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Firmagon

degarelix
Used for Prostate Cancer
Used for Prostate Cancer

Firmagon (degarelix) is an injection used to treat advanced prostate cancer. It's given by a healthcare provider and can't be injected at home on your own.

Reviewed by:
Carter Havican, PharmD
Last reviewed on March 10, 2022
basics-icon

What is Firmagon (degarelix)?

What is Firmagon (degarelix) used for?

  • Advanced prostate cancer

How Firmagon (degarelix) works

Firmagon (degarelix) is a gonadotropin releasing hormone (GnRH) antagonist. It blocks a natural hormone in your brain called GnRH that typically releases testosterone. This lowers the amount of testosterone in your body.

High levels of testosterone in men with prostate cancer can cause the tumor to get bigger. By lowering the amount of testosterone in the body, Firmagon (degarelix) helps shrink or slow tumor growth.

Drug Facts

Common BrandsFirmagon
Drug ClassGonadotropin releasing hormone (GnRH) antagonist
Controlled Substance ClassificationNot a controlled medication
Generic StatusNo lower-cost generic available
AvailabilityPrescription only
basics-icon

What are the side effects of Firmagon (degarelix)?

The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.

Common Side Effects

  • Injection site reactions (e.g., pain, redness, swelling, 35%)
  • Hot flashes (26%)
  • Weight gain (9%)

Other Side Effects

  • Chills
  • Constipation
  • Back pain
  • Joint pain
  • Urinary tract infection (UTI)
  • High blood pressure

Serious Side Effects

Contact your healthcare provider immediately if you experience any of the following.
  • Allergic reactions: difficulty breathing; severe itching; swelling of the eyes, lips, face, throat, hands, or feet
  • Heart rhythm problems: racing heart, fluttering in your chest, abnormal heartbeats

Source: DailyMed

The following side effects have also been reported

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor or nurse immediately if any of the following side effects occur:

More common

Back pain

blurred vision

dizziness

fever

flushing or redness of the skin

hard lump

headache

nervousness

pain

pounding in the ears

slow or fast heartbeat

small lumps under the skin

swelling

unusually warm skin

Less common

Bladder pain

bloody or cloudy urine

chills

decrease in testicle size

decreased interest in sexual intercourse

difficult, burning, or painful urination

difficulty in moving

frequent urge to urinate

inability to have or keep an erection

increased sweating

loss in sexual ability, desire, drive, or performance

lower back or side pain

muscle pain or stiffness

pain in the joints

Rare

Chest pain or discomfort

fainting

irregular heartbeat

pounding heartbeat

Incidence not known

Cough

difficulty swallowing

hives, itching, or skin rash

puffiness or swelling of the eyelids or around the eyes, face, lips or tongue

tightness in the chest

trouble breathing

unusual tiredness or weakness

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

Difficulty having a bowel movement (stool)

feeling of warmth

increased weight

redness of the face, neck, arms, and occasionally, upper chest

sudden sweating

Less common

Diarrhea

lack or loss of strength

nausea

night sweats

swelling of the breasts or breast soreness

trouble sleeping

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

pros-and-cons

Pros and cons of Firmagon (degarelix)

thumbs-up

Pros

Only given once a month

Doesn't cause tumor-flare syndrome (tumor growth) when you start treatment, like other prostate cancer medications

Starts to lower testosterone levels very quickly; many people reach their testosterone goal levels in 1 to 3 days

thumbs-down

Cons

Only available as an injection

Must be given by a healthcare provider

Very expensive and no generic available

pharmacist-tips

Pharmacist tips for Firmagon (degarelix)

pharmacist
  • Firmagon (degarelix) is given by a healthcare provider at their office or clinic.

    • You'll receive 2 injections as your first dose. Then, you'll get 1 injection for your following monthly doses.

      • Always schedule an appointment for your next injection, since it needs to be given monthly. Remember to mark these dates on your calendar so you don't miss your appointments.

        • Firmagon (degarelix) is injected under the skin in the stomach area. The injection site will change within the stomach area each time you receive a dose of Firmagon (degarelix). This helps lower your risk of skin irritation.

          • Don't rub or scratch the injection site. Make sure your injection site is free of any pressure from belts, waistbands, or other types of clothing.

            • Firmagon (degarelix) can cause hot flashes and flushing (redness and warm feeling throughout the body). Wear loose clothing, and avoid alcohol, caffeine, and spicy foods to lower possible effects from hot flashes.

              faqs

              Frequently asked questions about Firmagon (degarelix)

              Can I inject Firmagon (degarelix) myself?
              No, you can only receive Firmagon (degarelix) from a healthcare provider at their office or clinic. Your provider is trained to prepare and administer the medication properly and safely. Your provider is also able to monitor you in case any life-threatening allergic reactions to Firmagon (degarelix) occur during the injections.
              Why is there a small lump where I received my Firmagon (degarelix) injection?
              After each injection, it's normal to feel a small lump where your provider injected Firmagon (degarelix). This is where the medication is stored and released slowly into your body over 1 month.
              Is Firmagon (degarelix) chemotherapy?
              No, Firmagon (degarelix) is not chemotherapy. Chemotherapy medications help kill fast-growing cells in your body, including cancer cells, but also normal, healthy cells like those that help fight off infection. This means that chemotherapy can weaken your immune system and you can catch infections more easily. On the other hand, Firmagon (degarelix) is considered hormone therapy. It helps lower levels of the sex hormone testosterone that's responsible for tumor growth in prostate cancer. Hormone therapy doesn't affect your immune system.
              Will Firmagon (degarelix) cause me to lose my hair?
              In clinical studies, hair loss wasn't reported in people taking Firmagon (degarelix).
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              What are the risks and warnings for Firmagon (degarelix)?

              Firmagon (degarelix) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.

              risk-warning

              Allergic reactions

              Firmagon (degarelix) can cause dangerous allergic reactions. If you have trouble breathing, notice hives on your skin, or swelling of your tongue, lips, neck, or face (angioedema), tell your healthcare provider right away.

              risk-warning

              Heart rhythm problems

              • Risk factors: Heart conditions | Taking medications that affect heart rhythm | Electrolyte imbalance

                Firmagon (degarelix) can cause a heart rhythm problem called QT prolongation. You might be at higher risk if you have certain heart conditions, have electrolyte imbalances often, or take certain medications (e.g., medications that control your heart rhythm, antidepressants, antipsychotics, antibiotics). Depending on your risk for this problem, your provider might regularly check your heart rhythm through heart scans (electrocardiogram, EKG) and your electrolyte levels through blood tests. If you feel chest pain, a racing heart, or fluttering in your chest, call 911 and get medical attention right away.

                risk-warning

                Not for use in females

                Firmagon (degarelix) is not approved for females and should never be used in females. This is because the medication can cause harm to an unborn baby, such as birth defects. It might also cause the loss of the baby (miscarriage).

                dosage

                Firmagon (degarelix) dosage forms

                Typical dosing for Firmagon (degarelix)

                Firmagon (degarelix) is only available as an injection that's given by a healthcare provider.

                • Starting dose: The dose is 240 mg injected under your skin (subcutaneous), given as 2 injections (120 mg each) at your first clinic visit.

                • Maintenance dose: After your first dose, you will receive regular doses every 28 days. This maintenance dose is given as 80 mg injected under your skin as a single injection.

                interactions

                Interactions between Firmagon (degarelix) and other drugs

                Firmagon (degarelix) may interact with certain medications or supplements. Always let your doctor and pharmacist know about any other medications or supplements (including prescribed and over-the-counter medications, vitamins, and dietary or herbal supplements) that you are currently taking. The list below does not include all possible drug interactions with Firmagon (degarelix). Please note that only the generic name of each medication is listed below.

                Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

                Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

                Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

                alternatives

                What are alternatives to Firmagon (degarelix)?

                There are a number of medications that your doctor can prescribe in place of Firmagon (degarelix). Compare a few possible alternatives below.
                Firmagon (degarelix)
                Used for:
                • Advanced prostate cancer

                Used for:
                • Prostate cancer

                • Advanced hormone-receptive positive (HR+) breast cancer

                • Endometriosis

                • Endometrial thinning before endometrial ablation

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