Trelstar Depot

Last updated on RxList: 1/4/2019
Trelstar Depot Side Effects Center

Last reviewed on RxList 01/04/2019

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.


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Trelstar Depot Consumer Information

Get emergency medical help if you have signs of an allergic reaction: hives, red skin rash, severe itching, sweating; dizziness, fast heartbeats; trouble breathing or swallowing; swelling of your face, lips, tongue, or throat.

Some people using triptorelin have had new or worsening mental problems or seizures (convulsions). Call your doctor right away if you have a seizure, or any unusual changes in mood or behavior (anger, aggression, crying, feeling restless or irritable).

Triptorelin can cause a temporary increase in certain hormones, especially when you first start using this medicine. This may cause side effects that are similar to the condition being treated. Call your doctor at once if you have:

  • painful or difficult urination, burning when you urinate, blood in the urine;
  • bone pain;
  • (in children) new or worsening signs of puberty;
  • a seizure;
  • chest pain or pressure, pain spreading to your jaw or shoulder;
  • sudden numbness or weakness, slurred speech;
  • loss of movement in any part of your body;
  • high blood sugar--increased thirst, increased urination, hunger, dry mouth, fruity breath odor; or
  • nerve problems--back pain, muscle weakness, problems with balance or coordination, severe numbness or tingling in your legs or feet, loss of bladder or bowel control.

Common side effects may include:

  • pain, swelling, itching, or redness where an injection was given;
  • hot flashes;
  • decreased interest in sex, impotence, trouble having an orgasm;
  • headache, bone pain, pain or swelling in your legs;
  • nausea, vomiting, diarrhea, upset stomach;
  • vaginal bleeding; or
  • cold or flu symptoms (stuffy nose, sneezing, cough, sore throat, ear pain).

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 for Injectable Suspension)


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Trelstar Depot Professional Information


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 for Injectable Suspension)

© Trelstar Depot Patient Information is supplied by Cerner Multum, Inc. and Trelstar Depot Consumer information is supplied by First Databank, Inc., used under license and subject to their respective copyrights.

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