Is Firmagon (degarelix) the same as Lupron Depot?
No, Firmagon (degarelix) is not the same as Lupron but they are both hormone deprivation treatments that may be used for the treatment of advanced prostate cancer.
Firmagon is a gonadotropin-releasing hormone (GnRH) receptor antagonist and Lupron is a GnRH agonist. Even though they appear to have opposing mechanisms of action, they both achieve the same result, which is a significant lowering of testosterone levels.
- Firmagon works by binding to pituitary GnRH receptors, reducing the release of luteinizing hormone (LH) and follicle-stimulating hormone (FSH), and subsequently testosterone.
- Lupron works by stimulating GnRH receptors so much that it desensitizes the receptor and down-regulates the secretion of LH and FSH and subsequently testosterone. Because it works in this way, infusions of Lupron initially produce a transient increase in testosterone, but continued stimulation results in a profound decrease in circulating testosterone.
Put simply, Firmagon takes a more direct path to testosterone suppression than Lupron.
- Firmagon is an antagonist that immediately stops testosterone production, preventing a testosterone surge and eliminating the need for any additional therapies.
- Lupron is an agonist that desensitizes the GnRH receptor but causes an initial surge in testosterone and may require additional medication.
By day 3, Firmagon causes a 94% reduction in testosterone levels, whereas Lupron causes a 65% INCREASE in testosterone levels by day 3. But by 28 days, both Firmagon and Lupron achieve a 98% reduction in testosterone levels.
Research has also indicated that, on the whole, Firmagon improves health-related quality of life (HRQoL) in patients with prostate cancer more than what Lupron does.
- Patients taking Firmagon were less likely to experience a deterioration in their mental health HRQoL, such as anxiety or depression, and had an overall improved level of health, compared with those taking Lupron.
- Lupron seemed to have a more favorable impact on bodily pain and insomnia.
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Firmagon Vs. Lupron Depot: Cardiovascular Risks
Long-term use of GnRH agonists, such as Lupron Depot for prostate cancer treatment has been linked to increased cardiovascular disease risk. While laboratory studies suggested newer GnRH antagonists, such as Firmagon, might cause fewer heart problems than older GnRH agonists, more recent research has been conflicting.
- In terms of cardiovascular risk, a large observational database study (George et al, 2020) found little benefit for medicines such as Firmagon over Lupron, with possibly a slightly higher risk of a heart attack and arrhythmia reported with medicines such as Firmagon compared to ones such as Lupron.
- Firmagon was not associated with a lower risk of cardiovascular events than Lupron Depot in a retrospective cohort study (Wallach et al, 2021).
- In contrast, Firmagon demonstrated a lower incidence of major adverse cardiovascular events compared to GnRH agonists, such as Lupron depot in a meta-analysis of 13 studies (Odat et al, 2025). However, the incidence of stroke, high blood pressure, heart attack, heart failure, and arrhythmia did not reach statistically significant difference.
Further clinical trials are required to establish if there is any difference in cardiovascular risk between Firmagon and Lupron depot.
References
- Comparison of the Impact of Degarelix and Leuprolide on the Health-Related Quality of Life of Patients with Prostate Cancer: Results of a 12-Month Phase III Clinical Trial – Supplement https://www.urotoday.com/uij-archives/1304-supplements/50174-comparison-of-the-impact-of-degarelix-and-leuprolide-on-the-health-related-quality-of-life-of-patients-with-prostate-cancer-results-of-a-12-month-phase-iii-clinical-trial-supplement.html
- Degarelix Updated 10/2021 AHFS Monograph https://www.drugs.com/monograph/degarelix.html
- Firmagon (degarelix acetate) Updated 03/2020. Ferring Pharmaceuticals Inc. https://www.drugs.com/pro/firmagon.html#s-34090-1
- Firmagon (degarelix acetate) https://firmagon.com/hcp/low-testosterone/
- Lupron Depot (leuprolide acetate). Updated 02/2021. https://www.drugs.com/pro/lupron-depot.html
- Wallach JD, Deng Y, McCoy RG, et al. Real-world Cardiovascular Outcomes Associated With Degarelix vs Leuprolide for Prostate Cancer Treatment. JAMA Netw Open. 2021 Oct 1;4(10):e2130587. doi: 10.1001/jamanetworkopen.2021.30587. PMID: 34677594; PMCID: PMC8536955.
- Odat RM, Jain H, Jain J, et al. Risk of cardiovascular disease following degarelix versus gonadotropin-releasing hormone agonists in patients with prostate cancer: a systematic review and meta-analysis, Urologic Oncology: Seminars and Original Investigations. 2025: 43 (6), 359-369. ISSN 1078-1439. https://doi.org/10.1016/j.urolonc.2024.12.277.
- George G, Garmo H, Scailteux LM, et al. Risk of cardiovascular disease following gonadotropin-releasing hormone agonists vs antagonists in prostate cancer: Real-world evidence from five databases. Int J Cancer. 2021 May 1;148(9):2203-2211. doi: 10.1002/ijc.33397. Epub 2020 Nov 23. PMID: 33186481; PMCID: PMC8049028.
Read next
Are Lupron Depot and Eligard the same drug?
Lupron Depot and Eligard are brand name medicines that both contain the active ingredient leuprolide acetate. Both Lupron Depot and Eligard are prescribed to treat the symptoms of advanced prostate cancer. Lupron Depot is also approved to treat endometriosis, uterine fibroids, or central precocious puberty (CPP) in children (early puberty). Continue reading
Can you get pregnant on Lupron Depot?
Yes, you may still become pregnant if you are using Lupron Depot. Lupron Depot is not a method of birth control. Even though you may not have a period, unprotected intercourse could result in pregnancy. You should use a reliable non-hormonal birth control such as condoms, a diaphragm with contraceptive jelly, or a copper IUD to prevent pregnancy. Lupron Depot can cause harm to an unborn child. Contact your doctor right away if you think you are pregnant. Continue reading
Does Lupron Depot need to be refrigerated?
Before reconstitution, Lupron Depot for treatment of prostate cancer can be stored in its original container at room temperature (77°F [25°C]), with a range between 59°F to 86°F [15°C to 30°C]). Once Lupron Depot is reconstituted, inject the suspension immediately. Discard if not used within two hours, because Lupron Depot does not contain a preservative. Continue reading
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