home > drugs a-z list > viadur (leuprolide acetate implant) drug center > viadur (leuprolide acetate implant) drug - warnings and precautions

Viadur® (leuprolide acetate implant) , like other LH-RH agonists, causes a transient increase in serum concentrations of testosterone during the first week of treatment. Patients may experience worsening of symptoms or onset of new symptoms, including bone pain, neuropathy, hematuria, or ureteral or bladder outlet obstruction (see PRECAUTIONS).

Cases of ureteral obstruction and spinal cord compression, which may contribute to paralysis with or without fatal complications, have been reported with LH-RH agonists.

If spinal cord compression or renal impairment develops, standard treatment of these complications should be instituted.

General

Patients with metastatic vertebral lesions and/or with urinary tract obstruction should be closely observed during the first few weeks of therapy (see WARNINGS).

X-rays do not affect Viadur® (leuprolide acetate implant) functionality. Viadur® (leuprolide acetate implant) is radio-opaque and is well visualized on X-rays.

The titanium alloy reservoir of Viadur® (leuprolide acetate implant) is nonferromagnetic and is not affected by magnetic resonance imaging (MRI). Slight image distortion around Viadur® (leuprolide acetate implant) may occur during MRI procedures.

Hyperglycemia

Hyperglycemia and an increased risk of developing diabetes have been reported in men receiving GnRH agonists. Hyperglycemia may represent development of diabetes mellitus or worsening of glycemic control in patients with diabetes. Monitor blood glucose and/or glycosylated hemoglobin (HbA1c) periodically in patients receiving a GnRH agonist and manage with current practice for treatment of hyperglycemia or diabetes.

Cardiac Disorders

Increased risk of developing myocardial infarction, sudden cardiac death and stroke has been reported in association with use of GnRH agonists in men. The risk appears low based on the reported odds ratios, and should be evaluated carefully along with cardiovascular risk factors when determining a treatment for patients with prostate cancer. Patients receiving a GnRH agonist should be monitored for symptoms and signs suggestive of development of cardiovascular disease and be managed according to current clinical practice.

Information for Patients

An information leaflet for patients is included with the product.

Laboratory tests

Response to Viadur® (leuprolide acetate implant) should be monitored by measuring serum concentrations of testosterone and prostate-specific antigen periodically.

Results of testosterone determinations are dependent on assay methodology. It is advisable to be aware of the type and precision of the assay methodology to make appropriate clinical and therapeutic decisions.

Carcinogenesis, Mutagenesis, Impairment of Fertility

Two-year carcinogenicity studies were conducted in rats and mice. In rats, dose-related increases of benign pituitary hyperplasia and benign pituitary adenomas were noted at 24 months when the drug was administered subcutaneously at high daily doses (4 to 24 mg/m², 50 to 300 times the daily human exposure based on body surface area). There were significant but not dose-related increases of pancreatic islet-cell adenomas in females and of testicular interstitial cell adenomas in males (highest incidence in the low dose group). In mice no pituitary abnormalities were observed at up to 180 mg/m² (over 2000 times the daily human exposure based on body surface area) for 2 years.

Mutagenicity studies were performed with leuprolide acetate using bacterial and mammalian systems. These studies provided no evidence of a mutagenic potential.

Pregnancy

Teratogenic Effects

Pregnancy Category X (see CONTRAINDICATIONS).

Pediatric Use

Viadur® (leuprolide acetate implant) is contraindicated in pediatric patients and was not studied in children

(see CONTRAINDICATIONS).

Last reviewed on RxList: 3/8/2011
This monograph has been modified to include the generic and brand name in many instances.