ADVANCED PROSTATE CANCER:
BY SUBCUTANEOUS INJECTION IN A USUAL SINGLE DAILY DOSE OF 1 MG. IT IS ALSO GIVEN SUBCUTANEOUSLY OR INTRAMUSCULARLY AS DEPOT PREPARATIONS BUT THE DOSAGE AND ROUTE OF THESE MAY DIFFER BETWEEN COUNTRIES. IN THE UK, 3.75 MG MAY BE GIVEN ONCE A MONTH, OR 11.25 MG EVERY 3 MONTHS. IN THE USA, HOWEVER, THE DOSE IS 7.5 MG MONTHLY, 22.5 MG EVERY 3 MONTHS, OR 30 MG EVERY 4 MONTHS, GIVEN S/C OR IM, DEPENDING ON THE PREPARATION. A DEPOT PREPARATION OF 45 MG GIVEN S/C ONCE EVERY 6 MONTHS IS ALSO USED IN THE USA. A NONBIODEGRADABLE TITANIUM ALLOY IMPLANT IS ALSO AVAILABLE, WHICH IS INSERTED SUBCUTANEOUSLY INTO THE INNER PART OF THE UPPER ARM. IT CONTAINS 72 MG OF LEUPRORELIN ACETATE AND DELIVERS THE DRUG AT A CONTROLLED RATE OF 120 MICROGRAMS DAILY. AFTER 12 MONTHS IT MUST BE REMOVED, BUT CAN BE REPLACED BY ANOTHER IMPLANT TO CONTINUE THERAPY. AN ANTI-ANDROGEN SUCH AS CYPROTERONE ACETATE MAY BE GIVEN FOR SEVERAL DAYS BEFORE BEGINNING LEUPRORELIN THERAPY AND CONTINUED FOR ABOUT 3 WEEKS, TO AVOID THE RISK OF A DISEASE FLARE.
ENDOMETRIOSIS AND UTERINE FIBROIDS:
LEUPRORELIN ACETATE 3.75 MG MONTHLY MAY BE GIVEN AS A SINGLE DEPOT INJECTION, IM OR S/C. ALTERNATIVELY, 11.25 MG MAY BE GIVEN AS AN IM DEPOT EVERY 3 MONTHS. TREATMENT IS BEGUN DURING THE FIRST 5 DAYS OF THE MENSTRUAL CYCLE, AND MAY BE CONTINUED FOR UP TO 6 MONTHS FOR ENDOMETRIOSIS, WHILE IN WOMEN WITH ANAEMIA DUE TO UTERINE FIBROIDS IT IS CONTINUED, WITH IRON SUPPLEMENTATION, USUALLY FOR UP TO 3 MONTHS. TO PREPARE FOR UTERINE SURGERY INCLUDING ENDOMETRIAL ABLATION OR RESECTION, A SINGLE 3.75 MG DEPOT INJECTION MAY BE GIVEN 5 TO 6 WEEKS BEFORE THE PROCEDURE, OR MONTHLY FOR 3 TO 4 MONTHS BEFORE SURGERY FOR UTERINE FIBROIDS.
CENTRAL PRECOCIOUS PUBERTY :
LEUPRORELIN ACETATE HAS BEEN GIVEN BY IM DEPOT INJECTION IN A DOSE OF 300 MICROGRAMS/KG EVERY 4 WEEKS, ADJUSTED ACCORDING TO RESPONSE. DOSES OF 50 MICROGRAMS/KG DAILY BY S/C, ADJUSTED ACCORDING TO RESPONSE, HAVE ALSO BEEN USED.
LEUPRORELIN ACETATE HAS ALSO BEEN GIVEN IN OTHER SEX-HORMONE-RELATED DISORDERS AND HAS BEEN TRIED IN SOME GASTROINTESTINAL DISORDERS SUCH AS IRRITABLE BOWEL SYNDROME.