Degarelix (Firmagon)
Degarelix is a hormone therapy drug and is also known by its brand name Firmagon.
Degarelix is a treatment for advanced hormone dependent prostate cancer. Hormone dependent means that that the cancer cells need a hormone in order to grow.
How degarelix works
Prostate cancer depends on testosterone to grow. Drugs that stop the testes making testosterone can slow or stop the growth of prostate cancer cells.
Degarelix works by blocking gonadotrophin releasing hormone receptors in the pituitary gland in the brain. The pituitary gland then stops producing luteinising hormone. The luteinising hormone is then not available to trigger the testes to make testosterone.
How you have degarelix
You have degarelix as an injection just under the skin (subcutaneously) into the fatty tissue of your tummy (abdomen).
Nurse: This is a short film showing you how to give an injection just under your skin. This is called a subcutaneous or sub cut injection. This does not replace what your doctors and nurses tell you, so always follow their advice.
Voiceover: Subcutaneous injections may be part of your cancer treatment. Or, you may need them to prevent side effects of treatment, such as blood clots after surgery. Or to help control cancer symptoms, such as pain or sickness.
Most injections come in prefilled syringes.
Nurse: So, today I am going to show you how to give a subcutaneous injection. I am going to start by giving it into a practice cushion and then you can have a go at giving one yourself. Before you start, you need to get your equipment together. What you are going to need is an alcohol wipe to clean your skin, some cotton wool, a prefilled syringe and a sharps bin. It is important that you wash your hands with soap and water and dry them thoroughly before you start. Check that you have got the correct drug and that it is in date.
You can give the injection into the back of your arm, your tummy, your thigh or the outer part of your bottom. It is important that you vary where you give the injection. So it may be that you give it one day in your tummy and the next in your thigh.
So you start by cleaning the skin with the alcohol wipe and allowing it to air dry. Then you take the cover off the needle and pinch the skin up and hold it a bit like a pen and in an upright position, in a quick dart like motion pop it straight down into the skin. Then you press the plunger right to the end, quickly pull the needle out, dab it with cotton wool, pop the needle into the sharps bin. And then you need to wash your hands again.
So here’s what you are going to need. If you start by checking the drug and the expiry date. And then with the alcohol wipe give your skin a clean. That’s it give it a few seconds for the air to dry it. Ok and then if you want to pick up the syringe and take the cover off the needle. Then pinch your skin up and at a ninety degree angle gently push the needle in...then press the plunger...and then quickly remove it... dab your skin with the cotton wool and put the syringe in the sharps bin.
Tests during treatment
You might have blood tests before starting treatment and regularly during your treatment. The tests check your levels of blood cells and other substances in the blood. They also check how well your liver and kidneys are working.
Side effects
How often and how severe the side effects are can vary from person to person. They also depend on what other treatment you are having. For example, your side effects could be worse if you are also having other drugs or radiotherapy.
When to contact your team
Your doctor, nurse, or pharmacist will go through the possible side effects. They will monitor you closely during treatment and check how you are at your appointments. Contact your advice line as soon as possible if:
- you have severe side effects
- your side effects aren’t getting any better
- your side effects are getting worse
We haven't listed all the side effects here. Remember it is very unlikely that you will have all of these side effects, but you might have some of them at the same time.
Common side effects
These side effects happen in more than 10 in 100 people (more than 10%). You might have one or more of them. They include:
Hot flushes
We have some tips for coping with hot flushes and the possible treatments for men and women. Talk to your doctor if your hot flushes are hard to cope with. They might be able to prescribe you some medicines.
Inflammation around the injection site
Tell your nurse if you notice any signs of redness or irritation around the injection site.
Occasional side effects
These side effects happen in between 1 and 10 out of every 100 people (between 1 and 10%). You might have one or more of them. They include:
- a drop in red blood cells that can cause breathlessness, tiredness and looking pale
- weight gain
- difficulty sleeping or getting to sleep
- headaches and dizziness
- diarrhoea
- feeling sick
- an increase of liver enzymes in the blood
- excessive sweating including night sweats
- rash
- general discomfort or pain
- growth of breast tissue (gynaecomastia) - talk to your doctor if this becomes a problem
- your testicles become smaller
- you might have problems getting or maintaining an erection (erectile dysfunction) - talk to your doctor or nurse if this becomes a problem
- high temperature
- chills
- tiredness (fatigue)
- flu like symptoms
Rare side effects
This side effects happens in fewer than 1 in 100 people (fewer than 1%). You might have one or more of them. They include:
- an allergic reaction
- high blood sugar levels that might become diabetes
- high levels of cholesterol in the blood
- weight loss
- loss of appetite
- high or low levels of calcium in the blood
- depression
- a decrease in your sex drive
- difficulty thinking
- reduced sense of touch
- blurred vision
- changes to your heart beat (rhythm)
- high or low blood pressure
- difficulty breathing
- constipation
- being sick
- tummy (abdominal) discomfort or pain
- dry mouth
- an increase of bilirubin and alkaline phosphate in the blood
- skin changes such as hives, nodules, itching and redness
- bone thinning (osteoporosis)
- muscle problems such as weakness, pain and spasms
- swollen, stiff joints
- leaking urine, waking to pass urine at night and passing small amounts often
- passing dark coloured urine
- difficulty or pain passing urine
- problems with how well your kidneys work
- pain in the testicles, breasts and the area between your hips (pelvis)
- itching, burning or irritation of your penis and scrotum
- failure to ejaculate
- a general feeling of discomfort, illness or unease the cause of which is not easy to identify
- swelling of your hands and feet
Coping with side effects
We have more information about side effects and tips on how to cope with them.
What else do I need to know
Other medicines, foods and drink
Cancer drugs can interact with some other medicines and herbal products. Tell your doctor or pharmacist about any medicines you are taking. This includes vitamins, herbal supplements and over the counter remedies.
Fertility
This treatment might stop you being able to father a child.
Talk to your doctor before starting treatment if you think you may want to have a baby in the future. You may be able to store sperm before starting treatment.
Treatment for other conditions
Always tell other doctors, nurses, pharmacists or dentists that you’re having this treatment if you need treatment for anything else, including teeth problems.
More information about this treatment
For further information about this treatment go to the electronic Medicines Compendium (eMC) website.
You can report any side effect you have to the Medicines Health and Regulatory Authority (MHRA) as part of their Yellow Card Scheme.
