Buserelin (Suprefact ®)
Buserelin is a hormonal therapy that is used to treat prostate cancer. The information describes buserelin, how it is given and some of its possible side effects. It should ideally be read with our general information about prostate cancer.
Buserelin is a type of hormonal therapy used to treat advanced prostate cancer when the cancer has spread to other parts of the body, or when it has come back after initial treatment.
Hormones are substances produced naturally in the body. They act as chemical messengers and help control the activity of cells and organs. Hormonal therapies work by interfering with the production or action of particular hormones in the body.
You will see your doctor regularly while you have this treatment so they can monitor its effects. This information should help you discuss any queries about your treatment and its side effects with your doctor or specialist nurse.
Most prostate cancers need supplies of a hormone called testosterone to grow. Testosterone is produced by the testes and the adrenal glands.
The production of testosterone by the testes is stimulated by another hormone called luteinising hormone. This is produced by the pituitary gland, which is situated in the brain. Buserelin reduces the production of luteinising hormone, which leads to a reduction in testosterone levels. This may shrink or slow down the development of the cancer.
When buserelin is given
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Buserelin is used to control the growth of prostate cancer in men with advanced prostate cancer.
How buserelin is given
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Buserelin is given as an injection under the skin (subcutaneously) three times a day for the first week. The injection can be given by your GP, district nurse or at your local hospital. Some men, or their partners, are taught how to give it themselves.
Sometimes people find the injection slightly uncomfortable and may notice an area of redness at the injection site afterwards.
After the first week, buserelin is continued as a nasal spray six times a day in each nostril. Your doctor can advise you how to use the spray and at what times of the day.
Your doctor will discuss the length of treatment they feel is appropriate for your situation. Buserelin is often given for several months or even years. Treatment with buserelin may continue for as long as it is effective in controlling your cancer.
Possible side effects of buserelin
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Each person's reaction to any medicine is different. Many people have very few side effects with buserelin, while others may experience more. The side effects described here won't affect everyone and may be different if you are having more than one drug.
We have outlined the most common side effects but haven't included those that are rare and therefore unlikely to affect you. If you notice any effects that are not listed here, discuss them with your doctor or nurse.
You may have some of the following side effects, to varying degrees.
The nasal spray may cause temporary irritation to the lining of the nose. You should avoid using nasal decongestants for 30 minutes before and after using the nasal spray.
There may be a temporary increase in testosterone levels in the first few days or weeks after starting buserelin. Some men may have an increase in symptoms such as bone pain, or have problems passing urine. Rarely, other problems due to a temporary increase in the size of the tumour may occur. This is known as tumour flare and is normal. It should improve in a few weeks but if you have any problems, let your doctor know.
Other types of hormonal therapy drugs such as cyproterone acetate, flutamide or bicalutamide may be given for the first few weeks after starting buserelin to try to prevent tumour flare.
These can be common but many men find that hot flushes wear off after a period of time. There are a number of ways to help reduce hot flushes and sweats. Some men find it helps to cut down on tea, coffee, nicotine and alcohol. Research shows that hormones called progestogens or some antidepressants may help to control hot flushes. Your doctor or nurse can discuss this with you.
Some men find complementary therapies helpful. Your GP may be able to give you details about having these on the NHS.
Loss of sex drive (libido) and erection difficulties (impotence) can occur. These often return to normal after you stop taking the drug. Some men may find that these problems carry on after treatment is over. Talk to your doctor or nurse if these effects are a problem as they can prescribe drugs to help.
Bone thinning (osteoporosis)
You may be at a higher risk of osteoporosis if you are taking buserelin for long periods of time. Your doctor can give you advice on how this can be monitored and treated. Let them know if you have any discomfort in your bones or joints.
You may notice that you gain weight, particularly around your waist. Eating a healthy diet and exercising regularly may help control your weight.
You may feel less energetic than usual and need to rest more.
If you're taking the nasal spray, you may notice that you have headaches.
You may experience mood swings or feel nervous. Talk to your doctor if this continues.
Muscle and joint pain
If you have soreness or stiffness in the joints or shoulders, your doctor can prescribe painkillers to ease this.
Feeling sick (nausea), being sick (vomiting) and mild diarrhoea
Tell your doctor if you have any of these effects, as they can usually be controlled with medicines.
Breast tenderness or fullness
Occasionally buserelin may cause breast swelling and tenderness, known as gynaecomastia. Your doctor can advise you about how this can be prevented or treated.
You may find that your skin gets dry and that you have skin rashes.
If you experience dizziness, blurred vision, drowsiness or poor concentration, let your doctor know and avoid driving.
Always tell your doctor or nurse about any side effects you have. There are usually ways in which they can be controlled or improved.
Things to remember about buserelin
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Buserelin may interact with other medicines. Tell your doctor about any medication you are taking. This includes non-prescribed drugs such as complementary therapies, vitamins and herbal drugs.
Keep the medication in a safe place, out of the reach of children.
If your doctor decides to stop the treatment, return any remaining medication to the pharmacist. Do not throw it away.
Don't worry if you forget to take the buserelin. Do not take a double dose. The levels of the drug in your blood will not change very much, but try not to miss more than one or two doses in a row.
Remember to get a new prescription a few weeks before you run out of buserelin. Make sure that you have plenty for holidays.
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If you’re admitted to hospital for a reason not related to the cancer, it’s important to tell the doctors and nurses looking after you that you’re having hormonal treatment. You should tell them the name of your cancer specialist so they can ask them for advice.
It’s a good idea to know who you should contact if you have any problems or troublesome side effects when you’re at home. Your doctor or specialist nurse will be able to provide you with details of who to contact for advice.
This information has been compiled using information from a number of reliable sources, including:
electronic Medicines Compendium (eMC). www.medicines.org.uk (accessed September 2012).
British National Formulary. 63rd edition. March 2012. British Medical Association and Royal Pharmaceutical Society of Great Britain.
Sweetman, et al. Martindale: The Complete Drug Reference. 37th edition. 2011. Pharmaceutical Press.
With thanks to: Kavita Kantilal, E-Prescribing Pharmacist; and the people affected by cancer who reviewed this edition.
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