Timing of LHRH injection

Oldtimer,

Think you've got it the wrong way round!  The reason you are taking 28 days worth of bicalutamide is to prevent tumour flare.  The drug will still be in your body and over the 28 days has done its job.  Having the injection on the last day is giving you the maximum protection against flare.  This is normal.

Agree, many nurses giving the injection may not be fully up to speed on all aspects of hormone therapy but they do have to be trained to give the injection and in the case of Prostap, ensure the drug is mixed properly before giving it.  I imagine Zoladex is also an injection that needs the correct training.  I had 8 injections of Prostap (over 2 years) and only one was not given 100% so ended up with a sore abdomen but it settled down after a few days.

Regards

hi 

i had my first injection 2 weeks into my bicalutamide it was only for a month just to see how it went .

had my 3 month one after that , the nurse at my practice doesn't do a lot of these but as oldtimer says they are trained to give them .

not had any problems with the injections it stings slighty as its quite a big needle according to the nurse ! 

nothing to worry about :-)

Thanks for that SDI. In the wee small hours I too was hopefully coming around to that conclusion.  Nice to be confirmed. Think I was panicking.

Thanks for that anubis.  I never look at the needle when giving blood tests just lie back and think of England.

Hi oldtimer.

I had my first 1-month Prostap injection only three days after starting Bicalutamide and it appears to have worked OK. I had no symptoms of PC before starting the hormone treatment and none appeared after HT either. Our GP practice gives two 1-month injections as standard before moving on to the 3-month ones, but I think only one 1-month injection is the norm. You need to be aware that the 3-month injections really only last 12 weeks and not 13, so put the next one in your calendar. In our GP practice it's only possible to book nurse appointments six weeks ahead to I always make a note in the diary to book the next one halfway through the current cycle.

To avoid worrying too much, it might be wise to avoid a PSA test until you are a couple of months into your hormone treatment; as it might be a while before it takes effect. I started HT in early October 2018 and didn't have a PSA test until late in November (done at the same appointment when I had the first 3 month Prostap injection). It had dropped from 14 in September to 0.4 in November and is now at 0.1 following 20 sessions of radiotherapy.

As the HT was so effective, I was able to start my RT only three and a half months after starting HT.

Seamus47,

Prostap 3, if that is the drug being given here, is administered every 3 months (that's what the 3 means). 

12 weeks is 12 x 7 = 84 days. 

3 months is between 91 and 92 days.  13 weeks is 13 x 7 = 91 days. 

While it does not matter if you have the next injection slightly early, it is not catastrophic if you have it a few days late.  It takes up to 6 months for the Prostap 3 to be removed from the body and once I stopped, after 2 years, it continued to work on me for just under 6 months.

Don't be under the illusion Prostap 3 switches off on the 84th day.  That just puts unnecessary stress on new members of our club.

http://www.mhra.gov.uk/home/groups/par/documents/websiteresources/con120444.pdf

Regards     

Ultimately it is the oncologist who decides on the timing of these injections.

I once waited three months between injections and was told in no uncertain terms I was

to have a PROSTAP 3 injection every 12 weeks.

Would I lose any sleep if I were a few days either side of that, no, because as you say

the drug remains in the system for a long time. 

But the oncologist has an overview of your treatment and I have heard of some men having

PROSTAP 3 injections every 8 weeks for example.

Best wishes,

Hello Gentlemen

Its been quite interesting reading, looking at the variation in treatments. Perhaps I can add my own

On the day of my diagnosis I received my first injection of Zolaex LA (long acting), which is repeated at 12 week intervals.

I started a 28 course of Bicalutamide on the same day, to prevent tumour flare.

When I received my first injection I was told the repeat period is 12 weeks, and have been harpooned regularly since. It was pointed out that the repeat injections are my responsibility, so there are highlighted days in my diary. Mild panic until my second injection and find it’s very straightforward since.

Ido4,

I trust you know who the MHRA are? 

  "The Medicines and Healthcare products Regulatory Agency is an executive agency of the Department of Health and Social Care in the United Kingdom which is responsible for ensuring that medicines and medical devices work and are acceptably safe."

Sounds to me like your oncologist needs to bring himself/herself up to date on the timings!  Clearly doesn't know what 3 months means!!!  When you get your Prostap 3 injection there is an information leaflet in the box written by the manufacturer, Takeda.  Not surprisingly, this says the same.  Overdosing, which is what happens when given too early does, fortunately, no harm.     

Flightsim,

Zoladex is different.  Its timings are far more accurate so every 28 days is the norm for the 3.6 dose.  Multiply 28 x 3 = 84 days which is 12 weeks so you are correct.  Go to the top of the class!!!