Monthly injection that rapidly shuts down testosterone production. Used in advanced hormone-sensitive prostate cancer.
Regulatory status
Approved (FDA / EMA)
Family
GnRH antagonist
Scientific evidence
High
Number of findings
1
Where it acts
Sexual and reproductive · Hormones and metabolism
Also known as
degarelix, Firmagon, FE200486
Regulatory status
FDA (US): Approved (2008, Firmagon) for advanced prostate cancer
EMA (EU): Approved (2009, Firmagon) for advanced hormone-dependent prostate cancer
Dose
Starting dose of 240 mg (two 120 mg subcutaneous injections) and then 80 mg monthly (FDA/EMA labels; CS21 trial).
Safety
Very common injection-site reactions (about 40%), hot flashes, weight gain, fatigue, elevated transaminases. Androgen deprivation reduces bone density and may prolong the QT interval. Under medical supervision.
Interactions
Caution with drugs that prolong the QT interval (class IA/III antiarrhythmics, some antipsychotics, macrolides).
Differences between women and men
Indication exclusively for men (prostate cancer).
Effect by goal · level of evidence
Rapid chemical castration, without an initial surge
reducesHighRCT (AA)in people
96% castration at day 3
In 610 men with prostate cancer, 96% on degarelix had testosterone at castrate levels by day 3, versus none with leuprolide. At one year both maintained suppression (97–98% vs 96%).
It blocks the GnRH receptor in the pituitary and immediately slows LH and FSH. The testes stop making testosterone within a few days, without the initial 'flare' caused by agonists such as leuprolide.
What the evidence says
In people
Rapid chemical castration, without an initial flare. In 610 men with prostate cancer, 96% on degarelix had castrate-level testosterone by day 3, versus none on leuprolide. At one year both maintained suppression (97–98% vs 96%). PubMed 19035858