August 23, 2016
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Trelstar Depot

"Over the past 2 decades, male pattern baldness has repeatedly and consistently been found to be associated with an increased risk for prostate cancer in observational studies.

The tie makes theoretical sense in terms of physiology bec"...


Trelstar Depot

Trelstar Depot Side Effects Center

Medical Editor: John P. Cunha, DO, FACOEP

Last reviewed on RxList 3/17/2016

Trelstar (triptorelin pamoate) reduces the amount of testosterone produced in the body and is similar to a natural substance made by the body (luteinizing hormone releasing hormone-LHRH) used in the palliative treatment of advanced prostate cancer. Common side effects of Trelstar include:

  • hot flashes (flushing)
  • decreased sexual interest/ability
  • shrinking of the testicles
  • impotence
  • trouble having an orgasm and breast tenderness/swelling/pain as a result of lowered testosterone levels

Other side effects of Trelstar include dizziness headache back pain pain or swelling in your legs tired feeling nausea vomiting diarrhea upset stomach sleep problems (insomnia) or pain where the medicine was injected.

Trelstar is an injectable suspension that comes in 3 doses: 3.75 mg, 11.25 mg, 22.5 mg. Consult your doctor for the dosing schedule. It is unknown if Trelstar will interact with other medicines. Tell your doctor all medications and supplements you use. Trelstar is not usually used by women. During pregnancy, Trelstar should not be used because it may harm a fetus. If you become pregnant or think you may be pregnant, tell your doctor. Consult your doctor to discuss birth control. Breastfeeding is not recommended during treatment.

Our Trelstar (triptorelin pamoate) Side Effects Drug Center provides a comprehensive view of available drug information on the potential side effects when taking this medication.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What is Patient Information in Detail?

Easy-to-read and understand detailed drug information and pill images for the patient or caregiver from Cerner Multum.

Trelstar Depot in Detail - Patient Information: Side Effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have a serious side effect. Some of these side effects are symptoms of prostate cancer that may occur because the medicine raises your testosterone levels:

  • painful or difficult urination, burning when you urinate, blood in the urine;
  • bone pain;
  • numbness, tingling, or muscle weakness (especially in your legs and feet);
  • loss of movement in any part of your body;
  • fever, chills, body aches, flu symptoms;
  • sudden numbness or weakness, sudden severe headache, confusion, problems with vision or speech; or
  • chest pain or heavy feeling, pain spreading to the arm or shoulder, nausea, sweating, general ill feeling.

Less serious side effects may include:

  • hot flashes;
  • back pain, pain or swelling in your legs;
  • headache, dizziness, tired feeling;
  • decreased interest in sex, impotence, trouble having an orgasm;
  • nausea, vomiting, diarrhea, upset stomach;
  • sleep problems (insomnia);
  • breast pain or swelling; or
  • pain where the medicine was injected.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Read the entire detailed patient monograph for Trelstar Depot (Triptorelin pamoate)

What is Patient Information Overview?

A concise overview of the drug for the patient or caregiver from First DataBank.

Trelstar Depot Overview - Patient Information: Side Effects

SIDE EFFECTS: See also the How to Use section.

Hot flashes (flushing), decreased sexual interest/ability, shrinking of the testicles, and breast tenderness/swelling may occur as a result of lowered testosterone levels. Dizziness and headache may also occur with this drug. If any of these effects bother you, tell your doctor or pharmacist promptly.

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Tell your doctor immediately if any of these unlikely but serious side effects occur: bone/joint/unusual pain, easily broken bones, swelling of the ankles/feet, unusual weakness, inability to move (paralysis), increased thirst, unusual change in the amount of urine.

Get medical help right away if any of these rare but serious side effects occur: chest/jaw/left arm pain, fast/irregular heartbeat, severe dizziness, fainting, weakness on one side of the body, slurred speech.

Rarely, a serious problem with your pituitary gland (pituitary apoplexy) may occur, usually in the first hour to 2 weeks after your first dose of this medication. Get medical help right away if any of these serious side effects occur: sudden severe headache, mental/mood changes (such as confusion), vision changes, vomiting.

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

In the US -

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

In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

Read the entire patient information overview for Trelstar Depot (Triptorelin pamoate)

What is Prescribing information?

The FDA package insert formatted in easy-to-find categories for health professionals and clinicians.

Trelstar Depot FDA Prescribing Information: Side Effects
(Adverse Reactions)


Clinical Trials Experience

Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared with rates in the clinical trials of another drug and may not reflect the rates observed in practice.

The safety of the three TRELSTAR formulations was evaluated in clinical trials involving patients with advanced prostate cancer. Mean testosterone levels increased above baseline during the first week following the initial injection, declining thereafter to baseline levels or below by the end of the second week of treatment. The transient increase in testosterone levels may be associated with temporary worsening of disease signs and symptoms, including bone pain, neuropathy, hematuria, and urethral or bladder outlet obstruction. Isolated cases of spinal cord compression with weakness or paralysis of the lower extremities have occurred [see WARNINGS AND PRECAUTIONS].

Adverse reactions reported for each of the three TRELSTAR formulations in the clinical trials, are presented in Table 2, Table 3, and Table 4. Often, causality is difficult to assess in patients with metastatic prostate cancer. The majority of adverse reactions related to triptorelin are a result of its pharmacological action, i.e., the induced variation in serum testosterone levels, either an increase in testosterone at the initiation of treatment, or a decrease in testosterone once castration is achieved. Local reactions at the injection site or allergic reactions may occur.

The following adverse reactions were reported to have a possible or probable relationship to therapy as ascribed by the treating physician in at least 1% of patients receiving TRELSTAR 3.75 mg.

Table 2: TRELSTAR 3.75 mg: Treatment-Related Adverse Reactionstre Reported by 1% or More of Patients During Treatment

Adverse Reactions1 TRELSTAR 3.75 mg N = 140
N %
Application Site Disorders
  Injection site pain 5 3.6
Body as a Whole
  Hot flush 82 58.6
  Pain 3 2.1
  Leg pain 3 2.1
  Fatigue 3 2.1
Cardiovascular Disorders
  Hypertension 5 3.6
Central and Peripheral Nervous System Disorders 
  Headache 7 5.0
  Dizziness 2 1.4
Gastrointestinal Disorders
  Diarrhea 2 1.4
  Vomiting 3 2.1
Musculoskeletal System Disorders
  Skeletal pain 17 12.1
Psychiatric Disorders
  Insomnia 3 2.1
  Impotence 10 7.1
  Emotional lability 2 1.4
Red Blood Cell Disorders
  Anemia 2 1.4
Skin and Appendages Disorders
  Pruritus 2 1.4
Urinary System Disorders
  Urinary tract infection 2 1.4
  Urinary retention 2 1.4
1The following adverse reactions were reported to have a possible or probable relationship to therapy as ascribed by the treating physician in at least 1% of patients receiving TRELSTAR 11.25 mg.

Table 3: TRELSTAR 11.25 mg: Treatment-Related Adverse Reactions Reported by 1% or More of Patients During Treatment

Adverse Reactions1 TRELSTAR 11.25 mg N = 174
N %
Application Site
  Injection site pain 7 4.0
Body as a Whole
  Hot flush 127 73.0
  Leg pain 9 5.2
  Pain 6 3.4
  Back pain 5 2.9
  Fatigue 4 2.3
  Chest pain 3 1.7
  Asthenia 2 1.1
  Peripheral edema 2 1.1
Cardiovascular Disorders
  Hypertension 7 4.0
  Dependent edema 4 2.3
Central and Peripheral Nervous System Disorders
  Headache 12 6.9
  Dizziness 5 2.9
  Leg cramps 3 1.7
  Breast pain 4 2.3
  Gynecomastia 3 1.7
Gastrointestinal Disorders
  Nausea 5 2.9
  Constipation 3 1.7
  Dyspepsia 3 1.7
  Diarrhea 2 1.1
  Abdominal pain 2 1.1
Liver and Biliary System
  Abnormal hepatic function 2 1.1
Metabolic and Nutritional Disorders
  Edema in legs 11 6.3
  Increased alkaline phosphatase 3 1.7
Musculoskeletal System Disorders
  Skeletal pain 23 13.2
  Arthralgia 4 2.3
  Myalgia 2 1.1
Psychiatric Disorders
  Decreased libido 4 2.3
  Impotence 4 2.3
  Insomnia 3 1.7
  Anorexia 3 1.7
Respiratory System Disorders
  Coughing 3 1.7
  Dyspnea 2 1.1
  Pharyngitis 2 1.1
Skin and Appendages
  Rash 3 1.7
Urinary System Disorders
  Dysuria 8 4.6
  Urinary retention 2 1.1
Vision Disorders
  Eye pain 2 1.1
  Conjunctivitis 2 1.1
1 Adverse reactions for TRELSTAR 11.25 mg are coded using the WHO Adverse Reactions Terminology (WHOART)

The following adverse reactions occurred in at least 5% of patients receiving TRELSTAR 22.5 mg. The table includes all reactions whether or not they were ascribed to TRELSTAR by the treating physician. The table also includes the incidence of these adverse reactions that were considered by the treating physician to have a reasonable causal relationship or for which the relationship could not be assessed.

Table 4: TRELSTAR 22.5 mg: Adverse Reactions Reported by 5% or More of Patients During Treatment

Adverse Reactions1 TRELSTAR 22.5 mg N =120
Treatment-Emergent Treatment-Related
N % N %
General Disorders and Administration Site Conditions
  Edema peripheral 6 5.0 0 0
Infections and Infestations 
  Influenza 19 15.8 0 0
  Bronchitis 6 5.0 0 0
  Diabetes Mellitus/Hyperglycemia 6 5.0 0 0
Musculoskeletal and Connective Tissue Disorders
  Back pain 13 10.8 1 0.8
  Arthralgia 9 7.5 1 0.8
  Pain in extremity 9 7.5 1 0.8
Nervous System Disorders
  Headache 9 7.5 2 1.7
Psychiatric Disorders
  Insomnia 6 5.0 1 0.8
Renal and Urinary Disorders
  Urinary tract infection 14 11.6 0 0
  Urinary retention 6 5.0 0 0
Reproductive System and Breast Disorders
  Erectile dysfunction 12 10.0 12 10.0
  Testicular atrophy 9 7.5 9 7.5
Vascular Disorders
  Hot flush 87 72.5 86 71.7
  Hypertension 17 14.2 1 0.8
1Adverse reactions for TRELSTAR 22.5 mg are coded using the Medical Dictionary for Regulatory Activities (MedDRA).

Changes in Laboratory Values During Treatment

The following abnormalities in laboratory values not present at baseline were observed in 10% or more of patients:

TRELSTAR 3.75 mg: There were no clinically meaningful changes in laboratory values detected during therapy.

TRELSTAR 11.25 mg: Decreased hemoglobin and RBC count and increased glucose, BUN, SGOT, SGPT, and alkaline phosphatase at the Day 253 visit.

TRELSTAR 22.5 mg: Decreased hemoglobin and increased glucose and hepatic transaminases were detected during the study. The majority of the changes were mild to moderate.

Postmarketing Experience

The following adverse reactions have been identified during post approval use of gonadotropin releasing hormone agonists. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure.

During postmarketing surveillance, rare cases of pituitary apoplexy (a clinical syndrome secondary to infarction of the pituitary gland) have been reported after the administration of gonadotropin-releasing hormone agonists. In a majority of these cases, a pituitary adenoma was diagnosed with a majority of pituitary apoplexy cases occurring within 2 weeks of the first dose, and some within the first hour. In these cases, pituitary apoplexy has presented as sudden headache, vomiting, visual changes, ophthalmoplegia, altered mental status, and sometimes cardiovascular collapse. Immediate medical attention has been required.

During postmarketing experience, thromboembolic events including, but not limited to, pulmonary emboli, cerebrovascular accident, myocardial infarction, deep venous thrombosis, transient ischemic attack, and thrombophlebitis have been reported.

Read the entire FDA prescribing information for Trelstar Depot (Triptorelin pamoate)

Trelstar Depot - User Reviews

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