Formulary
Triptorelin: Indications, Dosing, Side Effects and Interactions
Administration of gonadorelin analogues produces an initial phase of stimulation; continued administration is followed by down-regulation of...
MedNext Academy | 5 min read
Triptorelin: Indications, Dosing, Side Effects and Interactions
Administration of gonadorelin analogues produces an initial phase of stimulation; continued administration is followed by down-regulation of...
Drug action
Administration of gonadorelin analogues produces an initial phase of stimulation; continued administration is followed by down-regulation of gonadotrophin-releasing hormone receptors, thereby reducing the release of gonadotrophins (follicle stimulating hormone and luteinising hormone) which in turn leads to inhibition of androgen and oestrogen production.
Indications and dose
**Advanced prostate cancer (specialist use only)**
- **Adult** (By Intramuscular Injection): 3 mg every 4 weeks.
**Endometriosis**
- **Adult** (By Intramuscular Injection): 3 mg every 4 weeks maximum duration of 6 months (not to be repeated), to be started during first 5 days of menstrual cycle.
**Reduction in size of uterine fibroids**
- **Adult** (By Intramuscular Injection): 3 mg every 4 weeks for at least 3 months, maximum duration of treatment 6 months (not to be repeated), to be started during first 5 days of menstrual cycle.
**Premenopausal breast cancer [as combination therapy] (specialist use only)**
- **Adult** (By Intramuscular Injection): 3 mg every 4 weeks for up to 5 years, initiated 6-8 weeks before starting aromatase inhibitor-for further information, consult product literature.
**Advanced prostate cancer**
- **Adult** (By Subcutaneous Injection, Or By Deep Intramuscular Injection): 3.75 mg every 4 weeks.
**Endometriosis,Reduction in size of uterine fibroids**
- **Adult** (By Subcutaneous Injection, Or By Deep Intramuscular Injection): 3.75 mg every 4 weeks maximum duration of 6 months (not to be repeated), to be started during first 5 days of menstrual cycle.
**Male hypersexuality with severe sexual deviation**
- **Adult** (By Intramuscular Injection): 11.25 mg every 12 weeks.
**Gonadotrophin-dependent precocious puberty (specialist use only) for Decapeptyl SR 11.25mg**
- **Child** (By intramuscular injection): 11.25 mg every 3 months, discontinue when bone maturation consistent with age of 12 years in girls or 13-14 years in boys.
**Gonadotrophin-dependent precocious puberty (specialist use only) for Decapeptyl SR 22.5mg**
- **Child** (By intramuscular injection): 22.5 mg every 6 months, discontinue when bone maturation consistent with age of 12-13 years in girls or 13-14 years in boys.
**Gonadotrophin-dependent precocious puberty for Gonapeptyl Depot**
- **Child (body-weight up to 20 kg)** (By subcutaneous injection, or by deep intramuscular injection): Initially 1.875 mg every 2 weeks for 3 doses, to be administered on days 0, 14, and 28 of treatment, then 1.875 mg every 3-4 weeks, discontinue when bone maturation consistent with age over 12 years in girls and over 13 years in boys.
- **Child (body-weight 20-30 kg)** (By subcutaneous injection, or by deep intramuscular injection): Initially 2.5 mg every 2 weeks for 3 doses, to be administered on days 0, 14, and 28 of treatment, then 2.5 mg every 3-4 weeks, discontinue when bone maturation consistent with age over 12 years in girls and over 13 years in boys.
- **Child (body-weight 31 kg and above)** (By subcutaneous injection, or by deep intramuscular injection): Initially 3.75 mg every 2 weeks for 3 doses, to be administered on days 0, 14, and 28 of treatment, then 3.75 mg every 3-4 weeks, discontinue when bone maturation consistent with age over 12 years in girls and over 13 years in boys.
Cautions
General cautions: History of depression; patients with metabolic bone disease (decrease in bone mineral density can occur) Specific cautions: When used for Breast cancer Risk factors for osteoporosis When used for Male hypersexuality with severe sexual deviation Risk factors for osteoporosis When used for Prostate cancer Risk factors for osteoporosis; risk of spinal cord compression in men; risk of ureteric obstruction in men Cautions For Salvacyl Increased risk of sensitivity to restored testosterone if treatment interrupted-consider administration of an anti-androgen before stopping treatment; transient increase in serum testosterone occurs on initiation-consider administration of an anti-androgen
Contraindications
In endometriosis do not use for longer than 6 months (do not repeat); undiagnosed vaginal bleeding Contra-indications For Salvacyl Severe osteoporosis
Side effects
General side-effects: Common or very common Anxiety; asthenia; depression; diabetes mellitus; dizziness; dry mouth; embolism; gastrointestinal discomfort; gynaecomastia; haemorrhage; headache; hot flush; hyperhidrosis; hypersensitivity; hypertension; joint disorders; menstrual cycle irregularities; mood altered; muscle complaints; nausea; oedema; ovarian and fallopian tube disorders; pain; painful sexual intercourse; pelvic pain; sexual dysfunction; skin reactions; sleep disorders; weight changes Uncommon Alopecia; appetite abnormal; asthma exacerbated; chills; confusion; constipation; diarrhoea; drowsiness; dyspnoea; flatulence; gout; muscle weakness; taste altered; testicular disorders; tinnitus; vertigo; vision disorders; vomiting Rare or very rare Abnormal sensation in eye; chest pain; difficulty standing; fever; hypotension; influenza like illness; musculoskeletal stiffness; nasopharyngitis; orthopnoea; osteoarthritis; QT interval prolongation Frequency not known Angioedema; malaise Specific side-effects: Common or very common With intramuscular use Bone disorders; bone fracture; breast abnormalities; glucose tolerance impaired; hyperglycaemia; musculoskeletal disorder; seborrhoea; sensation abnormal; urinary disorders; vulvovaginal disorders With subcutaneous use Dysuria; vulvovaginal dryness Uncommon With intramuscular use Broken nails; central nervous system haemorrhage; cerebral ischaemia; concentration impaired; cystocele; dry eye; fluid retention; hirsutism; hyperlipidaemia; memory impairment; myocardial ischaemia; oral ulceration; palpitations; syncope; thrombocytosis; tremor With subcutaneous use Paraesthesia Frequency not known With subcutaneous use Bone disorder; breast pain; memory loss Side-effects, further information During the initial stage increased production of testosterone may be associated with progression of prostate cancer. In susceptible patients this tumour 'flare' may cause spinal cord compression, ureteric obstruction or increased pain.
Pregnancy
Avoid.
Breast feeding
Avoid.
Medicinal forms
Clinical governance
**Author:** MedNext Clinical Team. **Clinical reviewer:** Dr Shameer Deen, MBBS, MS, MRCS. **Sources:** BNF, Indian Pharmacopoeia, CIMS India. **Correction:** Report errors at support@mednext.academy.
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