Treatment of hormone-dependent prostate cancer. Treatment confirmed by laparoscopic examination of endometriosis, where there are no indications for surgical treatment. In addition, for depot - diagnosis of prostate cancer hormone dependence (assessment of indications for hormonal treatment); preparation for surgical treatment of symptomatic uterine myomas, when it is recommended to reduce the size of myomas before the planned surgery.
Composition:
Decapeptyl 0.1 mg: 1 disposable syringe contains 105 μg of triptorelin acetate, equivalent to 95.6 μg of triptorelin.Decapeptyl Depot: 1 pre-filled syringe with microcapsules contains 3.75 mg of triptorelin.
Action:
Synthetic gonadorelin analogue (LH-RH), characterized by a longer half-life and greater affinity to the receptor. Administration of the preparation in the first phase stimulates pituitary secretion of LH and FSH hormones, and then the pituitary sensitivity threshold increases and gonadotropin secretion is reduced. As a result, the concentration of sex hormones in the blood decreases to the values occurring after the expiration of gonadal activity. These effects are transient. After intramuscular administration of the preparation, the maximum concentration of triptorelin in the blood occurs in the first hours, after which it decreases gradually over the Next 24 hours and on the 4th day reaches the second maximum. At day 44 after administration of the preparation in the form of depot, the concentration of triptorelin is below the determinable level. After subcutaneous administration, the maximum concentration is lower and its increase is more gradual than after intramuscular administration. Decreased concentration to indeterminate values triptorelin administered subcutaneously only after 65 days. Bioavailability in men: after intramuscular administration (depot) is 38.3% in the first 13 days, and further release is uniform and amounts to 0.92% of the dose per day; after subcutaneous administration, the bioavailability is 69% of the availability after intramuscular administration. Bioavailability in women: 35.7% of the dose after 27 days after administration (after 13 days of administration the bioavailability is 25.5%, and the further release of the active substance is linear and amounts to 0.73% of the administered dose per day).
Contraindications:
Hypersensitivity to triptorelin or other components of the preparation. Men: hormone-dependent prostate cancer, surgical castration (administration of the preparation does not cause further reduction of testosterone). Women: osteoporosis or risk of its occurrence (reduced bone density), pregnancy, and breastfeeding. The preparation is not recommended for children. Taking estrogen-containing preparations is contraindicated during the entire treatment period.
Precautions:
Particularly cautiously use in patients with polycystic ovary syndrome. In the treatment of uterine fibroids, the size of myomas should be monitored by ultrasonography in relation to the size of the uterus.
Pregnancy and lactation:
There is insufficient experience in people regarding the use of triptorelin during pregnancy, so make sure you are not pregnant before using the product. During treatment, women should use non-hormonal methods of contraception until regular menses return. In the case of simultaneous treatment of endometriosis and uterine fibroids, oral contraceptives should be administered during the first month of treatment. The preparation is not recommended during breastfeeding.
Side effects:
Side effects caused by suppression of sex hormones: in men, possible hot flushes, impotence, decreased libido, in rare cases gynecomastia, testicular atrophy, loss of hair on the chest, upper and lower limbs, sleep disorders; in women, possible hot flushes, spotting or bleeding, dryness of the vagina, dyspareunia. Normal menstruation recur after about 3 months after discontinuation of treatment. There may also be a small reduction in bone mass due to decreased estrogen levels. Bone tissue rebuilds completely after 6-9 months after discontinuation of treatment.In the first phase of treatment in men there may be a temporary increase in testosterone levels in the blood, which in some patients may be manifested by the severity of symptoms associated with underlying disease (urinary retention, bone pain in the presence of metastases, symptoms of spinal cord compression, myalgia and lymphoedema lower limbs). These symptoms disappear spontaneously after discontinuation of the preparation - administration of the anti-androgen group is recommended). Other side effects: men - pain and dizziness, low mood, weight changes, loss of appetite, bone pain, increased blood transaminases, thrombophlebitis; women - headache, irritability, nausea, depressed mood, sleep disturbances, fatigue, decreased libido, occasionally increased transaminases and slight increase in cholesterol, sensory disturbances, visual disturbances, weight gain, joint and muscle pain. Occasionally, allergic reactions (pruritus, skin rash, redness of the skin, fever, very rarely anaphylactic shock) have been observed. In individual cases, transient pain may occur at the injection site.
Dosage:
Decapeptide 0.1: the drug is given by subcutaneous injection at an initial dose of usually 0.5 mg per day for 7 days, then at a maintenance dose of 0.1 mg per day.Decapeptyl Depot: 3.75 mg deep intramuscularly every 28 days, changing the injection site for subsequent administrations. Preparation for radical surgery in prostate cancer - the preparation is given at least 3 months before the procedure. Determination of the hormone dependence of prostate cancer is possible after 3 months of treatment with the preparation. In women, due to the possibility of osteoporosis, use no longer than for 6 months.
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