Prospecto: information for the user
Lutrate Depot Monthly 3.75 mg powder and solvent for injectable suspension of prolonged release
Leuprolide acetate
Read this prospectus carefully before starting to use the medicationbecause it contains important information for you.
1.What is Lutrate Depot Monthly and for what it is used
2.What you need to know before starting to use Lutrate Depot Monthly
3.How to use Lutrate Depot Monthly
4.Possible adverse effects
5.Storage of Lutrate Depot Monthly
6.Contents of the package and additional information
Your doctor has prescribed Lutrate Depot Monthly for:
Your estrogen levels must have been adequately suppressed with this medication before starting treatment with an aromatase inhibitor such as exemestane, and should be monitored every three months during combined treatment with leuprorelin and an aromatase inhibitor (see the "Warnings and Precautions" section below for more information).
Warnings and Precautions
Consult your doctor or pharmacist before starting to take Lutrate Depot Mensual:
Immediately contact your doctor if you or your child experience severe headaches, visual problems, or tinnitus or buzzing.
Men and women
Only men
Only women
Children
Girls with central precocious puberty
Use of Lutrate Depot Mensual with other medications
Inform your doctor or pharmacist if you are using, have used recently, or may need to use any other medication. It may still be suitable to continue treatment with leuprorelin acetate; your doctor will decide what is best for you.
Leuprorelin acetate may interfere with some medications used to treat heart rhythm problems (e.g., quinidine, procainamide, amiodarone, and sotalol) or may increase the risk of heart rhythm problems when used with other medications (e.g., methadone (used for pain relief and detoxification of other medications), moxifloxacino (an antibiotic), and antipsychotics used to treat severe mental illnesses).
Pregnancy and lactation
Lutrate Depot Mensual is contraindicated during pregnancy. Spontaneous abortions may occur if this medication is administered during pregnancy.
It is unknown whether leuprorelin acetate is excreted in breast milk, therefore, this medication should not be administered to women or girls during lactation.
Driving and operating machinery
Visual disturbances and dizziness may occur during treatment. If you are affected, do not drive or operate machinery.
Lutrate Depot Mensual containsless than 23 mg of sodium (1 mmol) per dose; this is essentially "sodium-free".
Lutrate Depot Mensual contains Polisorbato 80
This medication contains 1 mg of polisorbate 80 in each dose. Polysorbates may cause allergic reactions. Inform your doctor if you have or your child has any known allergies.
Lutrate Depot Monthly should only be administered by your doctor or nurse. They will be responsible for preparing the product.
Adults including elderly:
The recommended dose of Lutrate Depot Monthly is one injection per month.The powder is reconstituted to form a suspension that is administered as a single intramuscular injection (in a muscle) once a month (approximately every 28-33 days).
The injection site should be varied at regular intervals.
Lutrate Depot Monthly should only be administered via intramuscular injection. It should not be administered by any other route.
The treatment regimen will be decided by your doctor
If you have breast cancer, you will be administered Lutrate Depot Monthly once a month in combination with tamoxifen or an aromatase inhibitor. Before starting treatment with an aromatase inhibitor or tamoxifen, you should have received at least two injections of leuprorelin with a one-month interval between each injection.
If you are administered Lutrate Depot Monthly to preserve ovarian function while receiving chemotherapy, you will usually be administered an injection of this medication two weeks before starting chemotherapy and then every month during the duration of your chemotherapy treatment.
Use in children:
The treatment of children should be under the general supervision of a pediatric endocrinologist.
The dose adjustment should be made individually.
The recommended starting dose depends on body weight:
Unless your doctor tells you otherwise, 2 ml of Lutrate Depot Monthly (3.75 mg of leuprorelin acetate) are administered once a month as a single intramuscular injection.
Considering the clinical activity of central precocious puberty in these rare cases, the following should be done:
Unless your doctor tells you otherwise, 1 ml of Lutrate Depot Monthly (1.88 mg of leuprorelin acetate) should be administered once a month as a single intramuscular injection. The remaining suspension should be discarded. Your doctor will monitor the child's weight gain.
Your doctor will determine the minimum effective dose through a blood test.
The duration of treatment depends on the clinical symptoms at the start of treatment or during treatment and will be decided jointly between the treating doctor, the legal guardian, and, if appropriate, the child being treated. Your doctor will determine the child's bone age at regular intervals.
In girls with a bone age of over 12 years and boys with a bone age of over 13 years, your doctor will evaluate whether to stop treatment based on the clinical effects in the child.
In girls, pregnancy should be ruled out before starting treatment. Generally, it cannot be ruled out during treatment. In these cases, consult your doctor.
The treatment is of long duration and is adjusted individually. Please agree with your doctor that the administration of Lutrate Depot Monthly should be carried out as precisely as possible at regular intervals of one month. An occasional delay of a few days (30 ± 2 days) in the injection date does not affect the treatment outcome.
If you use more Lutrate Depot Monthly than you should
This is unlikely, as your doctor or nurse will know the correct dose.However, if you suspect that you have received more medication than you should have, inform your doctor immediately so that necessary measures can be taken.
For overdose or accidental ingestion, consult the Toxicology Information Service, phone: 91 562 04 20, indicating the medication and the amount administered.
If you forget to use Lutrate Depot Monthly
It is essential not to miss a dose of Lutrate Depot Monthly.As soon as you know that you have missed an injection, contact your doctor, who will administer the next injection.
Only for women:If you forget a Lutrate Depot Monthly injection, it may cause intermenstrual bleeding or ovulation with a possibility of conception. If you think you may be pregnant, stop using this medication and contact your doctor immediately.
If you interrupt treatment with Lutrate Depot Monthly
Since medical treatment involves the administration ofLutrate Depot Monthlyfor a long period of time, interrupting treatment may result in an aggravation of symptoms related to the disease. Therefore, do not interrupt treatment prematurely without your doctor's permission.
If you have any other questions about the use of this medication, ask your doctor or pharmacist.
Like all medicines, this medicine can cause side effects, although not everyone will experience them.
Inform your doctor immediately if you notice any of the following symptoms:
During the first weeks of treatment, a temporary worsening of your condition may occur, but it should improve with continued treatment.
Men
The following side effects have been described:
Very common (may affect more than 1 in 10 people):
Hot flashes and reactions at the injection site.
Common (may affect up to 1 in 10 people):
Nocturnal sweating, cold sweats, fatigue, headache, pyrexia (elevated body temperature), increased appetite, erectile dysfunction, hyperhidrosis (excessive sweating), asthenia (lack or loss of strength), back pain, and reactions at the injection site such as pain, irritation, discomfort, erythema (redness of the skin), swelling (inflammation), hematomas (bruising), mood changes, and depression in prolonged treatments with leuprorelin.
Uncommon (may affect up to 1 in 100 people):
Swelling of the breasts, breast pain, dizziness, weakness, sleep disturbances, lower abdominal pain, diarrhea, nausea, vomiting, sensation of cold and heat, restlessness, fever, jaundice (yellowing of the eyes and skin), liver enzyme abnormalities, anorexia, elevated cholesterol, joint pain, muscle spasms, hand and foot pain, decreased libido, mood changes, urinary retention, frequent urination, urinary incontinence, swelling around the eyes, ejaculation dysfunction, hyperlipidemia (elevated blood lipid levels), pruritus (itching), urticaria (skin rash), mood changes, depression in short-term treatments with leuprorelin, and reactions at the injection site such as swelling, wounds, and bleeding.
Unknown (frequency cannot be estimated from available data):
Cardiac disorders: changes in the electrocardiogram (ECG) (prolongation of the QT interval).
Pulmonary inflammation, pulmonary disease.
Idiopathic intracranial hypertension (increased intracranial pressure around the brain characterized by headaches, diplopia, and other visual symptoms, tinnitus or ringing in one or both ears).
Women
Many of the side effects of Lutrate Depot Monthly are related to the decrease in estrogen levels. Estrogen levels return to normal after stopping treatment. Common side effects that may appear include hot flashes, mood changes, depression, and vaginal dryness. As can happen naturally when women reach menopause, this medication may cause a small reduction in bone density. Vaginal bleeding may occur during treatment.
The following side effects have been described:
Very common (may affect more than 1 in 10 people):
Difficulty sleeping, headache, or hot flashes.
Common (may affect up to 1 in 10 people):
Weight changes, mood changes, depression, paresthesia (tingling) in hands or feet, dizziness, nausea, joint pain, muscle weakness, breast tenderness, changes in breast size, vaginal dryness, swelling of the ankles, or skin reactions at the injection site (which include skin hardening, redness, pain, abscesses, swelling, nodules, ulcers, and skin damage).
Uncommon (may affect up to 1 in 100 people):
Loss of appetite, changes in blood lipids (cholesterol), visual disturbances, palpitations, diarrhea, vomiting, abnormalities in liver values in blood tests, hair loss, muscle pain, fever, chills, or fatigue.
Unknown (frequency cannot be estimated from available data):
Blood tests may show anemia (low red blood cell count), low white blood cell count, or platelet count, allergic reactions (including symptoms of rash, itching, hives, or a severe allergic reaction that causes difficulty breathing or dizziness), changes in blood sugar levels, paralysis, pulmonary embolism, high or low blood pressure, jaundice (yellowing of the skin), liver function abnormalities, spinal fracture, seizures, less dense bones, or vaginal bleeding, pulmonary inflammation, or pulmonary disease.
Idiopathic intracranial hypertension (increased intracranial pressure around the brain characterized by headaches, diplopia, and other visual symptoms, tinnitus or ringing in one or both ears).
Side effects when used for breast cancer treatment in combination with tamoxifen or an aromatase inhibitor
The following side effects have been observed when a similar class of medications called GnRH analogs (GnRH hormone-releasing hormone analogs) has been used for breast cancer treatment in combination with tamoxifen or an aromatase inhibitor:
Very common (may affect more than 1 in 10 people):
Nausea, feeling very tired, joint and muscle pain, osteoporosis, hot flashes, excessive sweating, difficulty sleeping, depression, decreased libido, vaginal dryness, pain during or after sex, urinary incontinence, increased blood pressure.
Common (may affect up to 1 in 10 people):
Diabetes, high blood sugar (hyperglycemia), pain, hematomas, redness, and swelling at the injection site, allergic reaction, bone fractures, blood clots in a blood vessel.
Uncommon (may affect up to 1 in 100 people):
Brain hemorrhage, lack of blood flow to the brain or heart.
Rare (may affect up to 1 in 1000 people):
Changes in the ECG (prolongation of the QT interval).
Children
In the initial phase of treatment, there is a temporary increase in sex hormone levels, followed by a drop in values within the prepubertal range. As a result, side effects may occur, especially at the beginning of treatment.
The following side effects have been described:
Common (may affect up to1 in 10 patients):
Mood changes, headache, abdominal pain / cramps, nausea / vomiting, acne, vaginal bleeding, spotting, vaginal discharge, reactions at the injection site.
Very rare (may affect up to 1 in 10,000 people):
Generalized allergic reactions (fever, skin rash, itching), severe allergic reactions that cause difficulty breathing or dizziness.
Like with other medications in this class: if you have an existing pituitary injury, there may be a higher risk of bleeding in the area, which could cause permanent damage.
Unknown (frequency cannot be estimated from available data):
Seizures, pulmonary inflammation, pulmonary disease.
Idiopathic intracranial hypertension (increased intracranial pressure around the brain characterized by headaches, diplopia, and other visual symptoms, tinnitus or ringing in one or both ears).
Notes:
Generally, vaginal bleeding during continued treatment (after possible withdrawal bleeding in the first month of treatment) should be evaluated as a potential sign of under-dosing. If vaginal bleeding occurs, inform your doctor.
Reporting side effects:
If you experience side effects, consult your doctor or pharmacist, even if they do not appear in this leaflet. You can also report them directly through the Spanish System for Pharmacovigilance of Medicinal Products for Human Use:www.notificaRAM.es. By reporting side effects, you can contribute to providing more information on the safety of this medication.
Your doctor or pharmacist will know how to conserve Lutrate Depot Monthly.
Keepthis medicationout of the sight and reach of children.
Do not store at a temperature above 25°C. Do not freeze.
Do not use this medication after the expiration date that appears on the packaging, vial, and preloaded syringe after “CAD”. The syringe has the same expiration date as the vial. The expiration date is the last day of the month indicated.
Once reconstituted with the solvent, the suspension must be administered immediately.
Medicationsshould not be disposed of through drains or in the trash. Dispose of the packaging and medications you do not need at the SIGRE collection pointat the pharmacy. Ask your pharmacist how to dispose of the packaging and medications you do not need. By doing so, you will help protect the environment.
Composition of Lutrate Depot Monthly
The active ingredient is leuprorelin acetate. Each vial contains 3.75 mg of leuprorelin acetate.
The other components are: polisorbate 80, mannitol (E-421), sodium carmelose (E-466), triethyl citrate, and poly(DL-lactide-co-glycolide) (PLGA).
The solvent contains (pre-filled syringe): mannitol, water for injectable preparations, sodium hydroxide (for pH adjustment) and hydrochloric acid (for pH adjustment).
Appearance of the product and contents of the package
Each package contains a vial with 3.75 mg of leuprorelin acetate, a pre-filled syringe with 2 ml of solvent, an adapter system, and a sterile 20G needle.
Holder of the marketing authorization and responsible for manufacturing
GP-PHARM, S.A.
Pol. Ind. Els Vinyets – Els Fogars Sector 2
Carretera comarcal 244, km22
08777 Sant Quintí de Mediona
Spain
This medicine is authorized in the member states of the European Economic Area with the following names:
Spain: Lutrate Depot Monthly 3.75 mg powder and solvent for prolonged-release injectable suspension
France: Zeulide 3.75 mg powder and solvent for prolonged-release injectable suspension
Last review date of this leaflet: February 2025.
Other sources of information
The detailed information of this medicine is available on the website of the Spanish Agency for Medicines and Medical Devices (AEMPS) ( http://www.aemps.gob.es/ )
This information is intended solely for healthcare professionals.
How to prepare the injection?
IMPORTANT: Read carefully before administering the product (the Instructions for use are also included in the tray containing the components of the kit).
You should follow aseptic technique during the reconstitution procedure.
Use only the solvent included in the commercial kit.
Once mixed, the product must be administered immediately. By single intramuscular injection.
This medicine is for single use only. Any remaining suspension must be discarded.
Check the contents of the kit and ensure that it includes everything mentioned in the leaflet.
The package contains:
1 (one) vial of Lutrate Depot Monthly 3.75 mg (leuprorelin acetate) powder for injectable suspension.
1 (one) pre-filled syringe containing the solvent for the suspension (mannitol 0.8% injectable solution)
1 (one) sterile, single-use device for reconstituting the product, including 1 (one) single-use sterile needle.
1 | Remove the pressure-closing cap completely from the top of the vial, so that the rubber stopper is exposed. Confirm that there are no remaining parts of the pressure-closing cap in the vial. | |
2 | Place the vial in a vertical position on a table. Remove the cover of the blister containing the vial adapter (MIXJECT). Do not remove the vial adapter from the blister. Place the blister containing the vial adapter firmly on top of the vial, perforating the rubber stopper in a completely vertical position. Press gently downwards until it fits in its position. | |
3 | Attach the white piece to the syringe until it fits. Remove the rigid cap of the syringe in a counterclockwise direction. Then, remove the blister from the MIXJECT adapter system. | |
4 | Connect the syringe to the adapter system by screwing it in a clockwise direction into the lateral opening of the adapter system. To ensure a hermetic connection, screw the syringe gently until it stops. | |
5 | While maintaining the syringe and vial firmly connected in a vertical position, slowly push the plunger of the syringe to transfer all the solvent to the vial. | |
6 | With the syringe still connected to the vial, gently shake the vial for about a minute until a uniform milky suspension is obtained. To avoid the separation of the suspension, perform the following steps without stopping. | |
7 | Turn the MIXJECT adapter system so that the vial is at the top. Hold the MIXJECT adapter system firmly by the syringe and slowly pull the plunger to transfer the contents of the vial to the syringe. Part of the product may accumulate or be deposited on the wall of the vial. This is normal. | |
8 | Disconnect the syringe from the MIXJECT adapter system. To do this, hold the syringe firmly and turn the vial clockwise (holding the plastic stopper of the adapter). | |
9 | Keep the syringe in a vertical position. With the opposite hand, remove the needle guard by pulling it upwards. Press the plunger slightly to expel the air from the syringe. The syringe containing the product is ready for immediate administration. | |
10 | Administer the injection intramuscularly by inserting the needle at a 90-degree angle in the gluteus. Ensure that the entire product is injected. The injection sites should be alternated. |
Instructions for use
Include in the lid of the tray containing the components of the Medicinal Product Kit
Lutrate Depot – Instructions for use
Read carefully before administering the product
Reconstitute immediately before administering by single intramuscular injection
Use only the solvent included in the commercial kit.
Product intended for single use only.
Any remaining suspension must be discarded.
1 | Remove the pressure-closing cap completely from the top of the vial, so that the rubber stopper is exposed. Confirm that there are no remaining parts of the pressure-closing cap in the vial. | |
2 | Place the vial in a vertical position on a table. Remove the cover of the blister containing the vial adapter (MIXJECT). Do not remove the vial adapter from the blister. Place the blister containing the vial adapter firmly on top of the vial, perforating the rubber stopper in a completely vertical position. Press gently downwards until it fits in its position. | |
3 | Attach the white piece to the syringe until it fits. Remove the rigid cap of the syringe in a counterclockwise direction. Then, remove the blister from the MIXJECT adapter system. | |
4 | Connect the syringe to the adapter system by screwing it in a clockwise direction into the lateral opening of the adapter system. To ensure a hermetic connection, screw the syringe gently until it stops. | |
5 | While maintaining the syringe and vial firmly connected in a vertical position, slowly push the plunger of the syringe to transfer all the solvent to the vial. | |
6 | With the syringe still connected to the vial, gently shake the vial for about a minute until a uniform milky suspension is obtained. To avoid the separation of the suspension, perform the following steps without stopping. | |
7 | Turn the MIXJECT adapter system so that the vial is at the top. Hold the MIXJECT adapter system firmly by the syringe and slowly pull the plunger to transfer the contents of the vial to the syringe. Part of the product may accumulate or be deposited on the wall of the vial. This is normal. | |
8 | Disconnect the syringe from the MIXJECT adapter system. To do this, hold the syringe firmly and turn the vial clockwise (holding the plastic stopper of the adapter). | |
9 | Keep the syringe in a vertical position. With the opposite hand, remove the needle guard by pulling it upwards. Press the plunger slightly to expel the air from the syringe. The syringe containing the product is ready for immediate administration. | |
10 | Administer the injection intramuscularly by inserting the needle at a 90-degree angle in the gluteus. Ensure that the entire product is injected. The injection sites should be alternated. |
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