Administration of Decapeptyl / Leuprorelin injections
Indications (Prostate Cancer, Breast Cancer, Gender Dysphoria)
- Treatment of certain stages of prostate cancer. It is Amber on the BNSSG Joint Formulary (therefore appropriate for shared care – responsibility for prescribing transferred from the specialist team to primary care). https://remedy.bnssg.icb.nhs.uk/formulary-adult/chapters/6-endocrine-system/66-gonadotrophin-responsive-conditions/ BNSSG Adult formulary [accessed 19.06.24]
- Treatment of certain stages of breast cancer. It is Amber on the BNSSG Joint Formulary (therefore appropriate for shared care – responsibility for prescribing transferred from the specialist team to primary care). https://remedy.bnssg.icb.nhs.uk/formulary-adult/chapters/6-endocrine-system/66-gonadotrophin-responsive-conditions/ BNSSG Adult formulary [accessed 19.06.24]
- Treatment of certain aspects of Gender Dysphoria. This comes under National Directive from NHS England:
General Practitioners should co-operate with the specialist Gender Identity Clinics and prescribe hormone therapy (feminising or virilising endocrine therapy) recommended for their patients by the Gender Identity Clinic. The specialists at the Gender Identity Clinic make recommendations for the prescription and monitoring of these therapies but they do not directly prescribe them, or provide physical and laboratory monitoring procedures for patients. ssc-1620-primary-care-responsibilities-in-prescribing.pdf (icb.nhs.uk) [accessed 19.06.24] – local practice policy is to follow this for patients from NHS gender dysphoria clinics, or on a case by case basis if for instance someone transfers to the practice having received this treatment at their previous practice following referral from a private gender dysphoria clinic. Existing practice patients who are referred from a private clinic should be directed to NHS gender dysphoria services.
Further BNSSG information see BNSSG formulary 6.8.5 Hormone Therapy for Gender Reassignment 6.8 Sex hormone responsive conditions (Remedy BNSSG ICB) [accessed 19.06.24]
Decapeptyl SR – IM injection
BNSSG CCG from Jun-22 advise 6 monthly formulation.
Decapeptyl SR 11.25mg (triptorelin pamoate) – Summary of Product Characteristics (SmPC) – (emc) (medicines.org.uk) [accessed 19/06/24]
Decapeptyl SR 22.5mg – Summary of Product Characteristics (SmPC) – (emc) (medicines.org.uk) [accessed 19/06/24]
Leuprorelin 11.25mg SC injection (Prostap 3 DCS)
It is given at a dose of Leuprorelin 11.25mg SC every 3 months:
Administration
Decapeptyl may be administered by a trained nurse following recent prescription which should be visible on EMIS medications record, or under PSD.
Follow instructions for reconstitution in the patient information leaflet:
Decapeptyl SR 22.5mg – Patient Information Leaflet (PIL) – (emc) (medicines.org.uk) [accessed 19/06/24]
Leuprorelin may be administered by a trained nurse following recent prescription which should be visible on EMIS medications record, or under PSD.
Follow instructions for reconstitution in the user manual:
SUMMARY OF PRODUCT CHARACTERISTICS (medicines.org.uk) [accessed 19/06/24]
Storage
Decapeptyl:
Do not store above 25°C. Do not refrigerate or freeze.
Keep container in the outer carton prior to use.
A stock will be kept in room 7.
Leuprorelin:
Do not store above 25°C. Do not refrigerate or freeze.
Store in the original container in order to protect from light.
A stock will be kept in room 7.
Monitoring
Decapeptyl:
Men with prostate cancer should have:
Minimum annual blood for PSA taken at CKMP, if taking PSA bloods for review at Out Patients please code this in notes. The patient should have an annual GP review.
For people with prostate cancer and conditions other than prostate cancer
Frequency of blood monitoring and injection should be written against problem heading. Patients often have results monitored in secondary care.
Leuprorelin:
Men with prostate cancer should have:
Minimum annual blood for PSA + LFT taken at CKMP, if taking PSA bloods for review at Out Patients please code this in notes. The patient should have an annual GP review.
For people with prostate cancer and conditions other than prostate cancer
Frequency of blood monitoring and injection should be written against problem heading. Patients often have results monitored in secondary care.
Coding
Decapeptyl:
Under prostate, breast cancer or Gender Dysphoria problem heading, record in consultation under procedure, code ‘Intramuscular injection of gonadorelin analogue’ and free text in the details of drug.
Leuprorelin:
Under prostate, breast cancer or Gender Dysphoria problem heading, record in consultation under procedure, code ‘Intramuscular injection of gonadorelin analogue’ and free text in the details of drug.
Recalls
Recall code in diary ‘intramuscular injection of gonadorelin analogue’ with when next injection is due.
PN in charge of this recall list will review patients who are due a recall. Patient should be contacted and booked in for TRN if requires decapeptyl or leuprorelin and a GP if requires zoladex.
References
The Electronic Medicines Compendium (EMC) Home – electronic medicines compendium (emc) [accessed 19/06/2024]
The British National Formulary (BNF) Triptorelin | Drugs | BNF | NICE [accessed 19/06/2024]
Version Control
| Date | Version | Author | Change Details |
| 28.06.2024 | 1.0 | John Moore | |
| 13/11/2024 | 1.1 | J Godfrey | Reviewed |