GnRH Agonist — Androgen Deprivation Therapy

Leuprorelin Acetate

Brand names: Prostap, Eligard

Leuprorelin acetate is a gonadotrophin-releasing hormone (GnRH) agonist depot used for androgen deprivation in advanced or locally advanced prostate cancer.

Auto-extracted from the source labelling — not yet independently clinician-verified. These values were distilled from the UK SPC (or the US label where noted) but have not had a clinician sign-off. Confirm against the current SmPC before prescribing.

Adult dose

Dose: 11.25 mg

Route: Subcutaneous injection (three-month depot)

Frequency: Every 3 months (administration interval 90 +/- 2 days)

Prostap 3 DCS 11.25 mg three-month depot — urology/prostate cancer. Prostate cancer: 11.25 mg as a single SC injection every 3 months; the majority of patients respond. Do not discontinue when remission or improvement occurs; treatment is usually continued on development of castrate-resistant prostate cancer per relevant guidelines. Monitor response by PSA and serum testosterone. Testosterone rises during the first 4 days of treatment (tumour 'flare'), then falls to castrate levels by 2-4 weeks and is maintained while treatment continues; if response appears sub-optimal, confirm serum testosterone is at/remaining at castrate levels. Vary the injection site. Prepared and administered by healthcare professionals. Tumour flare may transiently worsen urinary obstruction, bone pain or, in spinal cord compression, weakness/paraesthesia at initiation.

Dose auto-extracted from UK Summary of Product Characteristics (SPC) via the eMC — not yet clinician-verified. Always confirm against the product SmPC and your local formulary before prescribing.

Contraindications

Hypersensitivity to leuprorelin, any excipient, or other synthetic GnRH analogues/derivatives
No other known contraindications in men (initial tumour flare caution — see notes/warnings)

Side effects

Hot flushes (very common)
Bone pain / muscle weakness; initial tumour flare (worsening urinary obstruction, bone pain)
Reduced bone mineral density / osteoporosis with long-term androgen deprivation
Depression and mood changes
Hyperhidrosis (increased sweating); nausea

Clinical monograph

How it works

Continuous GnRH receptor stimulation initially raises and then, through receptor desensitisation, suppresses pituitary gonadotrophin release, lowering testosterone to castrate levels.

Prescribing in practice

An initial testosterone surge ('tumour flare') can transiently worsen disease, including spinal cord compression or urinary obstruction, so co-prescribe an anti-androgen around initiation in patients at risk.
Long-term androgen deprivation increases cardiovascular, metabolic and bone-density risks, warranting attention to overall risk factors.
Use with caution and appropriate cardiac assessment where there is risk of QT prolongation, in line with the SPC.

Monitoring

Monitor PSA and testosterone response, together with bone health, glycaemic and cardiovascular risk factors during long-term therapy.

Counselling the patient

Symptoms may briefly worsen when treatment starts; report new bone pain, weakness in the legs or difficulty passing urine urgently.
Hot flushes, reduced libido, erectile dysfunction and fatigue are common.
Attend for your scheduled depot injections to maintain testosterone suppression.

Evidence & guidelines

GnRH agonists are a standard means of achieving androgen deprivation in advanced prostate cancer and are recommended within NICE guidance.

Reference: NICE NG131 (Prostate Cancer); EAU Prostate Cancer Guidelines 2024; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. The structured dose values shown have been reviewed by a clinician. Monograph status: clinician-reviewed (2026-07-04).

Curated clinical cross-links plus same-class fallbacks.

Calculators

Drugs

Goserelin · GnRH Agonist — Androgen Deprivation Therapy

Pathways