TM Owner Allergan / AbbVie
Trelstar 22.5mg Vial
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Indications & Clinical Uses
- Trelstar 22.5 mg is the six-month depot formulation of triptorelin pamoate, a gonadotropin-releasing hormone (GnRH) agonist, given as a single intramuscular injection into the buttock once every 24 weeks.
- It is FDA-approved for the palliative treatment of advanced prostate cancer in adult men, working by initially raising then chronically suppressing testosterone to castrate levels, which slows the growth of hormone-sensitive prostate cancer.
- Trelstar is marketed under one current label covering three depot strengths of the same triptorelin pamoate suspension - 3.75 mg (monthly), 11.25 mg (three-monthly), and this 22.5 mg six-monthly formulation - so selecting the correct strength and vial for the intended dosing interval is essential; they are not interchangeable dose-for-dose.
- It is distributed in the US by Allergan USA (part of AbbVie) and manufactured by Debiopharm, Switzerland, and is given only by a healthcare professional in a clinic or hospital setting, never self-injected.
Side Effects
- Trelstar has no boxed warning.
- Because it first stimulates then suppresses testosterone, symptoms can worsen transiently in the first weeks of treatment (a 'flare'), including bone pain, difficulty urinating, or new spinal-cord-compression symptoms in men with existing metastases - watch for numbness, weakness or loss of bladder control and seek urgent care.
- The most common effects are hot flushes, injection-site reactions, decreased libido and erectile dysfunction, testicular atrophy, and fatigue.
- Long-term testosterone suppression can cause bone thinning (osteoporosis), anaemia, weight gain and mood changes, and can affect heart rhythm (QT prolongation), raising cardiovascular and diabetes risk over repeated six-monthly injections.
- Report chest pain, an irregular heartbeat, severe bone pain, or sudden loss of bladder or bowel control straight away.
Precautions & Warnings
- Trelstar should be used with caution in men with metastatic vertebral disease or urinary-tract obstruction, because of the initial testosterone flare, which can transiently worsen symptoms or, rarely, cause spinal cord compression in the first weeks after the first injection.
- It can prolong the QT interval, so caution and ECG monitoring are advised in men with heart-rhythm problems, electrolyte imbalance, or other QT-prolonging medicines.
- Bone density, blood glucose and lipids should be monitored during long-term treatment, since chronic testosterone suppression raises the risk of osteoporosis, diabetes and cardiovascular disease.
- Trelstar is contraindicated in known hypersensitivity to GnRH agonists.
- It is given only by intramuscular injection by a healthcare professional - never intravenously - and is not for use in women or children.
- Store vials at 20°C to 25°C; do not freeze.
Avoid Interactions
- Medicines that raise prolactin (hyperprolactinaemic drugs) should be avoided, because high prolactin can reduce pituitary GnRH receptor numbers and blunt Trelstar's effect.
- Other medicines that prolong the QT interval - including certain antiarrhythmics, some antibiotics and antipsychotics - add to the small QT-prolongation risk from testosterone suppression and should be used with caution and monitoring alongside Trelstar.
- There is no clinically significant food interaction.
- Trelstar should not be mixed with other injectable medicines in the same syringe.
- Tell your healthcare provider about all other medicines and supplements you take, particularly heart-rhythm medicines, before starting treatment, so your care team can decide whether extra ECG monitoring is needed during your six-monthly injections.
References
Frequently Asked Questions
Trelstar 22.5 mg (triptorelin pamoate) is a hormone-lowering injection for advanced prostate cancer in men. One dose lasts 6 months by suppressing testosterone, which slows cancer growth. It is one of three Trelstar depot strengths - the others are given monthly or every 3 months.
A doctor or nurse gives Trelstar 22.5 mg as a single injection into the buttock muscle once every 24 weeks (6 months). You do not inject it yourself. Because it briefly raises testosterone first, symptoms may flare for a few weeks before improving.
Common Trelstar side effects include hot flushes, injection-site reactions, low sex drive, erectile dysfunction and fatigue. Long-term use can thin bones and affect heart rhythm. In the first weeks, worsening bone pain, new numbness or trouble passing urine can signal a flare - tell your doctor at once.
Avoid other medicines that raise prolactin, as they can blunt Trelstar's effect. Use caution with drugs that affect heart rhythm (QT interval), such as certain antibiotics or antiarrhythmics. Trelstar is for men only. Tell your care team about every medicine you take before your injection.
It's the same medicine, triptorelin pamoate, but a different strength. Trelstar 22.5 mg lasts 6 months, the 11.25 mg dose lasts 3 months, and the 3.75 mg dose (formerly called Trelstar Depot) lasts 1 month. Your doctor picks the vial matching your planned injection schedule.
While on Trelstar, your doctor monitors testosterone levels, bone density and, in some men, heart rhythm and blood sugar, since long-term treatment can affect all of these. Report any new numbness, weakness, or difficulty passing urine promptly, especially in the first weeks of treatment.
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