Open Access

HOW I DO IT

Optimizing subcutaneous injection of the gonadotropin-releasing hormone receptor antagonist degarelix

Jack Barkin¹, Shelley Burton², Carole Lambert³

1 Department of Surgery, University of Toronto, Toronto, Ontario, Canada
2 Toronto Urology Clinical Study Group, Toronto, Ontario, Canada
3 Department of Radiation Oncology, CHUM Notre Dame, Montreal, Quebec, Canada
Address correspondence to Dr. Jack Barkin, Department of Surgery, University of Toronto, 404-960 Lawrence Avenue West, Toronto, ON M6A 3B5 Canada

Canadian Journal of Urology 2016, 23(1), 8179-8183.

Abstract

The gonadotropin-releasing hormone (GnRH) receptor antagonist degarelix has several unique characteristics compared to luteinizing hormone-releasing hormone (LHRH) analogs used in the management of prostate cancer. Notable differences of GnRH receptor antagonists include no flare reaction, and a more rapid suppression of testosterone, luteinizing hormone (LH), follicle stimulating hormone (FSH) and prostate-specific antigen (PSA) compared to LHRH analogs. Despite emerging evidence supporting the use of GnRH receptor antagonists over the more widely used LHRH analogs in the management of prostate cancer, physicians may be reluctant to prescribe degarelix. They may be concerned about patient complaints about injection-site reactions (ISRs). The subcutaneous injection of degarelix has been associated with a higher rate of ISRs compared with the intramuscular injections of LHRH analogs. This “How I Do It” article describes techniques and strategies that have been developed by physicians and nurses to reduce the discomfort associated with the subcutaneous delivery of degarelix.

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