Degarelix


Concise Prescribing Info
Indications/Uses
Advanced prostate cancer.
Dosage/Direction for Use
Adult : SC Loading dose: 240 mg. Maintenance: 80 mg once every 28 days, starting 28 days after the initial dose.
Dosage Details
Subcutaneous
Advanced prostate cancer
Adult: Loading dose: As 40 mg/mL solution: 240 mg (given as 2 separate injections of 120 mg). Maintenance: As 20 mg/mL solution: 80 mg once every 28 days, starting 28 days after the initial dose. Doses are administered in the abdominal area.
Reconstitution
Add 4.2 or 3 mL of sterile water for injection to a vial containing 80 or 120 mg, respectively, to provide a 20 or 40 mg/mL solution, respectively. Swirl gently, do not shake.
Contraindications
Hypersensitivity. Pregnancy and lactation.
Special Precautions
Patient with congenital long QT syndrome, history of or risk factors for QT prolongation (e.g. cardiac failure, electrolyte imbalance) and CV disease; diabetes, risk factors for low BMD. Moderate to severe renal (CrCl <50 mL/min) and severe hepatic impairment.
Adverse Reactions
Significant: Anaemia, hypersensitivity reactions, QT prolongation, decreased BMD, decreased glucose tolerance, CV disease, antibody formation.
Gastrointestinal disorders: Nausea, constipation, diarrhoea.
General disorders and administration site conditions: Chills, fatigue, pyrexia, influenza-like illness, injection site reactions (e.g. erythema, pain), asthenia, night sweats.
Investigations: Increased hepatic transaminases.
Metabolism and nutrition disorders: Increased weight.
Musculoskeletal and connective tissue disorders: Back pain, arthralgia.
Nervous system disorder: Dizziness, headache.
Psychiatric disorders: Insomnia.
Reproductive system and breast disorders: Gynaecomastia, erectile dysfunction, testicular atrophy.
Skin and subcutaneous tissue disorders: Rash, hyperhidrosis.
Vascular disorders: Hot flush, hypertension.
Potentially Fatal: Rarely, anaphylaxis.
Patient Counseling Information
This drug may cause dizziness and fatigue, if affected, do not drive or operate machinery.
MonitoringParameters
Monitor prostate-specific antigen (PSA), serum testosterone levels, LFTs, serum electrolytes (e.g. Na, K, Ca, Mg), BMD, ECG.
Drug Interactions
Increased risk of QT prolongation with class IA (e.g. disopyramide) or class III (e.g. amiodarone) antiarrhythmics, antipsychotics, methadone and moxifloxacin.
Lab Interference
May interfere with diagnostic test results for gonadotropic and gonadal functions.
Action
Description: Degarelix, a synthetic decapeptide, reversibly and competitively binds to gonadotropin-releasing hormone (GnRH) receptors in the anterior pituitary gland, thereby decreasing secretion of luteinising hormone (LH) and follicle stimulating hormone (FSH), and subsequently reducing testicular androgen synthesis.
Pharmacokinetics:
Absorption: Time to peak plasma concentration: Within 2 days (loading dose).
Distribution: Volume of distribution: Approx 1 L/kg. Plasma protein binding: Approx 90%.
Metabolism: Undergoes peptide hydrolysis in the hepato-biliary system.
Excretion: Mainly via faeces (approx 70-80%, mainly as peptide fragments); via urine (approx 20-30%). Terminal elimination half-life: Approx 43-53 days (loading dose); approx 28 days (maintenance dose).
Chemical Structure

Chemical Structure Image

Source: National Center for Biotechnology Information. PubChem Database. Degarelix, CID=16136245, https://pubchem.ncbi.nlm.nih.gov/compound/Degarelix (accessed on Jan. 20, 2020)

Storage
Store at or below 25°C.
Follow applicable procedures for receiving, handling, administration and disposal. Wear gloves during receiving, unpacking, and placing in storage.
ATC Classification
L02BX02 - degarelix ; Belongs to the class of other hormone antagonists and related agents. Used in the treatment of advanced prostate cancer.
References
Anon. Degarelix. AHFS Clinical Drug Information [online]. Bethesda, MD. American Society of Health-System Pharmacists, Inc. https://www.ahfscdi.com. Accessed 03/04/2018.

Anon. Degarelix. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 03/04/2018.

Buckingham R (ed). Degarelix. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com . Accessed 03/04/2018.

Firmagon (Ferring Pharmaceuticals Inc.). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 03/04/2018.

Joint Formulary Committee. Degarelix. British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 03/04/2018.

Disclaimer: This information is independently developed by MIMS based on Degarelix from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to MIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, MIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2020 MIMS. All rights reserved. Powered by MIMS.com
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