initial — co-prescribe anti-androgen 1–2 weeks)
  • Cardiovascular events

Interactions

  • QT-prolonging drugs

Monitoring

  • Testosterone/PSA
  • Bone density (long-term)

Reference: BNF; NICE NG131/NG73; https://bnf.nice.org.uk/drugs/leuprorelin-acetate/. Verify against your local formulary and the latest BNF before prescribing.

Related

Curated clinical cross-links plus same-class fallbacks.