Buserelin (Suprefact®) is a hormonal therapy drug used to treat prostate cancer. It can be given alone or with other types of treatment. It is best to read this information with our general information about hormonal therapies and the type of cancer you have.
Your doctor will talk to you about this treatment and its possible side effects before you agree (consent) to have treatment.
Hormones are chemicals that our bodies make. Hormones act as messengers and help control how cells and organs work. Hormonal therapies are drugs that change the way hormones are made, or how they work in the body.
Most prostate cancers need the hormone testosterone to grow. Almost all testosterone is made by the testicles.
Buserelin stops the testicles from making testosterone. This reduces testosterone levels and may shrink the prostate cancer or stop it growing.
How buserelin is given
For the first 7 days, buserelin is given as an injection under the skin (subcutaneously). You will be given the injection 3 times a day. After this you have it a nasal spray.
The injection can be given by your GP, practice nurse or at your local hospital. You may be shown how to do the injection yourself. Around the injected area, you may have some pain, swelling, redness or it may be a darker colour. Let your doctor know if this happens. Painkillers may help.
Tell your doctor or nurse if you are taking any medicines to thin your blood, as this may increase bruising.
Buserelin nasal spray
From day 8, you take buserelin as a nasal spray. You take it 6 times a day, in each nostril. Your doctor or nurse will advise you on how to use the spray and at what times of day you should take it. You need to avoid using nasal decongestants for 30 minutes before and after using the nasal spray.
Here are some important things to remember:
If you forget to take your buserelin spray, take it as soon as you remember it. However, if is nearly time for the next dose, skip the missed dose. Take your next dose at the normal time. Do not take a double dose to make up for the forgotten dose.
- Keep buserelin in a safe place, out of the sight and reach of children.
- Get a new prescription before you run out and make sure you have plenty for holidays.
- Return any remaining buserelin to the pharmacist if your treatment is stopped.
- Do not stop taking buserelin without talking to you doctor first.
We explain the most common side effects of this treatment here. We also include some less common side effects.
You may get some of the side effects we mention, but you are unlikely to get all of them. If you are also having treatment with other cancer drugs, you may have some side effects that we have not listed here.
You will see a doctor, nurse or pharmacist regularly while you are having this treatment. Always tell them about any side effects you have. They can give you drugs to help control most side effects. They can also offer advice to help you cope.
Most side effects can be managed. But sometimes side effects are harder to control. It is important not to stop taking hormonal therapy without telling your doctor. If side effects cannot be managed, your doctor may suggest you take a different type of hormonal therapy.
Serious and life-threatening side effects
Some cancer treatments can cause severe side effects. Rarely, these may be life-threatening. Your cancer doctor or nurse can explain the risk of these side effects to you.
Contact the hospital
Your nurse will give you telephone numbers for the hospital. If you feel unwell or need advice, you can call them at any time of the day or night. Save these numbers in your phone or keep them somewhere safe.
We cannot list every side effect for this treatment. There are some rare side effects that are not listed. You can visit the electronic Medicines Compendium (eMC) for more detailed information.
When you start this treatment, your testosterone levels may increase for the first few days or weeks. This may make some symptoms worse. Doctors call this tumour flare.
Your doctor may prescribe another hormonal therapy tablet to prevent or reduce tumour flare. You usually start taking these tablets before starting the hormonal therapy drug to treat the cancer. You may need to continue taking them for a few weeks.
Hot flushes and sweats
Hot flushes are a common side effect of this treatment. During a flush, your neck and face may feel warm and look red. Flushes may last from a few seconds up to 10 minutes. You may have sweats and then feel cold and clammy. Some people feel anxious or irritable during a hot flush.
There are things you can do to try to reduce flushes:
- Wear clothes made from natural fabrics, such as cotton.
- Wear layers of clothes that you can remove if you feel hot.
- Use cotton bed sheets and have layers of bedding that you can remove if you feel hot.
- Keep room temperatures cool or use a fan.
- Have cold drinks rather than hot ones. Try to avoid drinks with caffeine in them.
You may have fewer hot flushes and sweats as your body adjusts to hormonal treatment. Or your doctor can prescribe drugs to help. Flushes and sweats usually stop a few months after treatment finishes, but some people continue to have them.
You can read more about coping with hot flushes.
Most men lose their sex drive and have erection problems during hormonal therapy. Things often return to normal after you stop taking the drug. But some men continue to have problems after treatment is over. Your doctor can prescribe treatments to help with erection problems. But these treatments will not increase your sex drive.
The nasal spray may cause temporary irritation to the lining of your nose. Some people may have nose bleeds or notice changes in their sense of smell. Tell your doctor if you notice any of these symptoms.
This treatment may cause headaches. If this happens, tell your doctor or nurse. They can give you painkillers.
Feeling tired is a common side effect. Try to pace yourself and plan your day so you have time to rest. Gentle exercise, like short walks, can give you more energy. If you feel sleepy, do not drive or operate machinery.
Feeling sick and tummy pain
Buserelin can make you feel sick (nauseous) or give you abdominal (tummy) pain, but this is usually mild. If it does not improve, your doctor can give you anti-sickness drugs to help.
This treatment may affect your skin. It may cause a rash, which might be itchy. Your doctor or nurse can tell you what to expect. If your skin feels dry, try using an unperfumed moisturising cream every day.
Always tell your doctor or nurse about any changes to your skin. They can give you advice and may prescribe creams or medicines to help. Skin changes usually improve when treatment finishes.
Effects on the nervous system
Buserelin can affect the nervous system. Occasionally, buserelin can cause dizziness, drowsiness or sleep problems. Do not drive or operate machinery if you feel like this.
You may have pins and needles or feel tingling in your arms and legs. These symptoms are usually mild. Tell your doctor or nurse straight away if you notice any of these symptoms.
Memory and concentration
You may notice changes in your memory. You may also find it harder to concentrate. To help you remember things, try using:
- a notebook
- notes on your phone
- a calendar.
You may have some mood changes during this treatment. You may feel low or depressed. Let your doctor or nurse know if you notice any changes.
Muscle or joint pain
You may get pain in your muscles or joints. If this happens, tell your doctor so they can give you painkillers. Being physically active may help with the pain and keep your joints flexible. Keeping to a healthy weight may help too. Tell your doctor or nurse if the pain does not get better.
Bone thinning (osteoporosis)
If you take this treatment for several months or more, you may get bone thinning. This is called osteoporosis. This can increase your risk of a broken bone (fracture). You may have bone density scans to check your bone health before and during treatment.
Doing regular exercise, such as walking, can improve your bone health. Eating a healthy diet can help too. Your doctor may prescribe drugs called bisphosphonates to help protect your bones. They may also advise you to take calcium and vitamin D supplements.
Breast swelling or tenderness
This treatment may cause swelling and tenderness of your breast tissue. This is called gynaecomastia. Your doctor can give you advice on preventing and treating this.
Breast swelling or tenderness
This treatment can cause swelling and tenderness of your breast tissue. This is called gynaecomastia. Your doctor can give you advice on how this can be prevented or treated.
Anaemia (low number of red blood cells)
This treatment can reduce the number of red blood cells in your blood. These cells carry oxygen around the body. If the number of red blood cells is low, you may be tired and breathless. Tell your doctor or nurse if you feel like this. If you are very anaemic, you may need a drip to give you extra red blood cells. This is called a blood transfusion.
Effects on the liver
This treatment may affect how your liver works. This is usually mild. You will have blood tests to check how well your liver is working.
Raised cholesterol level
This treatment can raise the level of cholesterol (a fatty substance) in the blood. You may have a blood test to check the level of cholesterol. Your doctor may give you medicines to control your cholesterol levels.
Some people have an allergic reaction while having this treatment. Signs of a reaction can include:
- feeling hot or flushed
- a skin rash
- feeling dizzy
- a headache
- feeling breathless.
If you feel unwell or have any of these signs, tell a doctor or nurse straight away. Do not take any more of this treatment until you have spoken to them.
Effects on the heart
This treatment can affect the way your heart works. Your doctor may do tests to see how well your heart is working. You may have these tests before, during, and sometimes after treatment.
Contact a doctor straight away if you:
- have pain or tightness in your chest
- feel breathless or dizzy
- feel your heart is beating too fast or too slowly.
Other conditions can cause these symptoms. But it is important to get them checked by a doctor.
Raised blood sugar levels
This treatment can raise your blood sugar levels. If you have a raised blood sugar level, you may:
- feel thirsty
- need to pass urine (pee) more often
- feel tired.
Tell your doctor or nurse if you have these symptoms.
If you have diabetes, your blood sugar levels may be higher than usual. Your doctor will talk to you about how to manage this. You may need to change your insulin or tablet dose.
Blood clot risk
Cancer and some cancer treatments can increase the risk of a blood clot. Symptoms of a blood clot include:
- pain, redness or swelling in a leg or arm
- chest pain.
If you have any of these symptoms, contact a doctor straight away.
A blood clot is serious, but can be treated with drugs that thin the blood. Your doctor or nurse can give you more information.
Your doctor will advise you not to make someone pregnant while having this treatment. The drug may harm the developing baby. It is important to use effective contraception during your treatment.
Some medicines can affect how this treatment works or be harmful when you are having it. Always tell your cancer doctor about any drugs you are taking or planning to take, such as:
- medicines you have been prescribed
- medicines you buy in a shop or chemist
- vitamins, herbal drugs and complementary therapies.
Tell other doctors, pharmacists or dentists who prescribe or give you medicines that you are having this cancer treatment.
You can visit the electronic Medicines Compendium (eMC) for more detailed information about your treatment.
Medical and dental treatment
If you need medical treatment for any reason other than cancer, always tell the doctors and nurses that you are having cancer treatment. Give them the contact details for your cancer doctor so they can ask for advice.
If you think you need dental treatment, talk to your cancer doctor or nurse. Always tell your dentist you are having cancer treatment.