Leuprorelin Sandoz
GnRH Agonist Implant for Hormone-Dependent Prostate Cancer
Quick Facts About Leuprorelin Sandoz
Key Takeaways About Leuprorelin Sandoz
- Effective testosterone suppression: Leuprorelin Sandoz reduces testosterone to castrate levels within 2–4 weeks, slowing or halting growth of hormone-dependent prostate cancer
- Convenient 3-monthly dosing: The subcutaneous implant is administered once every three months by a healthcare professional, requiring only four visits per year
- Initial testosterone flare: Testosterone levels temporarily rise during the first 1–2 weeks, which may worsen symptoms; anti-androgen cover is often prescribed to manage this
- Cardiovascular and metabolic monitoring required: Long-term use may increase the risk of cardiovascular events, diabetes, and reduced bone density – regular monitoring is essential
- Do not stop without medical advice: Treatment should not be interrupted without your doctor's approval, even if symptoms improve, as this may allow the cancer to progress
What Is Leuprorelin Sandoz and What Is It Used For?
Leuprorelin Sandoz is a GnRH agonist implant that suppresses testosterone production to treat advanced hormone-dependent prostate cancer. It is also used in combination with radiotherapy for locally advanced and localised prostate tumours. The active substance, leuprorelin acetate, works by downregulating the pituitary–gonadal axis to achieve medical castration.
Leuprorelin belongs to a class of medications known as gonadotropin-releasing hormone (GnRH) agonists, sometimes referred to as luteinising hormone-releasing hormone (LHRH) agonists. These drugs mimic the body's natural GnRH but act in a paradoxical manner: while they initially stimulate the pituitary gland to release luteinising hormone (LH) and follicle-stimulating hormone (FSH), continuous administration leads to downregulation and desensitisation of GnRH receptors. The result is a profound suppression of LH and FSH secretion, which in turn dramatically reduces testosterone production by the testes.
Prostate cancer is the most commonly diagnosed cancer in men worldwide, with approximately 1.4 million new cases per year according to the World Health Organization (WHO). The majority of prostate cancers are hormone-dependent, meaning their growth is driven by androgens – particularly testosterone and its more potent derivative, dihydrotestosterone (DHT). By reducing testosterone to castrate levels (typically below 50 ng/dL or 1.7 nmol/L), Leuprorelin Sandoz effectively slows or halts the proliferation of hormone-sensitive cancer cells.
Leuprorelin Sandoz is specifically indicated for the treatment of symptoms associated with advanced hormone-dependent prostate cancer (prostate carcinoma). It is also used for the treatment of locally advanced and localised hormone-dependent prostate tumours in combination with radiotherapy, or as adjuvant therapy following radiotherapy. In these settings, androgen deprivation therapy (ADT) with GnRH agonists has been shown in multiple randomised controlled trials to improve both disease-free survival and overall survival.
The concept of hormonal manipulation in prostate cancer dates back to the landmark work of Charles Huggins in the 1940s, who demonstrated that surgical castration (orchiectomy) could lead to tumour regression. GnRH agonists such as leuprorelin offer a reversible alternative to surgical castration, achieving equivalent testosterone suppression without the permanence and psychological impact of orchiectomy. When Leuprorelin Sandoz treatment is stopped, testosterone levels and pituitary hormone levels gradually return to normal, although the speed of recovery varies between individuals.
Leuprorelin was first approved for medical use in the 1980s and has been used in the treatment of prostate cancer for over four decades. It is included on the World Health Organization's List of Essential Medicines, reflecting its importance as a cornerstone therapy in oncology. The European Association of Urology (EAU) and the American Urological Association (AUA) both recommend GnRH agonists as standard first-line androgen deprivation therapy for advanced prostate cancer.
What Should You Know Before Receiving Leuprorelin Sandoz?
Before starting Leuprorelin Sandoz, inform your doctor about all your medical conditions, especially cardiovascular disease, diabetes, bone disorders, and any history of depression. This medication is not for use in women or children and is contraindicated in patients with hypersensitivity to GnRH agonists.
Contraindications
You should not receive Leuprorelin Sandoz if any of the following apply to you:
- Allergy to leuprorelin or any other ingredient in this medicine (including the polylactic acid excipient)
- Allergy to similar substances such as other GnRH agonists (e.g. goserelin or buserelin)
- Non-hormone-dependent cancer – Leuprorelin Sandoz only works against cancers that are sensitive to testosterone; if your cancer is not hormone-dependent, this treatment will not be effective
- Female patients – this specific formulation is intended for the treatment of prostate cancer in men only
- Children and adolescents – Leuprorelin Sandoz is intended for adult use only
Warnings and Precautions
Talk to your doctor or nurse before receiving Leuprorelin Sandoz if you have or have had any of the following conditions:
- Cardiovascular disease including heart rhythm disorders (arrhythmias) – leuprorelin may increase the risk of QT prolongation, a heart rhythm abnormality. If you are taking medication for arrhythmias, your doctor will monitor you particularly carefully
- High blood pressure – your doctor will monitor your blood pressure regularly throughout treatment
- Previous bilateral orchiectomy (surgical removal of both testes) – Leuprorelin Sandoz will not provide any additional reduction in testosterone levels in this case
- Spinal cord compression or urinary tract obstruction – the initial testosterone flare at the start of treatment may temporarily worsen these symptoms, potentially requiring hospitalisation for the first few weeks
- Risk of osteoporosis – long-term testosterone suppression can reduce bone mineral density and increase the risk of fractures
- Diabetes mellitus – androgen deprivation therapy can affect blood sugar control, and your doctor will need to monitor your glucose levels closely
- Fatty liver disease (hepatic steatosis) – inform your doctor if you have this condition, as hormonal changes may affect liver metabolism
- Severe or persistent headache, visual disturbances, or ringing/buzzing in the ears (possible signs of raised intracranial pressure)
- Reddish, non-raised, target-like spots on the trunk, often with blisters, skin peeling, or sores in the mouth, throat, nose, or eyes (possible Stevens-Johnson syndrome or toxic epidermal necrolysis)
- Sudden swelling and pain caused by a blood clot in a vein
- Difficulty breathing, chest pain, fainting, or rapid pulse with bluish skin (possible pulmonary embolism)
Depression, which can be severe, has been reported in patients receiving leuprorelin. Inform your doctor if you experience low mood, feelings of hopelessness, or any change in your mental health during treatment. Your doctor may recommend additional support or adjust your treatment plan.
Driving and Operating Machinery
Leuprorelin Sandoz and the underlying cancer can cause fatigue, dizziness, and visual disturbances, which are more likely if combined with alcohol consumption. If you experience any of these symptoms, you should not drive or operate machinery without your doctor's approval. You are responsible for assessing your fitness to drive, and you should discuss this with your doctor or pharmacist if you are uncertain.
How Does Leuprorelin Sandoz Interact with Other Drugs?
Leuprorelin Sandoz can interact with medications that affect heart rhythm (QT-prolonging drugs), including certain antiarrhythmics, antibiotics, antipsychotics, and methadone. Always tell your doctor about all medications you are taking, including over-the-counter products and herbal supplements.
The most clinically significant drug interactions with leuprorelin relate to its potential to prolong the QT interval on an electrocardiogram (ECG). Androgen deprivation therapy itself is associated with QT prolongation, and combining leuprorelin with other QT-prolonging drugs can additively or synergistically increase this risk. QT prolongation can, in rare cases, lead to a potentially life-threatening arrhythmia called torsades de pointes.
Major Interactions
| Drug | Category | Effect | Recommendation |
|---|---|---|---|
| Amiodarone | Antiarrhythmic | Both drugs prolong QT interval; additive risk of torsades de pointes | Avoid combination if possible; ECG monitoring required if used together |
| Sotalol | Antiarrhythmic / Beta-blocker | Additive QT prolongation risk | ECG monitoring before and during treatment; consider alternatives |
| Quinidine / Procainamide | Antiarrhythmic (Class IA) | Significant additive QT prolongation | Avoid combination; use with extreme caution under specialist supervision only |
| Methadone | Opioid analgesic | Both drugs independently prolong QT interval | ECG monitoring; assess risk-benefit carefully |
Moderate Interactions
| Drug | Category | Effect | Recommendation |
|---|---|---|---|
| Moxifloxacin | Fluoroquinolone antibiotic | QT prolongation risk when combined with leuprorelin | Use alternative antibiotic if possible; monitor ECG if concurrent use is unavoidable |
| Antipsychotics (e.g. haloperidol, quetiapine, olanzapine) | Psychiatric medication | Many antipsychotics prolong QT; additive risk with leuprorelin | Cardiology review recommended; regular ECG monitoring |
| SSRIs / SNRIs (e.g. citalopram, escitalopram) | Antidepressants | Some SSRIs (particularly citalopram) have QT-prolonging potential | Prefer antidepressants with lower QT risk (e.g. sertraline); monitor if used together |
| Diabetes medications (insulin, metformin, sulfonylureas) | Antidiabetics | Leuprorelin may impair glucose tolerance and alter blood sugar levels | Monitor blood glucose frequently; dose adjustment of diabetic medications may be needed |
| Bisphosphonates (e.g. alendronate, zoledronic acid) | Bone-protective agents | Not a negative interaction – bisphosphonates are often co-prescribed to protect against bone loss | Beneficial combination; your doctor may prescribe these to counteract leuprorelin-induced bone loss |
If you are already taking medications for other conditions, do not stop any of them without consulting your doctor. Your healthcare team will coordinate your treatment to minimise the risk of harmful interactions while ensuring you receive optimal care for all your medical conditions.
What Is the Correct Dosage of Leuprorelin Sandoz?
The recommended dose is one 5 mg subcutaneous implant injected into the abdominal wall every three months. The injection must be administered by a doctor or nurse. In rare cases, the next injection may be delayed by up to four weeks without affecting treatment efficacy.
Leuprorelin Sandoz is administered exclusively by healthcare professionals. You should not attempt to inject the implant yourself. The medication comes as a pre-filled syringe containing a biodegradable implant that slowly releases leuprorelin over the three-month treatment interval.
How the Implant Is Given
Subcutaneous Implant – Adults
Dose: 1 implant containing 5 mg leuprorelin every 3 months
Route: Subcutaneous injection into the anterior abdominal wall (below the navel)
Preparation: The injection site is cleaned and disinfected. Local anaesthesia may be applied to reduce discomfort. The needle is inserted subcutaneously at a shallow angle, nearly parallel to the skin.
Injection interval: Normally every 12 weeks. In rare cases, the next injection may be delayed by up to 4 weeks without significantly affecting treatment outcomes.
Blood Tests and Monitoring
Your doctor will perform regular blood tests to ensure the treatment is working effectively. Key parameters include:
- Testosterone levels – should fall to castrate levels (below 50 ng/dL / 1.7 nmol/L) within 2–4 weeks of the first injection. Levels are typically checked after the first 3 months and periodically thereafter
- Prostate-specific antigen (PSA) – a tumour marker that should decline with effective treatment. A rising PSA may indicate disease progression or inadequate testosterone suppression
- Acid phosphatase – may initially rise at the start of treatment before declining to normal or near-normal levels
- Blood glucose – monitored particularly in patients with diabetes or those at risk of metabolic disturbance
- Bone mineral density – periodic scans may be recommended for patients on long-term treatment
Treatment Duration
The duration of treatment is determined by your doctor and depends on the stage and behaviour of your prostate cancer. Leuprorelin Sandoz can be used for several years as long as it remains effective and you tolerate the treatment well. Treatment should not be stopped even if cancer symptoms have subsided or the cancer has gone into remission, unless your doctor specifically advises discontinuation.
Your doctor will monitor treatment effectiveness at regular intervals through clinical examinations (including digital rectal examination), imaging studies, and blood tests. If you experience a recurrence of symptoms such as bone pain, difficulty urinating, or leg weakness during ongoing treatment, inform your doctor promptly, as these may indicate the need for additional evaluation or a change in treatment strategy.
Missed Dose
If you believe your scheduled injection has been missed, contact your doctor as soon as possible. Regular administration every three months is important for maintaining consistent testosterone suppression. While a short delay of up to four weeks is generally tolerated without loss of efficacy, longer gaps may allow testosterone levels to rise, potentially enabling cancer progression.
Overdose
As Leuprorelin Sandoz is administered by a healthcare professional, overdose is unlikely. However, if an excess amount is inadvertently administered, your doctor will monitor your condition and provide appropriate supportive care as needed. There is no specific antidote for leuprorelin overdose. Contact your local poison control centre or emergency services if you have any concerns.
Stopping Treatment
Do not stop Leuprorelin Sandoz treatment without your doctor's permission. If treatment is discontinued prematurely, your disease-related symptoms may worsen as testosterone levels rise again. Your doctor will discuss the appropriate duration of treatment with you based on your individual cancer stage, treatment response, and overall health status.
What Are the Side Effects of Leuprorelin Sandoz?
The most common side effects of Leuprorelin Sandoz include hot flushes, increased sweating, bone pain, decreased libido, erectile dysfunction, reduced testicle size, weight gain, and injection site reactions. Most side effects are related to the intended reduction in testosterone levels.
Like all medicines, Leuprorelin Sandoz can cause side effects, although not everybody gets them. Many of the side effects listed below are a direct consequence of the hormonal changes caused by testosterone suppression and are therefore expected effects of the treatment rather than unexpected adverse reactions.
- Signs of a severe allergic reaction (anaphylaxis): warmth sensation, skin rash, itching or hives, swelling of the face, lips, tongue, or throat, difficulty breathing, wheezing, drop in blood pressure, rapid pulse, or loss of consciousness
- Swelling and pain in a limb caused by a blood clot in a vein (deep vein thrombosis)
- Difficulty breathing, chest pain, fainting, rapid pulse, or bluish skin discolouration (possible pulmonary embolism)
- Target-like skin lesions with blisters, skin peeling, or sores in the mouth, throat, nose, or eyes (possible Stevens-Johnson syndrome or toxic epidermal necrolysis)
Initial Testosterone Flare
At the start of treatment, testosterone levels temporarily rise for approximately 1–2 weeks before falling to castrate levels. This testosterone flare can cause a temporary worsening of cancer-related symptoms, including:
- Bone pain (may start or worsen)
- Difficulty urinating due to urinary tract obstruction
- Spinal cord compression (causing back pain, numbness, or weakness in the legs)
- Muscle weakness in the legs
- Lymphoedema (swelling due to blocked lymph drainage)
These worsened symptoms usually resolve without needing to stop treatment. Your doctor may prescribe an anti-androgen (such as bicalutamide or flutamide) for the first few weeks to counteract the effects of the testosterone flare.
Very Common
May affect more than 1 in 10 people
- Hot flushes (vasomotor symptoms)
- Increased sweating (hyperhidrosis)
- Bone pain (related to initial flare or long-term hormonal changes)
- Decreased or lost sexual desire (reduced libido)
- Erectile dysfunction
- Reduced testicle size (testicular atrophy)
- Weight gain
- Injection site reactions: redness, hardening, pain, swelling, or itching (usually resolve with continued treatment; abscess formation rare)
Common
May affect up to 1 in 10 people
- Gynaecomastia (breast enlargement in men)
- Decreased appetite or increased appetite
- Depression and mood changes
- Sleep disturbances (insomnia)
- Headache
- Abnormal sensations such as tingling or numbness (paraesthesia)
- Nausea and vomiting
- Joint pain (arthralgia) or back pain
- Muscle weakness
- Increased need to urinate at night (nocturia)
- Increased daytime urinary frequency
- Difficulty urinating or painful urination (dysuria)
- Fatigue
- Peripheral oedema (swelling of ankles, feet, or fingers)
- Weight loss
- Elevated liver enzymes (ALT, AST, GGT) and other enzymes (LDH, alkaline and acid phosphatase)
Uncommon
May affect up to 1 in 100 people
- Systemic allergic reactions (fever, itching, increased white blood cells, rash)
- Diarrhoea
- Dry skin or dry mucous membranes
- Testicular pain
- Urinary retention (inability to empty the bladder)
- Increased night sweats
Rare and Very Rare
May affect up to 1 in 1,000 people or fewer
- Changes in blood sugar levels (hyperglycaemia or hypoglycaemia)
- Dizziness
- Transient changes in taste sensation
- Blood pressure changes (hypertension or hypotension)
- Hair loss (alopecia)
- Pituitary apoplexy (very rare – reported after the first injection in patients with pre-existing pituitary tumours)
- Interstitial lung disease (pneumonitis – primarily reported in Japan)
- QT prolongation on ECG
- Seizures (convulsions)
- Idiopathic intracranial hypertension (raised pressure inside the skull)
- Erythema multiforme (target-like skin lesions)
Long-Term Effects on Bone Health
Testosterone plays an important role in maintaining bone mineral density. When testosterone levels are suppressed by Leuprorelin Sandoz over extended periods, bone density may gradually decline, increasing the risk of osteoporosis and fractures. However, research indicates that bone loss with medical castration using GnRH agonists is generally less severe than that seen after surgical orchiectomy.
Your doctor may recommend a bisphosphonate (such as zoledronic acid or alendronate) or other bone-protective medication to help maintain bone density. Adequate calcium and vitamin D intake, regular weight-bearing exercise, and periodic bone density monitoring (DEXA scan) are also important components of bone health management during long-term ADT.
If you experience any side effects not listed here, or if any side effect becomes severe, contact your doctor or pharmacist. Reporting suspected side effects helps ensure ongoing monitoring of the medicine's benefit-risk balance.
How Should You Store Leuprorelin Sandoz?
Store Leuprorelin Sandoz at or below 30°C. Keep out of the reach and sight of children. Do not use after the expiry date printed on the carton, sterile pouch, and syringe label.
Leuprorelin Sandoz should be stored in its original packaging (the sealed sterile pouch) to protect it from light and moisture until it is ready for use. Do not freeze the product. The expiry date (marked "EXP" on the packaging) refers to the last day of the stated month.
This medication is administered in a clinical setting by a healthcare professional, so patients do not normally need to store it at home. If you have been provided with the implant to bring to your appointment, ensure it is kept in a cool, dry place and not exposed to excessive heat or direct sunlight.
Do not dispose of unused or expired medicines in household waste or through the sewage system. Return any unused medication to your pharmacy for safe disposal to protect the environment from pharmaceutical contamination.
What Does Leuprorelin Sandoz Contain?
Each Leuprorelin Sandoz implant contains 5 mg of leuprorelin (as leuprorelin acetate) as the active substance. The only other ingredient is polylactic acid, which forms the biodegradable implant matrix.
Active Ingredient
The active substance is leuprorelin (as leuprorelin acetate). Each subcutaneous implant contains 5 mg of leuprorelin (as leuprorelin acetate). Leuprorelin is a synthetic nonapeptide analogue of naturally occurring gonadotropin-releasing hormone (GnRH), modified to be more resistant to enzymatic degradation and to have higher receptor binding affinity than native GnRH.
Inactive Ingredients (Excipients)
The only excipient is polylactic acid (PLA), a biodegradable polymer that forms the implant matrix. Over the three-month treatment period, the polylactic acid slowly degrades in the body, releasing leuprorelin at a controlled rate. The polymer is eventually broken down into lactic acid, which is a naturally occurring substance in the body and is safely metabolised.
Product Appearance and Packaging
Leuprorelin Sandoz is supplied as a small, cylindrical implant contained within a pre-filled polycarbonate syringe with an injection needle. The syringe assembly is sealed in a sterile pouch made of PET/aluminium/PE composite film.
Available pack sizes:
- 1 pre-filled syringe with 1 implant
- 2 pre-filled syringes with 1 implant each
- 3 pre-filled syringes with 1 implant each
- 5 pre-filled syringes with 1 implant each
Not all pack sizes may be available in every country.
Manufacturer
Marketing authorisation holder: Sandoz A/S, Copenhagen, Denmark
Manufacturer: Sandoz GmbH, Kundl, Austria
How Does Leuprorelin Sandoz Work in the Body?
Leuprorelin Sandoz works by initially stimulating and then paradoxically suppressing the pituitary gland's release of hormones that control testosterone production. After 2–4 weeks, testosterone falls to castrate levels, depriving hormone-sensitive prostate cancer cells of their growth stimulus.
The hypothalamic–pituitary–gonadal (HPG) axis is the hormonal pathway that controls testosterone production. The hypothalamus produces gonadotropin-releasing hormone (GnRH) in a pulsatile fashion, which stimulates the anterior pituitary gland to release luteinising hormone (LH) and follicle-stimulating hormone (FSH). LH then acts on Leydig cells in the testes to produce testosterone.
Leuprorelin is a synthetic analogue of GnRH that is approximately 80–100 times more potent than naturally occurring GnRH. When administered as a sustained-release implant, it provides continuous (non-pulsatile) stimulation of GnRH receptors on the pituitary gland. This continuous exposure initially causes a brief surge in LH, FSH, and consequently testosterone (the "flare" effect during the first 1–2 weeks). However, sustained, non-pulsatile stimulation leads to receptor downregulation and desensitisation – the pituitary GnRH receptors become unresponsive, LH and FSH production ceases, and testosterone production by the testes is profoundly suppressed.
The resulting testosterone levels are comparable to those achieved by surgical castration (bilateral orchiectomy) and remain below 50 ng/dL (1.7 nmol/L) – the widely accepted threshold for castrate levels – throughout the treatment period. Some guidelines and studies now advocate for an even lower threshold of 20 ng/dL (0.7 nmol/L) for optimal oncological outcomes.
Pharmacokinetic Profile
After subcutaneous injection, the polylactic acid implant begins to release leuprorelin through a combination of diffusion and polymer degradation. Peak plasma concentrations are typically reached within the first few hours to days after injection, corresponding to the initial stimulatory phase. Thereafter, leuprorelin is released at a steady rate for the remainder of the three-month dosing interval, maintaining castrate testosterone levels.
Leuprorelin is primarily degraded by peptidases into smaller inactive fragments. It has a relatively short elimination half-life of approximately 3 hours when given as a free peptide, but the depot formulation ensures sustained plasma levels for the full 12-week treatment period. No clinically significant hepatic or renal metabolism is involved, so dose adjustments for liver or kidney impairment are not typically required.
The effectiveness of testosterone suppression should be confirmed by measuring serum testosterone levels. Your doctor will typically check testosterone and PSA levels after the first 3 months and at regular intervals thereafter to verify that the treatment is achieving and maintaining adequate hormonal control.
Frequently Asked Questions About Leuprorelin Sandoz
Leuprorelin Sandoz is used to treat advanced hormone-dependent prostate cancer by suppressing testosterone production to castrate levels. It is also used in combination with radiotherapy for locally advanced and localised hormone-dependent prostate tumours. The medication belongs to the GnRH agonist class and works by downregulating the pituitary–gonadal axis, effectively depriving hormone-sensitive cancer cells of their growth stimulus.
Leuprorelin Sandoz is given as a subcutaneous (under the skin) implant injection into the front of the abdomen, below the navel. The injection is performed by a doctor or nurse once every three months. The injection site is first disinfected, and local anaesthesia may be applied to minimise discomfort. The implant slowly releases the active substance over the 3-month period.
The testosterone flare is a temporary rise in testosterone levels that occurs during the first 1–2 weeks of treatment. This can temporarily worsen cancer-related symptoms such as bone pain, difficulty urinating, or spinal cord compression. To manage this, doctors often prescribe a short course of anti-androgen medication (such as bicalutamide) starting a few days before the first injection and continuing for several weeks. The flare effect does not recur with subsequent injections.
Yes, long-term treatment with Leuprorelin Sandoz can reduce bone mineral density because testosterone plays a key role in maintaining bone health in men. This increases the risk of osteoporosis and fractures. Your doctor may prescribe a bisphosphonate or denosumab to protect your bones, and may recommend calcium and vitamin D supplements, regular weight-bearing exercise, and periodic bone density scans (DEXA) to monitor your bone health during treatment.
Treatment duration is determined by your doctor and can continue for several years if the treatment remains effective and is well tolerated. Do not stop treatment without your doctor's approval, even if symptoms have improved or the cancer appears to be in remission. Your doctor will monitor your condition with regular blood tests (PSA and testosterone) and clinical examinations to assess ongoing treatment effectiveness.
Leuprorelin Sandoz achieves the same level of testosterone suppression as surgical castration (bilateral orchiectomy) and is considered equally effective for treating hormone-dependent prostate cancer. The key advantage is that medical castration with GnRH agonists is reversible – when treatment is stopped, testosterone levels gradually return to normal over time, though the speed of recovery varies between individuals. Surgical castration is permanent and irreversible.
References
This article is based on the following international medical guidelines and peer-reviewed sources. All medical claims have evidence level 1A, the highest quality of evidence based on systematic reviews of randomised controlled trials.
- Mottet N, van den Bergh RCN, Briers E, et al. EAU-EANM-ESTRO-ESUR-ISUP-SIOG Guidelines on Prostate Cancer. European Urology. 2024. European Association of Urology Guidelines. doi:10.1016/j.eururo.2023.04.027
- Lowrance WT, Breau RH, Chou R, et al. Advanced Prostate Cancer: AUA/ASTRO/SUO Guideline Part I. The Journal of Urology. 2021;205(1):14–21. doi:10.1097/JU.0000000000001375
- National Institute for Health and Care Excellence (NICE). Prostate cancer: diagnosis and management. NICE guideline [NG131]. Updated 2024.
- World Health Organization (WHO). WHO Model List of Essential Medicines – 23rd list. Geneva: WHO; 2023.
- European Medicines Agency (EMA). Leuprorelin – Summary of Product Characteristics. EMA product information database. Accessed January 2026.
- Huggins C, Hodges CV. Studies on prostatic cancer: I. The effect of castration, of estrogen and of androgen injection on serum phosphatases in metastatic carcinoma of the prostate. Cancer Research. 1941;1(4):293–297.
- Bolla M, de Reijke TM, Van Tienhoven G, et al. Duration of androgen suppression in the treatment of prostate cancer. The New England Journal of Medicine. 2009;360(24):2516–2527. doi:10.1056/NEJMoa0810095
- British National Formulary (BNF). Leuprorelin acetate. NICE BNF monograph. Accessed January 2026.
Editorial Team
This article has been written and reviewed by the iMedic Medical Editorial Team, a group of licensed specialist physicians with expertise in oncology, urology, and clinical pharmacology.
Medical Writers
Board-certified physicians specialising in oncology, urology, and clinical pharmacology with documented academic and clinical experience in prostate cancer management.
Medical Reviewers
Independent review board ensuring clinical accuracy, adherence to international guidelines (EAU, AUA, NICE, WHO), and evidence level 1A standards.
All content follows the GRADE evidence framework and is reviewed against current international guidelines. We have no commercial funding or pharmaceutical sponsorship. For more information, see our editorial standards and medical team pages.