Decapeptyl (triptorelin, GnRH analogues)

Decapeptyl is the brand name of the drug triptorelin acetate (or other forms). Triptorelin is a gonadotropin releasing hormone (GnRH) agonist. It binds to receptors and trigger the release of follicle-stimulating hormone (FSH) and luteinizing hormone (LH). FSH and LH are gonadotropins that have effects on female ovaries and male testes.

Uses

What is Decapeptyl used for?

Decapeptyl is commonly used for:

• Advanced prostate cancer
• Endometriosis
• Uterine fibroids
• Female infertility
• Precocious (early) puberty

How should I take Decapeptyl?

If you are using the pre-filled daily syringe, there is no need to reconstitute the medication. Administer the dose as instructed by your doctor, either via intramuscular (IM) or subcutaneous (SQ) route. The best area to inject is the gluteal or buttocks area for IM injection, while the abdomen or thighs are ideal for SQ injections. Rotate between injection sites to prevent soreness and injury.

How do I store Decapeptyl?

This product is best stored in the refrigerator (2-8°C) or in a cool place (<25°C) away from direct light and moisture. To prevent drug damage, you should not store it in the bathroom or the freezer. 

There may be different brands of this drug that may have different storage needs. So, it is important to always check the product package for instructions on storage, or ask your pharmacist. For safety, you should keep all medicines away from children and pets.

You should not flush this product down the toilet or pour them into a drain unless instructed to do so. Additionally, it is important to properly discard this product when it is expired or no longer needed. Consult your pharmacist for more details about how to safely discard your product.

Precautions & Warnings

What should I know before using Decapeptyl?

Before using this drug, tell your doctor if you are/have:

Is it safe during pregnancy or breastfeeding?

There is positive evidence that this drug can cause serious birth defects and should never be taken while pregnant under any circumstance. Inform your doctor if you are pregnant or plan to become pregnant if you are currently taking this drug. You may be advised to use contraception while taking this drug.

Decapeptyl is a pregnancy risk category X, according to the US Food and Drug Administration (FDA).

FDA pregnancy risk category reference below:

• A=No risk
• B=No risk in some studies
• C=There may be some risk
• D=Positive evidence of risk
• X=Contraindicated
• N=Unknown

Side Effects

What side effects can occur from Decapeptyl?

Like all drugs, this product may have side effects. If they occur, side effects are generally mild and resolve once treatment is finished or the dose is lowered. Some reported side effects include:

• Pain, redness or inflammation of the skin at the injection site
• Hot flushes
• Dizziness
• Sweating
• Headache
• Decreased sex drive
• Mood changes (including depression)
• Disturbances of the gut (such as diarrhea, constipation, nausea, vomiting or abdominal pain)
• Weight changes
• Visual disturbances
• Difficulty sleeping (insomnia)
• Edema
• Muscle and joint pain
• Increase in blood pressure
• Decreased bone density
• Shortness of breath
• Wheezing
• Difficulty breathing
• Swelling of the face, lips, tongue or other parts of the body
• Rash, itching or hives on the skin
• Acne

Side effects specific to men may include:

• Problems with getting an erection (erectile dysfunction) or ejaculation
• Abnormal enlargement of breasts (gynecomastia)
• Feeling weak or tired

Side effects specific to women may include:

• Vaginal dryness
• Painful sex
• Breast pain

However, not everyone experiences these side effects. In addition, some people may experience other side effects. So, if you have any concerns about a side effect, please consult your doctor or pharmacist.

Interactions

What drugs may interact with Decapeptyl?

This medication may interact with other drugs that you are currently taking, which can change how your drug works or increase your risk for serious side effects. 

To avoid any potential drug interactions, you should keep a list of all the drugs you are using (including prescription drugs, nonprescription drugs, and herbal products) and share it with your doctor and pharmacist.

Drugs with known interactions:

• Antidiabetic agents
• Choline C11
• Corifollitropin alfa
• Gallium Ga 68 PSMA-11
• Haloperidol
• Indium 111 capromab pendetide
• Piflufolastat F18
• QT-prolonging agents (e.g. amiodarone, sotalol, quinidine)

If you experience an adverse drug interaction, stop taking this drug and continue taking your other medication. Inform your doctor immediately to reevaluate your treatment plan. Approaches include dose adjustment, drug substitution, or ending therapy.

Does food or alcohol interact with Decapeptyl?

This drug may interact with food or alcohol by altering the way the drug works or increase the risk for serious side effects. Please discuss with your doctor or pharmacist any potential food or alcohol interactions before using this drug.

What health conditions may interact with Decapeptyl?

This drug may interact with underlying conditions. This interaction may worsen your health condition or alter the way the drug works. Therefore, it is important to always let your doctor and pharmacist know all the health conditions you currently have.

Dosage

The information provided is not a substitute for any medical advice. Therefore, you should always consult with your doctor or pharmacist before using any medication.

What is the dose for an adult?

Prostate cancer (advanced)

• Administer Decapeptyl 3.75 mg once every 4 weeks (1 month) via intramuscular (IM) injection or;
• 11.25 mg once every 12 weeks (3 months) or;
• 22.5 mg once every 24 weeks (6 months).

Controlled ovarian hyperstimulation for ART adjunctive therapy

• Administer 0.1 mg once a day via subcutaneous (SQ) injection 5 to 7 days before the expected start of menses (period).
• Dose should be adjusted as necessary and continued until the follicles are a suitable size, approximately 4 to 7 weeks.

Endometrial stromal sarcoma

• Administer 3.75 mg via IM injection once every 28 days for 3 to 5 months. This is an off-label use for this drug.

Endometriosis

• 1st option: Administer 3.75 mg via IM injection once every 4 weeks for a total of 6 doses.
• 2nd option: Administer 3.75 mg once every 6 weeks for a total of 4 doses.
• 3rd option: Administer 11.25 mg once every 3 months.
• Estrogen or progestin therapy is recommended at the start of therapy and should be evaluated after 3 months. Treatment should not exceed 6 to 12 months.

Paraphilia/hypersexuality

• Via SQ injection: Administer 1 mg; if tolerated, follow with monthly IM injections as shown below.
• Via IM injection: Administer 3.75 mg once a month.

Precocious puberty

Based on body weight:

• Less than 20 kg: Administer 1.875 mg via IM injection.
• 20 to 30 kg: Administer 2.5 mg via IM injection.
• More than 30 kg: Administer 3.75 mg via IM injection.
• Administer on days 0, 14, and 28. Repeat the same dose every 4 weeks (1 month). If response is insufficient, repeat the dose every 3 weeks.

In vitro fertilization

• Administer 0.5 mg via SQ injection for 7 to 10 days, then 0.1 mg via SQ injection once a day.

What is the dose for a child?

To treat premature puberty Decapeptyl is given as a three-monthly injection. Treatment is stopped around the usual age for reaching puberty and should not be continued beyond when bone development has reached that expected in girls aged 12 years and boys aged 13 to 14 years.

How is Decapeptyl available?

Decapeptyl is available in the following dosage forms and strengths:

• Daily injection (Decapeptyl CR) disposable pre-filled syringe containing 3.75 mg in 1 mL solvent.
• Depot injection (3 monthly): powder and solvent for suspension for injection containing 11.25 mg
• Decapeptyl SR 3 mg, 11.25 mg (triptorelin pamoate)
• Decapeptyl LP (6 monthly): 22.5 mg (triptorelin embonate)

What should I do in case of an emergency or overdose?

In case of an emergency or an overdose, call your local emergency services or go to the nearest emergency room.

What should I do if I miss a dose?

If you miss a dose, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and take your regular dose as scheduled. Do not take a double dose.