Dosing & Uses
Dosage Forms & Strengths
lyophilized powder for reconstitution (Trelstar)
- Reconstitution results in suspension for IM injection
- 3.75mg/vial
- 11.25mg/vial
- 22.5mg/vial
Advanced Prostate Cancer
Trelstar: Due to different release characteristics, the dosage strengths are not additive and must be selected based upon the desired dosing schedule
22.5 mg IM q6Months, OR
11.25 mg IM q3Months, OR
3.75 mg IM 1Month
Dosing Considerations
Monitor serum testosterone and PSA
Dosage Forms & Strengths
lyophilized powder for reconstitution (Triptodur)
- 22.5mg/vial; reconstitution results in suspension for IM injection
- Each single-use (6 month) kit contains drug vial, prefilled diluent syringe, and 21 gauge needle
Central Precocious Puberty
Triptodur: Indicated for central precocious puberty, in patients aged ≥2 yr
<2 years: Safety and efficacy not established
≥2 years: 22.5 mg IM q6Months
Also see Administration
Dosage Modifications
Renal impairment: Not studied
Hepatic impairment: Not studied
Dosing Considerations
Discontinue at appropriate age of puberty onset
Monitor
- Monitor LH levels beginning 1-2 months following therapy initiation, during therapy, and with each subsequent dose
- Measure height every 3-6 months; monitor bone age periodically
- Noncompliance or inadequate dosing may result in irregular gonadotropins and/or sex steroids levels affecting preputial process; inadequate dosing may require switching to GnRH agonist alternative
Interactions
Interaction Checker
No Results
Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor
Contraindicated (3)
- amiodarone
triptorelin increases toxicity of amiodarone by QTc interval. Contraindicated. Increases risk of torsades de pointes.
- anagrelide
triptorelin increases toxicity of anagrelide by QTc interval. Contraindicated. Increases risk of torsades de pointes.
- dofetilide
triptorelin increases toxicity of dofetilide by QTc interval. Contraindicated. Increases risk of torsades de pointes.
Serious - Use Alternative (51)
- amisulpride
amisulpride and triptorelin both increase QTc interval. Avoid or Use Alternate Drug. ECG monitoring is recommended if coadministered.
- arsenic trioxide
triptorelin increases toxicity of arsenic trioxide by QTc interval. Avoid or Use Alternate Drug. Increases risk of torsades de pointes.
- artemether
triptorelin increases toxicity of artemether by QTc interval. Avoid or Use Alternate Drug. Increases risk of torsades de pointes.
- artemether/lumefantrine
triptorelin increases toxicity of artemether/lumefantrine by QTc interval. Avoid or Use Alternate Drug.
- asenapine
asenapine and triptorelin both increase QTc interval. Avoid or Use Alternate Drug.
- asenapine transdermal
asenapine transdermal and triptorelin both increase QTc interval. Avoid or Use Alternate Drug.
- buprenorphine
buprenorphine and triptorelin both increase QTc interval. Avoid or Use Alternate Drug.
- buprenorphine buccal
buprenorphine buccal and triptorelin both increase QTc interval. Avoid or Use Alternate Drug.
- buprenorphine subdermal implant
buprenorphine subdermal implant and triptorelin both increase QTc interval. Avoid or Use Alternate Drug.
- buprenorphine transdermal
buprenorphine transdermal and triptorelin both increase QTc interval. Avoid or Use Alternate Drug.
- buprenorphine, long-acting injection
buprenorphine, long-acting injection and triptorelin both increase QTc interval. Avoid or Use Alternate Drug.
- citalopram
triptorelin increases toxicity of citalopram by QTc interval. Avoid or Use Alternate Drug. Increases risk of torsades de pointes.
- desflurane
desflurane and triptorelin both increase QTc interval. Avoid or Use Alternate Drug.
- disopyramide
triptorelin increases toxicity of disopyramide by QTc interval. Avoid or Use Alternate Drug. Increases risk of torsades de pointes.
- dronedarone
triptorelin increases toxicity of dronedarone by QTc interval. Avoid or Use Alternate Drug. Increases risk of torsades de pointes.
- eliglustat
triptorelin increases toxicity of eliglustat by QTc interval. Avoid or Use Alternate Drug. Increases risk of torsades de pointes.
- encorafenib
encorafenib and triptorelin both increase QTc interval. Avoid or Use Alternate Drug.
- entrectinib
triptorelin and entrectinib both increase QTc interval. Avoid or Use Alternate Drug.
- escitalopram
triptorelin increases toxicity of escitalopram by QTc interval. Avoid or Use Alternate Drug. Increases risk of torsades de pointes.
- fexinidazole
fexinidazole and triptorelin both increase QTc interval. Avoid or Use Alternate Drug. Avoid coadministration of fexinidazole with drugs known to block potassium channels or prolong QT interval.
- fingolimod
fingolimod and triptorelin both increase QTc interval. Avoid or Use Alternate Drug.
- fluoxetine
triptorelin increases toxicity of fluoxetine by QTc interval. Avoid or Use Alternate Drug. Increases risk of torsades de pointes.
- glasdegib
triptorelin and glasdegib both increase QTc interval. Avoid or Use Alternate Drug. If coadministration unavoidable, monitor for increased risk of QTc interval prolongation.
- ibutilide
triptorelin increases toxicity of ibutilide by QTc interval. Avoid or Use Alternate Drug. Increases risk of torsades de pointes.
- iloperidone
triptorelin increases toxicity of iloperidone by QTc interval. Avoid or Use Alternate Drug. Increases risk of torsades de pointes.
- inotuzumab
inotuzumab and triptorelin both increase QTc interval. Avoid or Use Alternate Drug. If unable to avoid concomitant use, obtain ECGs and electrolytes before and after initiation of any drug known to prolong QTc, and periodically monitor as clinically indicated during treatment.
- isoflurane
isoflurane and triptorelin both increase QTc interval. Avoid or Use Alternate Drug.
- lefamulin
lefamulin and triptorelin both increase QTc interval. Avoid or Use Alternate Drug.
- lopinavir
triptorelin increases toxicity of lopinavir by QTc interval. Avoid or Use Alternate Drug. Increases risk of torsades de pointes.
- lumefantrine
triptorelin increases toxicity of lumefantrine by QTc interval. Avoid or Use Alternate Drug. Increases risk of torsades de pointes.
- mifepristone
triptorelin increases toxicity of mifepristone by QTc interval. Avoid or Use Alternate Drug. Increases risk of torsades de pointes.
- nilotinib
triptorelin increases toxicity of nilotinib by QTc interval. Avoid or Use Alternate Drug. Increases risk of torsades de pointes.
- olanzapine
olanzapine and triptorelin both increase QTc interval. Avoid or Use Alternate Drug.
- oxaliplatin
oxaliplatin and triptorelin both increase QTc interval. Avoid or Use Alternate Drug.
- palifermin
palifermin increases toxicity of triptorelin by Other (see comment). Avoid or Use Alternate Drug. Comment: Palifermin should not be administered within 24 hr before, during infusion of, or within 24 hr after administration of antineoplastic agents. Coadministration of palifermin within 24 hr of chemotherapy resulted in increased severity and duration of oral mucositis.
- paliperidone
triptorelin increases toxicity of paliperidone by QTc interval. Avoid or Use Alternate Drug. Increases risk of torsades de pointes.
- panobinostat
triptorelin and panobinostat both increase QTc interval. Avoid or Use Alternate Drug. Panobinostat is known to significantly prolong QT interval. Panobinostat prescribing information states use with drugs known to prolong QTc is not recommended.
- pimozide
triptorelin increases toxicity of pimozide by QTc interval. Avoid or Use Alternate Drug. Increases risk of torsades de pointes.
- pitolisant
triptorelin and pitolisant both increase QTc interval. Avoid or Use Alternate Drug.
- procainamide
triptorelin increases toxicity of procainamide by QTc interval. Avoid or Use Alternate Drug. Increases risk of torsades de pointes.
- quetiapine
triptorelin increases toxicity of quetiapine by QTc interval. Avoid or Use Alternate Drug. Increases risk of torsades de pointes.
- quinidine
triptorelin increases toxicity of quinidine by QTc interval. Avoid or Use Alternate Drug. Increases risk of torsades de pointes.
- sevoflurane
sevoflurane and triptorelin both increase QTc interval. Avoid or Use Alternate Drug.
- siponimod
siponimod and triptorelin both increase QTc interval. Avoid or Use Alternate Drug.
- sotalol
triptorelin increases toxicity of sotalol by QTc interval. Avoid or Use Alternate Drug. Increases risk of torsades de pointes.
- tetrabenazine
triptorelin increases toxicity of tetrabenazine by QTc interval. Avoid or Use Alternate Drug. Increases risk of torsades de pointes.
- thioridazine
triptorelin increases toxicity of thioridazine by QTc interval. Avoid or Use Alternate Drug. Increases risk of torsades de pointes.
- toremifene
triptorelin increases toxicity of toremifene by QTc interval. Avoid or Use Alternate Drug. Increases risk of torsades de pointes.
- vandetanib
triptorelin increases toxicity of vandetanib by QTc interval. Avoid or Use Alternate Drug. Increases risk of torsades de pointes.
- vemurafenib
triptorelin increases toxicity of vemurafenib by QTc interval. Avoid or Use Alternate Drug. Increases risk of torsades de pointes.
- ziprasidone
triptorelin increases toxicity of ziprasidone by QTc interval. Avoid or Use Alternate Drug. Increases risk of torsades de pointes.
Monitor Closely (78)
- albuterol
albuterol and triptorelin both increase QTc interval. Use Caution/Monitor.
- alfuzosin
triptorelin and alfuzosin both increase QTc interval. Use Caution/Monitor.
- apomorphine
triptorelin increases toxicity of apomorphine by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.
- arformoterol
triptorelin increases toxicity of arformoterol by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.
- aripiprazole
aripiprazole and triptorelin both increase QTc interval. Use Caution/Monitor.
- atomoxetine
atomoxetine and triptorelin both increase QTc interval. Use Caution/Monitor.
- azithromycin
triptorelin increases toxicity of azithromycin by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.
- bedaquiline
triptorelin increases toxicity of bedaquiline by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.
- ceritinib
triptorelin increases toxicity of ceritinib by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.
- chloroquine
triptorelin increases toxicity of chloroquine by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.
- chlorpromazine
triptorelin increases toxicity of chlorpromazine by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.
- cholera vaccine
triptorelin decreases effects of cholera vaccine by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Immunosuppressive therapies, including irradiation, antimetabolites, alkylating agents, cytotoxic drugs and corticosteroids (used in greater than physiologic doses), may reduce the immune response to cholera vaccine.
- ciprofloxacin
triptorelin increases toxicity of ciprofloxacin by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.
- clarithromycin
triptorelin increases toxicity of clarithromycin by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.
- clozapine
triptorelin increases toxicity of clozapine by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.
- crizotinib
triptorelin increases toxicity of crizotinib by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.
- degarelix
triptorelin increases toxicity of degarelix by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.
- dengue vaccine
triptorelin decreases effects of dengue vaccine by immunosuppressive effects; risk of infection. Use Caution/Monitor. Immunosuppressive therapies (eg, irradiation, antimetabolites, alkylating agents, cytotoxic drugs, corticosteroids [greater than physiologic doses]) may reduce immune response to dengue vaccine.
- deutetrabenazine
deutetrabenazine and triptorelin both increase QTc interval. Use Caution/Monitor. At the maximum recommended dose, deutetrabenazine does not prolong QT interval to a clinically relevant extent. Certain circumstances may increase risk of torsade de pointes and/or sudden death in association with drugs that prolong the QTc interval (eg, bradycardia, hypokalemia or hypomagnesemia, coadministration with other drugs that prolong QTc interval, presence of congenital QT prolongation).
- dolasetron
triptorelin increases toxicity of dolasetron by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.
- donepezil
donepezil and triptorelin both increase QTc interval. Use Caution/Monitor.
- doxepin
doxepin and triptorelin both increase QTc interval. Use Caution/Monitor.
- droperidol
triptorelin increases toxicity of droperidol by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.
- efavirenz
efavirenz and triptorelin both increase QTc interval. Use Caution/Monitor.
- eribulin
triptorelin increases toxicity of eribulin by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.
- erythromycin base
triptorelin increases toxicity of erythromycin base by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.
- erythromycin ethylsuccinate
triptorelin increases toxicity of erythromycin ethylsuccinate by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.
- erythromycin lactobionate
triptorelin increases toxicity of erythromycin lactobionate by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.
- erythromycin stearate
triptorelin increases toxicity of erythromycin stearate by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.
- ezogabine
triptorelin increases toxicity of ezogabine by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.
- fingolimod
triptorelin increases toxicity of fingolimod by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.
- flecainide
triptorelin increases toxicity of flecainide by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.
- fluconazole
triptorelin increases toxicity of fluconazole by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.
- formoterol
triptorelin increases levels of formoterol by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.
- fostemsavir
triptorelin and fostemsavir both increase QTc interval. Use Caution/Monitor. QTc prolongation reported with higher than recommended doses of fostemsavir.
- gallium Ga 68 PSMA-11
triptorelin will decrease the level or effect of gallium Ga 68 PSMA-11 by unspecified interaction mechanism. Modify Therapy/Monitor Closely. Androgen deprivation therapy and other therapies targeting the androgen pathway may result in changes in the uptake of gallium Ga 68 PSMA-11 in prostate cancer. The effect of ADT on the performance of gallium Ga 68 PSMA-11 is unknown.
- gemifloxacin
triptorelin increases toxicity of gemifloxacin by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.
- gemtuzumab
triptorelin and gemtuzumab both increase QTc interval. Use Caution/Monitor.
- gilteritinib
gilteritinib and triptorelin both increase QTc interval. Use Caution/Monitor.
- granisetron
granisetron and triptorelin both increase QTc interval. Use Caution/Monitor.
- haloperidol
triptorelin increases toxicity of haloperidol by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.
- hydroxyzine
hydroxyzine and triptorelin both increase QTc interval. Use Caution/Monitor.
- indacaterol, inhaled
triptorelin increases toxicity of indacaterol, inhaled by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.
- itraconazole
itraconazole and triptorelin both increase QTc interval. Use Caution/Monitor.
- lapatinib
triptorelin increases toxicity of lapatinib by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.
- lenvatinib
triptorelin and lenvatinib both increase QTc interval. Use Caution/Monitor. Lenvatinib prescribing information recommends monitoring ECG closely when coadministered with QT prolonging drugs.
- levofloxacin
triptorelin increases toxicity of levofloxacin by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.
- lithium
lithium and triptorelin both increase QTc interval. Use Caution/Monitor.
- metformin
triptorelin decreases effects of metformin by pharmacodynamic antagonism. Use Caution/Monitor.
- methadone
triptorelin increases toxicity of methadone by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.
- mirtazapine
mirtazapine and triptorelin both increase QTc interval. Use Caution/Monitor.
- moxifloxacin
triptorelin increases toxicity of moxifloxacin by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.
- ofloxacin
triptorelin increases toxicity of ofloxacin by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.
- ondansetron
triptorelin increases toxicity of ondansetron by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.
- osilodrostat
osilodrostat and triptorelin both increase QTc interval. Use Caution/Monitor.
- osimertinib
triptorelin increases toxicity of osimertinib by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.
- oxaliplatin
oxaliplatin will increase the level or effect of triptorelin by Other (see comment). Use Caution/Monitor. Monitor for ECG changes if therapy is initiated in patients with drugs known to prolong QT interval.
- pasireotide
triptorelin increases toxicity of pasireotide by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.
- pazopanib
triptorelin increases toxicity of pazopanib by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.
- pentamidine
triptorelin increases toxicity of pentamidine by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.
- perflutren
triptorelin increases toxicity of perflutren by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.
- primaquine
primaquine and triptorelin both increase QTc interval. Use Caution/Monitor.
- propafenone
triptorelin increases toxicity of propafenone by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.
- ranolazine
triptorelin increases toxicity of ranolazine by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.
- romidepsin
triptorelin increases toxicity of romidepsin by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.
- saquinavir
triptorelin increases toxicity of saquinavir by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.
- sertraline
sertraline and triptorelin both increase QTc interval. Use Caution/Monitor.
- siponimod
siponimod and triptorelin both increase immunosuppressive effects; risk of infection. Use Caution/Monitor. Caution if coadministered because of additive immunosuppressive effects during such therapy and in the weeks following administration. When switching from drugs with prolonged immune effects, consider the half-life and mode of action of these drugs to avoid unintended additive immunosuppressive effects.
- solifenacin
solifenacin and triptorelin both increase QTc interval. Use Caution/Monitor.
- sorafenib
triptorelin increases toxicity of sorafenib by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.
- sunitinib
triptorelin increases toxicity of sunitinib by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.
- tacrolimus
tacrolimus and triptorelin both increase QTc interval. Use Caution/Monitor.
- telavancin
triptorelin increases toxicity of telavancin by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.
- trazodone
triptorelin increases toxicity of trazodone by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.
- triclabendazole
triclabendazole and triptorelin both increase QTc interval. Use Caution/Monitor.
- valbenazine
valbenazine and triptorelin both increase QTc interval. Use Caution/Monitor.
- voriconazole
triptorelin increases toxicity of voriconazole by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.
- vorinostat
vorinostat and triptorelin both increase QTc interval. Use Caution/Monitor.
Minor (2)
- maitake
maitake increases effects of triptorelin by pharmacodynamic synergism. Minor/Significance Unknown. Maitake mushroom has anti-tumor effects (animal/in vitro research).
- taurine
triptorelin decreases levels of taurine by unspecified interaction mechanism. Minor/Significance Unknown.
Adverse Effects
>10%
Trelstar
- Hot flushes (82%)
- Skeletal pain (17%)
Triptodur
- Injection site pain (45%)
- Nasopharyngitis (14%)
- Headache (14%)
- Injection site redness (14%)
1-10%
Trelstar
- Impotence (10%)
- Headache (7%)
- Hypertension (5%)
- Injection site pain (5%)
- Generalized pain (3%)
- Vomiting (3%)
- Fatigue (3%)
- Insomnia (3%)
- UTI (3%)
- Diarrhea (2%)
- Pruritus (2%)
- UTI (2%)
- Spinal cord compression (rare)
Triptodur
- Upper respiratory infection (9%)
- Vaginal bleeding (8%)
- Cough (7%)
- Hot flushes (5%)
- Injection site pruritus (2.3%)
- Injection site swelling (2.3%)
Postmarketing Reports
Pituitary apoplexy
Convulsions
Thromboembolic events including pulmonary emboli, CVA, MI, DVT, TIA, and thrombophlebitis
Interstitial lung disease
Pseudotumor cerebri (idiopathic intracranial hypertension)
Warnings
Contraindications
Hypersensitivity
Pregnancy or women who may become pregnant
Cautions
Risk of pituitary apoplexy (rare)
Hyperglycemia and an increased risk of developing diabetes have been reported in men receiving GnRH agonists
Cases of spinal cord compression, which may contribute to weakness or paralysis with or without fatal complications, have been reported with GnRH agonists
Reports of MI, sudden cardiac death, and stroke in men treated with GnRH agonists
QT prolongation
- Androgen deprivation therapy may prolong the QT/QTc interval; consider whether the benefits of androgen deprivation therapy outweigh the potential risks in patients with congenital long QT syndrome, congestive heart failure, frequent electrolyte abnormalities, and in patients taking drugs known to prolong the QT interval
- Electrolyte abnormalities should be corrected
- Consider periodic monitoring of ECG and electrolytes
Triptodur
- Gonadotropin and sex steroid levels may initially rise above baseline during initial therapy or subsequent doses owing to transient stimulatory effect of drug; puberty signs and symptoms (eg vaginal bleeding) may transiently increase
- Psychiatric events: Monitor development or worsening psychiatric symptoms (eg, crying, irritability, impatience, anger, and aggression)
- Convulsion episodes: Increase risk with history of seizures, epilepsy, cerebrovascular disorders, central nervous system anomalies or tumors, and concomitant use of medications associated with convulsions (eg, SSRIs)
- Pseudotumor cerebri (idiopathic intracranial hypertension) reported in pediatric patients receiving GnRH agonists, including leuprolide acetate; monitor patients for signs and symptoms of pseudotumor cerebri, including headache, papilledema, blurred vision, diplopia, loss of vision, pain behind the eye or pain with eye movement, tinnitus, dizziness, and nausea
Pregnancy & Lactation
Pregnancy
Based on findings in animal studies and mechanism of action, therapy can cause fetal harm when administered to a pregnant woman; expected hormonal changes that occur with treatment increase risk for pregnancy loss; in animal developmental and reproductive toxicology studies, daily administration of drug to pregnant rats during period of organogenesis caused maternal toxicity and embryo-fetal toxicities, including loss of pregnancy, at doses as low as 0.2, 0.8, and 8 times estimated human daily dose based on body surface area; advise pregnant patients and females of reproductive potential of potential risk to fetus
Based on mechanism of action, treatment may impair fertility in males of reproductive potential
Lactation
The safety and efficacy not established in females; there are no data on presence of drug in human milk, effects of drug on milk production, or on breastfed child; because of potential for serious adverse reactions in a breastfed child from treatment, a decision should be made to either discontinue breastfeeding, or discontinue drug taking into account importance of drug to mother
Pregnancy Categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk. C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done. D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk. X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist. NA: Information not available.Pharmacology
Mechanism of Action
GnRH analog; decreases levels of LH and FSH resulting in suppression of steroidogenesis with subsequent decrease in testosterone (male) and estrogen (female) levels; a sustained decrease in LH and FSH secretion occurs after chronic and continuous administration
Pharmacokinetics
Trelstar
- Half-life: 3 hr
- Protein bound: None
- Vd: 30-33 L
- Time to peak: 1-3 hr
- Metabolism: Unknown; may involve CYP metabolism
- Metabolites: Not identified
- Clearance: 150 mL/min
- Excretion: urine (42%)
Triptodur
- Time to peak: 4 hr
- Metabolism: Unknown
- Metabolites: Not identified
- Clearance: 212 mL/min
- Excretion: urine
Administration
IM Preparation
Reconstitution lyophilized powder with diluent provided
Gently swirl vial until milk suspension forms
IM Administration
Must be administered under physician supervision
Use suspension immediately; avoid partial or combination syringe use
Alternate injection sites
Trelstar: Administer as single IM injection in either buttock
Triptodur: Inject entire syringe content into either buttock or thigh
Storage
Store at room temperature 20-25°C (68-77°F)
Do not freeze
Images
| BRAND | FORM. | UNIT PRICE | PILL IMAGE |
|---|---|---|---|
| Trelstar intramuscular - | 3.75 mg vial |  | |
| Trelstar intramuscular - | 22.5 mg vial |  | |
| Trelstar intramuscular - | 22.5 mg vial |  | |
| Trelstar intramuscular - | 11.25 mg vial |  |
Copyright © 2010 First DataBank, Inc.
Patient Handout
triptorelin pamoate intramuscular
TRIPTORELIN 6 MONTH (22.5 MG) - INJECTION
(trip-toe-REL-in)
COMMON BRAND NAME(S): Trelstar
USES: Triptorelin is used to treat advanced prostate cancer. It is not a cure. Most types of prostate cancer need the hormone testosterone to grow and spread. Triptorelin works by reducing the amount of testosterone that the body makes. This effect helps slow or stop the growth of cancer cells and helps relieve symptoms such as painful/difficult urination. This medication is similar to a natural substance made by the body (luteinizing hormone releasing hormone-LHRH). Talk to your doctor about the risks and benefits of treatment.
HOW TO USE: This medication is given as an injection into the muscle of your buttocks by a health care professional. It is given as directed by your doctor, usually once every 6 months.Follow the dosing schedule carefully to get the most benefit from this drug. To help you remember, mark your calendar to keep track of your next dose.During the first few weeks of treatment, your testosterone level will actually increase before it decreases. This is a normal response by your body to this drug. This effect may result in new or worsening symptoms for the first few weeks. If you have prostate cancer that has spread to the spine or that has caused urinary blockage, you may require closer monitoring by your doctor, especially when you first start treatment. Tell your doctor right away if you experience any of the following serious side effects: bone pain, numbness/tingling/weakness of the arms/legs, blood in the urine, painful/difficult urination.Tell your doctor if your condition does not improve or if it worsens.
SIDE EFFECTS: See also the How to Use section.Hot flashes (flushing), decreased sexual interest/ability, shrinking of the testicles, and breast tenderness/swelling may occur as a result of lowered testosterone levels. Dizziness and headache may also occur with this drug. If any of these effects bother you, tell your doctor or pharmacist promptly.Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Tell your doctor right away if you have any serious side effects, including: bone/joint/unusual pain, easily broken bones, swelling of the ankles/feet, unusual weakness, inability to move (paralysis), increased thirst, increased urination, mental/mood changes (such as depression).Get medical help right away if you have any very serious side effects, including: chest/jaw/left arm pain, fast/irregular heartbeat, severe dizziness, fainting, weakness on one side of the body, trouble speaking.A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.
PRECAUTIONS: Before using triptorelin, tell your doctor or pharmacist if you are allergic to it; or to other LHRH-type drugs (such as leuprolide); or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: kidney disease, liver disease, personal or family history of weak/broken bones (osteoporosis), diabetes, heart disease (such as heart attack), stroke, high cholesterol, mental/mood problems (such as depression).Triptorelin may cause a condition that affects the heart rhythm (QT prolongation). QT prolongation can rarely cause serious (rarely fatal) fast/irregular heartbeat and other symptoms (such as severe dizziness, fainting) that need medical attention right away.The risk of QT prolongation may be increased if you have certain medical conditions or are taking other drugs that may cause QT prolongation. Before using triptorelin, tell your doctor or pharmacist of all the drugs you take and if you have any of the following conditions: certain heart problems (heart failure, slow heartbeat, QT prolongation in the EKG), family history of certain heart problems (QT prolongation in the EKG, sudden cardiac death).Low levels of potassium or magnesium in the blood may also increase your risk of QT prolongation. This risk may increase if you use certain drugs (such as diuretics/"water pills") or if you have conditions such as severe sweating, diarrhea, or vomiting. Talk to your doctor about using triptorelin safely.This drug may make you dizzy. Alcohol or marijuana (cannabis) can make you more dizzy. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Limit alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).Older adults may be more sensitive to the side effects of this drug, especially QT prolongation (see above).Females: Triptorelin is not usually used by women. It must not be used by pregnant women because it may harm an unborn baby. If you become pregnant or think you may be pregnant, tell your doctor right away. Breast-feeding is also not recommended during triptorelin treatment. Consult your doctor for more details and before breast-feeding, and to discuss reliable forms of birth control.
DRUG INTERACTIONS: Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.
OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center.
NOTES: Lab and/or medical tests (such as testosterone blood levels, PSA blood tests, blood glucose) should be done while you are using this medication. Keep all medical and lab appointments. Consult your doctor for more details.
MISSED DOSE: It is important to get each dose of this medication as scheduled. If you miss a dose, ask your doctor or pharmacist right away for a new dosing schedule.
STORAGE: Not applicable. This medication is given in a doctor's office and will not be stored at home.
Information last revised May 2023. Copyright(c) 2023 First Databank, Inc.
IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.
Formulary
Adding plans allows you to compare formulary status to other drugs in the same class.
To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.
Adding plans allows you to:
- View the formulary and any restrictions for each plan.
- Manage and view all your plans together – even plans in different states.
- Compare formulary status to other drugs in the same class.
- Access your plan list on any device – mobile or desktop.
