Leuprolide Disease Interactions

Increased risk of developing myocardial infarction, sudden cardiac death and stroke has been reported in association with the use of GnRH agonists such as leuprolide, and triptorelin. Cardiovascular risk factors should be evaluated carefully before treatment initiation. Patients should be monitored for symptoms and signs suggestive of development or cardiovascular disease and should be managed according to current clinical practice.

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Hyperglycemia and an increased risk of developing diabetes have been reported in men receiving GnRH agonists such as leuprolide and triptorelin. Caution is advised in patients with diabetes as treatment with these agents may risk glycemic control. Monitor blood glucose and/or HbA1c periodically in patients receiving treatment.

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Androgen deprivation therapy may prolong the QT/QTc interval. Health care providers should consider if benefits of therapy outweigh the potential risks in patients with congenital long QT syndrome, congestive heart failure, electrolyte abnormalities, or taking other drugs that can also prolong the QT interval. Consider periodic monitoring of EKG and electrolytes.

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Decreased bone density has been reported in men who have had orchiectomy or who have been treated with a GnRH agonist analog as leuprolide. It can be anticipated that long periods of medical castration in men will have effects on bone density. Bone density loss may not be reversible. Therapy with leuprolide should be administered cautiously in patients with major risk factors for decreased bone mineral content, such as chronic alcohol and/or tobacco use, a strong family history of osteoporosis, or chronic use of drugs that can reduce bone mass (e.g., anticonvulsants, corticosteroids). Therapy beyond six months with gonadotropin-releasing hormone analogs is not recommended for patients with major risk factors for decreased bone mineral content.

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Convulsions have been observed in patients taking leuprolide, including patients who have a history of seizures, epilepsy, or brain disorders, and in those taking medications associated with convulsions. Convulsions have also been reported in patients without any of these conditions. Caution is advised in patients with a history of seizures.

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