Men who have aggressive (high-risk), advanced or metastatic prostate cancer are commonly prescribed hormonal therapy drugs called, gonadotropin-releasing hormone (GnRH) agonists that suppress the growth of prostate cancer cells by inhibiting the production of testosterone. This class of medication is very effective in slowing the growth of prostate cancer progression and in many cases, increasing survival in advanced stages of the disease.
Examples of GnRH agonists include: Eligard, Lupron, Synarel, Trelstar, Vantas, Viadur, Zoladex
Side effects and complications from the long term use of these medications have been well-documented (i.e. hot flashes, weight gain, fatigue, muscle mass loss, osteopenia, decreased libido, etc.)
New data has concluded that GnRH agonists also increase the risk of stroke, heart disease and diabetes. The U.S. Food and Drug Administration is calling for all manufacturers of these medications to immediately add these complications to the warning list on their GnRH agonist products. Furthermore, they are recommending that all physicians who prescribe these medications to carefully monitor their patients for the potential development (or exacerbation) of these serious conditions. (Read the FDA warning here.)
For patients who are on a GnRH agonist, it is important for your physician to monitor your blood glucose and/or glycosylated hemoglobin (HbA1c) as these tests can indicate the development or exacerbation of diabetes. Before starting a GnRH agonist, you should tell your doctor if you have heart disease, had a prior stroke or heart attack, or hypertension. Smoking also increases your risk of stroke and heart disease, and therefore should be mentioned to your doctor even if you don’t have any prior history of cardiovascular disease.