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Supprelin LA (Subcutaneous)

Generic Name: histrelin (Subcutaneous route)

his-TREL-in

Commonly used brand name(s)

In the U.S.

  • Supprelin LA
  • Vantas

Available Dosage Forms:

  • Kit
  • Implant

Therapeutic Class: Endocrine-Metabolic Agent

Pharmacologic Class: Gonadotropin Releasing Hormone Agonist

Uses For Supprelin LA

Histrelin is a synthetic (man-made) hormone that is similar to a natural hormone that is produced in the brain. This medicine works in the brain to reduce the blood levels of sex hormones, such as testosterone and estrogen. It is inserted just beneath the skin of the upper arm where it releases small amounts of histrelin in the body every day for 12 months.

Histrelin (Vantas®) is used to treat advanced prostate cancer in adults. It will reduce the level of testosterone, a male hormone, in the blood. Testosterone makes most prostate cancers grow. Histrelin is not a cure for prostate cancer, but it may help relieve the symptoms.

Histrelin (Supprelin® LA) is used to treat central precocious puberty (CPP) in children. CPP is a condition wherein puberty begins at an unusually early age. This usually means puberty occurs before 8 years of age in girls and before 9 years of age in boys.

This medicine is to be given only by or under the direct supervision of a trained healthcare professional.

Before Using Supprelin LA

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

The Vantas® form of histrelin should not be used in children.

Appropriate studies performed to date have not demonstrated pediatric-specific problems that would limit the usefulness of Supprelin® LA in children 2 years of age and older. However, use in children younger than 2 years of age is not recommended. Safety and efficacy have not been established.

Geriatric

No information is available on the relationship of age to the effects of Supprelin® LA or Vantas® in the elderly.

Pregnancy

Pregnancy Category Explanation
All Trimesters X Studies in animals or pregnant women have demonstrated positive evidence of fetal abnormalities. This drug should not be used in women who are or may become pregnant because the risk clearly outweighs any possible benefit.

Breast Feeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

  • Amifampridine
  • Amisulpride
  • Bepridil
  • Cisapride
  • Dronedarone
  • Mesoridazine
  • Pimozide
  • Piperaquine
  • Saquinavir
  • Sparfloxacin
  • Terfenadine
  • Thioridazine
  • Ziprasidone

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Alfuzosin
  • Amiodarone
  • Amitriptyline
  • Anagrelide
  • Apomorphine
  • Aripiprazole
  • Aripiprazole Lauroxil
  • Arsenic Trioxide
  • Asenapine
  • Astemizole
  • Atazanavir
  • Azithromycin
  • Bedaquiline
  • Chloroquine
  • Chlorpromazine
  • Ciprofloxacin
  • Citalopram
  • Clarithromycin
  • Clomipramine
  • Clozapine
  • Crizotinib
  • Cyclobenzaprine
  • Dabrafenib
  • Dasatinib
  • Delamanid
  • Desipramine
  • Deutetrabenazine
  • Disopyramide
  • Dofetilide
  • Dolasetron
  • Domperidone
  • Donepezil
  • Doxepin
  • Droperidol
  • Ebastine
  • Efavirenz
  • Eribulin
  • Erythromycin
  • Escitalopram
  • Famotidine
  • Felbamate
  • Fingolimod
  • Flecainide
  • Fluconazole
  • Fluoxetine
  • Formoterol
  • Foscarnet
  • Fosphenytoin
  • Galantamine
  • Gatifloxacin
  • Gemifloxacin
  • Granisetron
  • Halofantrine
  • Haloperidol
  • Hydroquinidine
  • Hydroxychloroquine
  • Hydroxyzine
  • Ibutilide
  • Iloperidone
  • Imipramine
  • Itraconazole
  • Ivabradine
  • Ketoconazole
  • Lapatinib
  • Levofloxacin
  • Lumefantrine
  • Mefloquine
  • Methadone
  • Metronidazole
  • Mifepristone
  • Mizolastine
  • Moxifloxacin
  • Nelfinavir
  • Nilotinib
  • Norfloxacin
  • Octreotide
  • Ofloxacin
  • Olanzapine
  • Ondansetron
  • Paliperidone
  • Panobinostat
  • Paroxetine
  • Pasireotide
  • Pazopanib
  • Pentamidine
  • Perphenazine
  • Pimavanserin
  • Pipamperone
  • Pitolisant
  • Posaconazole
  • Probucol
  • Procainamide
  • Prochlorperazine
  • Promethazine
  • Propafenone
  • Protriptyline
  • Quetiapine
  • Quinidine
  • Quinine
  • Ranolazine
  • Ribociclib
  • Rilpivirine
  • Risperidone
  • Ritonavir
  • Sertindole
  • Sevoflurane
  • Sodium Phosphate
  • Sodium Phosphate, Dibasic
  • Sodium Phosphate, Monobasic
  • Solifenacin
  • Sorafenib
  • Sotalol
  • Sulpiride
  • Sunitinib
  • Tacrolimus
  • Tamoxifen
  • Telaprevir
  • Telavancin
  • Telithromycin
  • Tetrabenazine
  • Tizanidine
  • Tolterodine
  • Toremifene
  • Trazodone
  • Trimipramine
  • Vandetanib
  • Vardenafil
  • Vemurafenib
  • Venlafaxine
  • Vilanterol
  • Vinflunine
  • Voriconazole
  • Vorinostat
  • Zuclopenthixol

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

  • Bladder blockage or
  • Diabetes or
  • Heart attack, history of or
  • Heart disease or
  • Hyperglycemia (high blood sugar) or
  • Kidney problems (reduced urine flow) or
  • Nerve problems in the spine from cancer lesions in the bones or
  • Problems passing urine or
  • Spinal cord problems or
  • Stroke, history of—Use with caution. May make these conditions worse in men.
  • Brain tumor, history of or
  • Seizures or epilepsy, history of—Use with caution. May cause side effects to become worse.
  • Congestive heart failure or
  • Electrolyte imbalance or
  • Heart rhythm problems (eg, congenital long QT syndrome)—May cause side effects to become worse.
  • Depression, history of or
  • Mental illness, history of—Use with caution. May make these conditions worse.

Proper Use of histrelin

This section provides information on the proper use of a number of products that contain histrelin. It may not be specific to Supprelin LA. Please read with care.

A doctor or other trained health professional will give you this medicine. The histrelin implant will be placed under the skin in the inner area of the upper arm.

Your doctor will treat the upper arm with a numbing medicine (anesthetic) and then cut a small incision to insert the implant. The incision will be closed with either stitches or surgical strips. A pressure bandage will be placed over the arm and left in place for 24 hours.

Do not remove the surgical strips. Allow them to fall off on their own after several days. If the incision has been stitched, your doctor will remove the stitches or they will dissolve after several days.

After the implant is inserted, you should keep the arm clean and dry. Do not swim or bathe for 24 hours. You should avoid any heavy lifting or strenuous exercise for the first 7 days after the implant is inserted.

The implant will be left in place for one year (12 months) and then removed. If needed, your doctor will insert a new implant to continue treatment for another year.

This medicine may come with a Medication Guide and patient instructions. Read and follow these instructions carefully. Ask your doctor or pharmacist if you have any questions.

Use only the brand of this medicine that your doctor prescribed. Different brands may not work the same way.

Precautions While Using Supprelin LA

It is very important that your doctor check the progress of you or your child at regular visits to make sure the implant is in the proper place and is working properly. Blood tests may be needed to check for unwanted effects.

For female patients: You should not receive this medicine if you are pregnant or may become pregnant. Using this medicine while you are pregnant can harm your unborn baby. Use an effective form of birth control to keep from getting pregnant during treatment with this medicine. If you think you have become pregnant while using the medicine, tell your doctor right away.

You may have some pain, redness, or bruising at the site where the implant is placed. If your arm has not healed within 2 weeks after you received the implant or if you continue to have redness or pain, call your doctor.

For children using Supprelin® LA:

  • The medicine can cause a brief increase in blood levels of some hormones. During this time, you may notice more signs of puberty in your child, including light vaginal bleeding and breast enlargement in girls. If your child's symptoms do not improve within 4 weeks, or if they get worse, call your doctor.
  • This medicine may cause some children to be agitated, irritable, or display other abnormal behaviors. Make sure the doctor knows if your child is having trouble sleeping, gets upset easily, has a big increase in energy, or starts to act reckless. Also tell the doctor if your child has sudden or strong feelings, such as feeling nervous, angry, restless, violent, or scared. If you or your caregiver notice any of these side effects, tell your doctor right away.
  • Using this medicine may increase your child's risk of having seizures. Check with your doctor right away if your child starts to have convulsions, muscle spasm or jerking of all extremities, sudden loss of consciousness, or loss of bladder control.

For male patients:

  • When you start using Vantas®, some of your symptoms might get worse for a short time. You might also have new symptoms such as bone pain, back pain, a tingling or numbness in the body, blood in the urine, or trouble urinating. The symptoms should improve in a few weeks. Tell your doctor if you have any new symptoms or your symptoms get worse.
  • This medicine may cause your blood sugar level to increase. If you are diabetic and notice a change in the results of your blood or urine sugar tests, check with your doctor.
  • This medicine may increase your risk of having a heart attack or stroke. Check with your doctor right away if you have chest pain or discomfort, difficulty with speaking, headache, pain or discomfort in the arms, jaw, back or neck, shortness of breath, sweating, or vomiting while using the medicine.
  • Contact your doctor right away if you have any changes to your heart rhythm. You might feel dizzy or faint, or you might have a fast, pounding, or uneven heartbeat. Make sure your doctor knows if you or anyone in your family has ever had a heart rhythm problem such as QT prolongation.

Before you have any medical tests, tell the medical doctor in charge that you are using histrelin implant. The results of some tests may be affected by this medicine.

Supprelin LA Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor or nurse immediately if any of the following side effects occur:

Rare
  • Bloody urine
  • decreased frequency or amount of urine
  • increased thirst
  • loss of appetite
  • lower back or side pain
  • nausea
  • swelling of the face, fingers, or lower legs
  • trouble breathing
  • unusual tiredness or weakness
  • vomiting
  • weight gain
Incidence not known
  • Bloating of the stomach
  • dark urine
  • discouragement
  • feeling sad or empty
  • irritability
  • light-colored stools
  • loss of interest or pleasure
  • seizures
  • stomach pain
  • trouble concentrating
  • trouble sleeping
  • yellow eyes or skin

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common
  • Decrease in testicle size
  • feeling of warmth
  • local infection, irritation, pain, redness, or swelling on the skin where the implant was placed
  • redness of the face, neck, arms, and upper chest
  • sudden sweating
Less common
  • Decreased interest in sexual intercourse
  • difficulty having a bowel movement
  • flushing or redness of the skin
  • headache
  • inability to have or keep an erection
  • loss in sexual ability, desire, drive, or performance
  • swelling of the breast or breast soreness in both females and males
  • unusually warm skin

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

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