Eligard 22.5mg (swollen ankles and feet)

Youkilis,
Sorry about the lousy SEs. Why the switch away from Lupron? I wonder if the newer pill form of ADT, Orgovyx, might be a good option.

Sending supportive thoughts your way, Youkilis!

It's encouraging to MANY of us here that you are a 16-year prostate cancer SURVIVOR.

That being said, I'm sorry for the side effects that you are experiencing, after a switch to ELIGARD.

With it being a multi-month dose, the side effects may linger, unfortunately.

I wonder if there's a doctor that can offer ideas to mitigate the side effects you are experiencing?

I'm sorry for the pain and discomfort you are experiencing. Hopefully, you have an old comfortable pair of slippers you can wear!

I switched from LUPRON to FIRMAGON, and then later to ZOLADEX. I had no issues transitioning from one form of ADT to the next.

The reason for this was that LUPRON and FIRMAGON did not fully suppress my testosterone, which created "spikes and flares" in my PSA.

FIRMAGON also left me with painful site injection reactions which stung like a hornet's sting for a few days and left painful welts on my abdomen. So we all can experience side effects from various medications or treatments.

For me, ZOLADEX worked the magic.

It's good to know there are various forms of ADT.

Hopefully, your side effects will lessen. I hope there's a doctor that could also address this, in the meantime, and get you some relief.

With my best ~
CYCLONE ~ # Iowa State University

Youkilis said...
Hi Cyclone, Thanks for your thoughtful reply. I am aware of the nasty after effects of the Firmagon shot and it has to be given monthly. What can you tell me about Zoladex regarding side effects. Is it given monthly? One of my problems with handling these drugs is my advanced age. Lupron side effects were very manageable for me ten years ago and now they are very intense; even the 7.5mg one monthly shot. The side effects of Eligard 22.5mg are much worse than a comparable shot of Lupron. I will ask both my urologist and my oncologist if Zoladex would be a good option for me. After 16 years, my pc is still in the box so I feel blessed. However, my PSA doubling time is starting to increase. Thanks in advance for your reply. Youkilis

tell that damn doctor to do his job and get you back on lupron! good luck man!

Similar to you, Youkilis. Diagnosed 14 years ago, some months ago switched from lupron to Eligard, some sweelling in feet and ankles. Earlier stopped degarelix after several years due to fainting spells the following day.

Hello, Youkilis ~

It's almost like your body is having an adverse reaction to the ELIGARD injection.

With the swelling - and now the rash - could it be akin to an allergic reaction?

Has your medical team presented any antidotes, in the meantime ~ or solutions for mitigating the side effects?

Benedryl ? Steroids? SOMETHING!

I also wonder if your medical team could reach out to the manufacturers of ELIGARD for some insight?

Just thinking aloud ~ wanting all the best for you ~

CYCLONE ~ # Iowa State University

I agree with those who replied since my last response. I think we had different situations in that my swelling is not a big problem, just that my shoes are tighter than before, I am not aware of any fluctuations in the swelling.

To give you guys an update, my face rash has gotten worse; red welts everywhere. Worse yet, my lower legs and ankles turned very warm and red and the pain increased. I contacted my cardiologist and sent her pictures (she's out of town) and was diagnosed with cellulitis. I am on 500mg of Cephalexin (an antibiotic) and regular applications of emuaidMax. Obviously, this is a fairly serious reaction from the 3-month Eligard injection. I spent the day in bed because it was too painful to walk but I am up and around this evening. My experience with Eligard should raise a red flag about this drug! I will post progress reports. PS My son reminded me that I took the same dose of Eligard two years ago and had the same reaction, only to a much lesser extent. However, back then I did not connect the infection with the Eligard.

I had some/many of those side effects from Eligard chemotherapy, also from Firmagon and Lupron chemo. Further, I quickly (1 week after first Firmagon injection, and again 1 week after first Lupron) developed shingles despite having had both Zostavax and Shengrix vaccinations.

Once the Eligard killed off my testicles, testosterone wasn't much of an issue, only the cancer and chemo side effects. One of those was pruritis on my arms (big nasty itchy weeping sores that left scars), swelling of my ankles (I assume a lymphatic system malfunction) and itchy bleeding sores all over my calves. Most of those went away a couple of years after I quit getting those chemical injections. Of course, I replaced those with the side effects from Xtandi (enzalutamide) which are worse and more persistent than those from the other chemotherapy drugs.

Goserelin appears to be very similar to leuprolide and shares many of the side effects, though it does appear to be slightly less obnoxious (IMHO due to more frequent lower dosages). All of these chemicals have the ability to severely damage our immune systems as well. My medical team is concerned that this has happened to mine and are currently monitoring that as those side effects have not gone away in the almost 3 years since my last dose of leuprolide + enzalutamide chemo. "It is well - known in the medical community that these drugs can permanently damage the immune system." As per my medical team.

Side note: leuprolide, gozerelin and enzalutamide chemotherapy etc are referred to as "androgen deprivation therapy" or "hormonal therapy" so as not to frighten patients away from taking them. This as the end goal is to get the patient to take them to slow the cancer and the term "chemotherapy" scares a lot of folks. But...

"since Lupron injures both cancerous and normal cells it is a form of chemotherapy". The Medicare copy of the invoice reads "(hormonal) chemotherapy drug....$6000, injection of chemotherapy drug....$100"
An unfortunate 'side effect' of this manipulative tactic is that the profound - and often permanent - side effects of these powerful chemicals comes as a complete surprise to patients that get those side effects.

The choice as to where, exactly, the injection is given appears to be solely at the discretion of the injector. I have got those nasty shots pretty much in all of the sites noted above - belly, side, arm and butt. Each time by a different person who was adamant that they "knew" exactly how to do it right (and the others were all doing it wrong). :applause:

The following from Drugs.com clears up (maybe) the differences between Lupron and Eligard. The active ingredient is identical but the formulations seem to be quite different, which probably explains different reactions to the medications. During the Pandemic when there was a Lupron shortage I had Eligard substituted for Lupron twice. The first injection was administered (incorrectly?) just like Lupron, as far as I could tell. The second time it was give subcutaneously in my upper arm. Both injections burned like hell as the medication went in. Lupron never has.

Medical Answers
Are Lupron Depot and Eligard the same drug?
Medically reviewed by Leigh Ann Anderson, PharmD. Last updated on Dec 8, 2022.


Official answer
by Drugs.com
Lupron Depot and Eligard are brand names for drugs 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 FDA-approved for the treatment of endometriosis, uterine fibroids, or central precocious puberty (CPP) in children (early puberty).

Leuprolide acetate, the generic name for Lupron Depot and Eligard, is classified as a gonadotropin releasing hormone (GnRH) agonist and is often referred to as hormone therapy. These drugs work by reducing the amount of the hormone in your body called testosterone (in men) or estrogen (in women).

Lupron Depot is given as an intramuscular (IM) injection into the muscle. Eligard is given as a subcutaneous (under the skin) injection. Lupron Depot and Eligard are available as single dose kits that contain a prefilled injection syringe of:

7.5 mg (given every month)
22.5 mg (given every 3 months)
30 mg (given every 4 months)
45 mg (given every 6 months)
Depot formulations, like Lupron Depot and Eligard, continuously release medicine into your body over a certain period of time after injection. This means you may not need to get a shot every day (or even every month). Both medicines supply a continuous release of leuprolide and these injections are only given by a healthcare provider.

For the palliative treatment of prostate cancer:

Lupron Depot is injected into a muscle of your upper arm, upper thigh or buttocks once every month, OR once every 3, 4 or 6 months for the treatment of prostate cancer, based on the dose you need. Lupron Depot should be injected with 2 hours of preparation or it should be discarded.
Eligard is injected subcutaneously (under the skin) in areas such as abdomen (stomach area) once every month, OR once every 3, 4 or 6 months based on the dose you need. Eligard should be injected within 30 minutes of preparation or it should be discarded.
You will receive this injection in your doctor’s office, in a clinic or in the hospital. Leuprolide is not available in a pill form.
Which drugs contain leuprolide?
There are different brand names and package inserts for these products, with different uses and doses. It is important to follow your doctor’s exact dosing instructions and read the patient information for specific use. Ask your doctor or pharmacist if you have questions.

The various package insert information, brand names and approved uses for leuprolide acetate can be found here:

Eligard (FDA-approved use: symptoms of prostate cancer)
Fensolvi (FDA-approved use: central precocious puberty)
Lupron Depot (FDA-approved use: symptoms of prostate cancer)
Lupron Depot 3.75 mg and Lupron Depot 11.25 mg - (FDA-approved use: endometriosis, uterine fibroids)
Lupron-Depot Ped (FDA-approved use: central precocious puberty)
Is there a generic for Lupron Depot?
There is no therapeutically equivalent generic version of Lupron Depot or Eligard commercially available in the U.S. at this time.

Leuprolide 1 mg/0.2 mL injection strength is available as a generic (non-depot form) for the palliative treatment of prostate cancer or central precocious puberty, but this form must be injected daily.

Hi Mumbo, Yes, the swollen legs and feet are a direct side effect of the Eligard. I have been using a prescription diuretic to reduce the swelling. My skin in the ankle area was dry and slightly cracked as a result of the painful swelling. Bacteria likely entered the cracked skin and bingo, I had a nasty case of cellulitis diagnosed by my doctor. She immediately prescribed 500mg of Cephalexin 500mg taken every six hours and the application of a topical cream called emuaid max. 24 hours later the redness and pain are nearly gone. My guess is all these prostate cancer drugs have nasty side effects and I can tell you from experience that as one ages, the side effects worsen. At age 75, they were tolerable, at 84 they aren't.