Degarelix is a prescription medication used to treat advanced prostate cancer in men. Unlike some traditional hormonal therapies, Degarelix works by directly and rapidly lowering testosterone levels—without the initial testosterone surge seen in other treatments. It’s available as a subcutaneous injection (given under the skin) and is typically administered in a clinical setting.
In this detailed, beginner-friendly guide, you’ll learn what Degarelix is, how it works, who it’s prescribed for, how it’s administered, what side effects to watch for, key safety tips, price details, and how it compares with other prostate cancer treatments like leuprolide or Firmagon.
Quick disclaimer: This article is for educational purposes only and does not replace professional medical advice. Always follow your healthcare provider’s instructions.
What Is Degarelix?
Degarelix is a gonadotropin-releasing hormone (GnRH) antagonist, primarily used in the treatment of advanced hormone-dependent prostate cancer. Its brand name is Firmagon.
Unlike LHRH agonists like leuprolide or goserelin (which can cause an initial spike in testosterone), Degarelix immediately suppresses testosterone—helping reduce the risk of cancer flare-ups.
Available Form:
- Subcutaneous Injection (Administered monthly or every 28 days)
- Strengths: Usually given as an initial 240 mg dose, followed by monthly 80 mg maintenance doses.
How Does Degarelix Work?
Degarelix works by blocking GnRH receptors in the pituitary gland. This action prevents the release of luteinizing hormone (LH) and follicle-stimulating hormone (FSH), which are responsible for stimulating the testicles to produce testosterone.
Since testosterone fuels the growth of prostate cancer cells, Degarelix essentially starves the cancer by lowering testosterone levels quickly and effectively.
- Mechanism type: Hormonal antagonist
- Action: Testosterone suppression
- Effect speed: Fast (within 3 days)
- Targeted: Yes – testosterone-driven cancer
Common Uses of Degarelix
Degarelix is prescribed for:
- Advanced prostate cancer
- Metastatic hormone-sensitive prostate cancer
- Cases requiring fast testosterone suppression (to avoid flare effects)
- Patients who cannot tolerate LHRH agonists
It’s typically not used for early-stage prostate cancer or as a curative therapy on its own. It’s part of a broader treatment plan that may include surgery, radiation, or other medications.
Degarelix Dosage & Administration
Degarelix is injected under the skin of the abdomen—by a healthcare provider in a clinical setting.
Initial dose:
- 240 mg administered as two injections of 120 mg each, typically in the abdominal area.
Maintenance dose:
- 80 mg every 28 days (given as a single injection).
Note: Always let your provider know if you have a bleeding disorder, skin condition, or allergy before receiving your injection.
Step-by-Step Injection Overview
- Administered subcutaneously in the stomach area (not intramuscularly).
- Given in a clinic or hospital under supervision.
- Injection site may rotate to avoid irritation.
- Post-injection observation may be required to monitor for allergic reactions.
Patients do not inject themselves; Degarelix must be given by trained professionals.
Side Effects of Degarelix
Most side effects are related to hormonal suppression or the injection itself. Some are temporary and improve with time.
Common Side Effects:
- Injection site reactions (pain, swelling, redness, hard lumps)
- Hot flashes
- Fatigue
- Increased weight
- Reduced libido and erectile dysfunction
- Mood swings or depression
Less Common but Important:
- Liver enzyme elevation (regular monitoring may be required)
- Osteoporosis or bone thinning (especially with long-term use)
- QT prolongation (heart rhythm issues in rare cases)
- Allergic reaction (hives, trouble breathing, facial swelling)
Let your provider know if any severe reactions or ongoing side effects develop.
Warnings & Precautions
- Kidney/Liver Conditions: Use with caution; monitor labs.
- Heart Issues: Risk of QT prolongation; ECG may be needed.
- Bone Health: Long-term testosterone suppression can weaken bones.
- Pregnancy: Not for use in women. It is classified as pregnancy risk category X.
- Children: Not approved for pediatric use.
- Injection Safety: Should not be injected into inflamed or infected skin areas.
Drug and Product Interactions
Because Degarelix isn’t metabolized like typical oral drugs, interactions are rare—but it’s important to tell your doctor about:
- Heart medications
- Drugs that prolong QT interval (e.g., certain antibiotics or antipsychotics)
- Supplements or herbal products
Degarelix vs. Other Prostate Cancer Hormonal Therapies
| Feature | Degarelix (Firmagon) | Leuprolide (Lupron) |
|---|---|---|
| Class | GnRH antagonist | GnRH agonist |
| Testosterone flare | No | Yes (requires anti-androgen) |
| Speed of effect | Rapid | Slower onset |
| Injection frequency | Monthly | Monthly or 3-6 months |
| Site reaction | Higher rate | Lower |
| Ideal for | High-risk or flare-sensitive | General hormone therapy |
Cost & Availability
Degarelix is prescription-only and often covered by insurance for prostate cancer.
- Brand: Firmagon
- Cost (U.S.): Around $1,800–$2,000/month (before insurance)
- Generic: Not widely available as of now
- Assistance programs: Available through manufacturers and some pharmacies
Special Section: Degarelix Injection Tips
- Do not self-inject. It’s administered by healthcare providers.
- Report any hard lumps or persistent swelling at the injection site.
- Stay hydrated to help with fatigue and flushing.
- Eat balanced meals to help manage weight gain and fatigue.
- Exercise regularly (if your doctor approves) to support bone and heart health.
Frequently Asked Questions (FAQ)
Q1. Is Degarelix a chemotherapy drug?
No. It’s a hormone therapy, not chemotherapy.
Q2. How fast does Degarelix work?
It begins lowering testosterone within 3 days.
Q3. What if I miss a dose?
Call your healthcare provider immediately to reschedule. Do not delay maintenance injections.
Q4. Can Degarelix cause sexual side effects?
Yes, common effects include reduced libido and erectile dysfunction due to low testosterone.
Q5. Is Degarelix safe for long-term use?
Yes, but bone health and cardiovascular status should be monitored regularly.
Q6. Can Degarelix be used with radiation?
Yes. It is often combined with radiation therapy for prostate cancer management.
Q7. Is Firmagon the same as Degarelix?
Yes. Firmagon is the brand name; Degarelix is the generic name.
Q8. Is Degarelix painful?
The injection may cause discomfort, redness, or lumps, but this typically resolves in a few days.
Q9. Can I stop Degarelix once I feel better?
No. It must be continued as prescribed to keep testosterone levels low.
Q10. How often do I get injections?
After the first dose, you’ll usually get one injection every 28 days.
Q11. Are there alternatives to Degarelix?
Yes. Alternatives include leuprolide, goserelin, and historectomy in rare cases. Your provider will decide based on your case.
Q12. Does Degarelix shrink the prostate?
It doesn’t directly shrink the prostate but reduces cancer progression by lowering testosterone.
Final Thoughts
Degarelix is a fast-acting, reliable hormone therapy for men with advanced prostate cancer—particularly those needing immediate testosterone suppression. It offers key benefits over traditional LHRH agonists by avoiding the testosterone flare and starting treatment effect sooner.
To get the most benefit from Degarelix:
- Stick to the schedule—never miss a dose
- Report side effects or unusual symptoms early
- Get regular follow-ups for testosterone levels, PSA tests, bone health, and heart function
- Talk to your doctor if you experience mood changes, hot flashes, or persistent fatigue
When used appropriately, Degarelix helps control prostate cancer and improve long-term outcomes—while offering a safer profile for high-risk patients.