Adult Dosing
Advanced prostate cancer [Vantas]
- Insert 1 implant SC q12 months; delivers continuous release of 50 mcg/day for 12 months
Notes:- Insert aseptically in the inner aspect of the upper arm using sterile insertion device
- Remove after 12 months of therapy; at the time of removal, may insert another implant to continue therapy
- Can insert a new implant into the same pocket as the removed implant, or at a different site in the same arm or in the contralateral arm
Pediatric Dosing
- Vantas is not indicated for use in pediatric patients
- Safety and effectiveness of Supprelin LA in pediatric patients <2 yrs have not been established
Central precocious puberty (CPP) [Supprelin LA]
- Insert 1 implant SC q12 months; delivers continuous release of histrelin 65 mcg/day for 12 months
Notes:- Insert aseptically in the inner aspect of the upper arm using sterile insertion device
- Discontinuation should be considered at the physician's discretion and at the appropriate time point for the onset of puberty (approximately 11 yrs for females and 12 yrs for males)
- At the time of removal, may insert another implant to continue therapy
- Can insert a new implant into the same pocket as the removed implant, or at a different site in the same arm or in the contralateral arm
[Outline]
See Supplemental Patient Information
- A transient elevation in serum concentrations of testosterone in both sexes and estradiol in females may be observed during initial week of therapy, which may result in worsening of symptoms of puberty or onset of new symptoms
- Spinal cord compression has been reported with histrelin use, which may result in paralysis, ureteral obstruction and renal impairment. Closely monitor patients with vertebral metastases and urinary obstruction during the first few weeks of therapy
- Spontaneous extrusion of the implant and difficulty locating the implant has been reported in certain patients. Ensure compliance with correct insertion and removal procedures to avoid complications
- Instruct patients to refrain from wetting the inserted arm for 24 hours and to avoid strenuous exercise or lifting heavy weights for 7 days following implant insertion
- Men treated with GnRH agonists are at an increased risk of hyperglycemia and development of diabetes mellitus or worsening of glycemic control in diabetics. Monitor blood glucose and/or glycosylated hemoglobin (HbA1c) regularly in these patients
- Men treated with GnRH agonists are at increased risk of developing myocardial infarction, sudden cardiac death and stroke. Monitor patients for signs and symptoms indicating development of cardiovascular disease
- Periodically monitor serum concentrations of testosterone and prostate-specific antigen levels to assess therapeutic response in patients treated with Vantas
- Monitor LH, FSH and estradiol or testosterone levels at 1 month after implantation, followed by once every 6 months in patients treated with Supprelin LA. Also, monitor height and bone age every 6-12 months
Caution: Use cautiously in
Supplemental Patient Information
- Instruct patients to refrain from getting the inserted arm wet for 24 hrs and from strenuous exertion of the inserted arm for 7 days following implant insertion
- Advise patients to routinely visit their physicians to ensure that the implant is present and functioning well in the body
Pregnancy Category:X
Breastfeeding: Safety unknown. As per manufacturer's data, due to the potential for serious adverse reactions in nursing infants, a decision should be made whether to discontinue nursing or to discontinue the drug, analyzing the importance of the drug to the mother. Vantas is not indicated for use in women.
