Buserelin acetate (Suprefact)

Buserelin is a form of hormone therapy called an LHRH (luteinizing hormone-releasing hormone) agonist. It comes as an injection and as a nasal spray. The brand name is Suprefact.

Reviewed February 2010

To be updated February 2012

What is buserelin?+

Buserelin is a form of hormone therapy called an LHRH (luteinizing hormone-releasing hormone) agonist. It comes as an injection and as a nasal spray. The brand name is Suprefact.

Buserelin and other LHRH agonists work by stopping the brain from telling your body to make testosterone. Without testosterone the prostate cancer cells are not able to grow. Buserelin will not cure prostate cancer but it can keep the cancer under control for many months or years.

How do I take buserelin?+

For the first seven days of treatment you will have an injection of buserelin under the skin three times each day. The injection is not usually painful but your skin may darken or redden for a short time afterwards. You may be given the injection by your GP, practice nurse, district nurse or at your local hospital. You may also be taught how to give the injection yourself.

After you finish the seven day course of injections, you will be able to take buserelin as a nasal spray. You will need to spray once in each nostril six times a day. A good way of remembering when to take each dose is to spray in each nostril before and after breakfast, your midday meal and your evening meal.

If you have a cold, continue to take the nasal spray as it will still work. However, you should avoid using other types of nasal spray to treat colds before and for 30 minutes after your buserelin treatment.

Flare
A few days before starting buserelin treatment you will need to take a short course of anti-androgen tablets such as bicalutamide, flutamide or cyproterone acetate. This is to prevent the body's normal response to the first injection, which is to produce testosterone. This temporary rise in testosterone, known as flare, could cause the cancer to grow more quickly for a short time. Taking an anti-androgen tablet can help this flare. You will start taking the tablets a week or so before the first injection and continue taking them for a week or two afterwards.

What happens if I miss a dose?
If you miss an injection, take it as soon as you remember unless it is nearly time for your next dose. Then have the next injection as planned. Never have two injections at the same time.

If you forget to use the nasal spray, take it as soon as you remember unless you are due to take the next dose. Never take two doses together. If you are not sure what to do, contact your specialist team or pharmacist.

What are the side effects?+

Like all drugs, buserelin may cause side effects in some men.1 The risk of side effects may vary depending on the dose you are taking. We have listed the most common ones here but you should tell your specialist team if you notice any other changes while you are having treatment.

Some men get very few side effects and others get more. Many side effects will only last for as long as you are taking the drug. However, if you take buserelin for a long period of time, it may take several months after you finish treatment for the side effects to stop.

You can find out more about the side effects of hormone therapy and ways that you and your specialist team can manage them by reading our page on Living with hormone therapy.

Before you take buserelin, you should tell your doctor if you have diabetes or high blood pressure or if you have ever had depression. This is because buserelin can sometimes make these problems worse. You should also let your specialist team know if you are taking any prescription or over-the-counter medicines. If you have any questions or worries about any side effects, speak to your specialist team. You can also call our free and confidential Helpline.

Nose bleeds

The nasal spray may cause mild irritation in your nose and may change your senses of taste and smell or make your voice hoarse. You can help to reduce any irritation by being gentle when you blow your nose.

Loss of sex drive and erectile dysfunction


Some men taking buserelin may lose their desire for sex (libido).You may also have problems getting and keeping an erection. In most cases this will last as long as you are on hormone therapy and may take while to return to normal if you stop the treatment.

Weight gain or loss

Your normal weight may change while you are taking buserelin.

Tiredness

You may feel tired and have trouble sleeping whilst you are taking buserelin You may find that your tiredness improves over time but many men find that regular exercise gives them more energy and helps them to cope with treatment.2

Bone thinning

If you take buserelin for more than a few months, it may cause your bones to become weaker (osteoporosis). You may also have some pain and stiffness in your joints. If you already have osteoporosis, have a family history of osteoporosis or have had factures in the past, talk to your doctor before you start treatment with an LHRH agonist like buserelin.

Anxiety and depression

Buserelin can affect your mood. You may find that you feel more emotional than usual. Talking to family, friends or specialist team about how you feel can help with any worries.

Nausea, vomiting, diarrhoea and constipation

Some men get an upset stomach or feel sick from time to time when they are taking buserelin. If needed, your specialist team can give you medicine to ease the symptoms.

Itchy skin

Some men find that their skin and scalp becomes dryer or that they get spots. You may be able to products from your pharmacist or GP to help manage this if it bothers you.

Hot flushes

Hot flushes give you a sudden feeling of warmth in the upper body and can be similar to those experienced by women going through the menopause These usually start in the first month of treatment. Hot flushes can vary from a few seconds of feeling overheated to a few hours of sweating that can stop you from sleeping or cause discomfort.

Breast swelling and tenderness

A small number of men will have swollen breasts (gynaecomastia) and tenderness in the breast area. This can affect one or both breasts and can range from mild sensitivity to ongoing pain. The amount of swelling can also vary from a small amount to a more noticeable enlarged area.

Reporting unusual side effects: The Yellow Card Scheme

If you think you are experiencing a side effect from your medication that is not mentioned in the information leaflet that comes with it, then you can report it using the Yellow Card Scheme. This is run by the Medicines and Healthcare product Regulatory Agency (MHRA). They will investigate and if they find a problem with a medication then the MHRA will take action to protect the public.

There are three ways you can report a side effect:

  • Use the online Yellow Card form
  • Ask your pharmacist for a Yellow Card form
  • Call the Yellow Card freephone on 0808 100 3352
How long will I need to take buserelin?+

You can take buserelin for as long as it is controlling the cancer. Speak to your specialist team or call our confidential Helpline for information on other treatments that can be used if hormone therapy is no longer controlling the cancer.

More information+

To find out more about hormone therapy you can read:

Reviewers+
  • Mr Simon F Brewster, Consultant Urological Surgeon, Churchill Hospital, Oxford and Honorary Senior Clinical Lecturer in Surgery, University of Oxford
  • Bruce Turner, Uro-oncology Nurse Practioner, Homerton University Hospital NHS Foundation Trust and Whipps Cross University Hospital NHS Trust, London
  • Cathryn Woodward, Consultant Clinical Oncologist, Addenbrooke's Hospital, Cambridge
  • The Prostate Cancer Charity Information Volunteers
  • The Prostate Cancer Charity Support & Information Specialist Nurses

Written and edited by:
The Prostate Cancer Charity Information Team

References+

Sources of information used in the production of this fact sheet:

1. Summary of Product Characteristics. Suprefact 100 micrograms Nasal Spray Solution / Suprefact 1mg/ml injection. Available at: http://emc.medicines.org.uk/

2. Segal RJ, Reid RD, Courneya KS et al. Resistance training in men receiving androgen deprivation therapy for prostate cancer. Journal of Clinical Oncology 2003; 21: 1653-1659.