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Monthly vs 3 monthly Zoladex side effect difference

User
Posted 24 Feb 2023 at 08:44

I am wondering about the different side effects experience on 28 day monthly goselerin (Zoladex) implants as opposed to the 3 monthly version. 


 


I have had 5 monthly implants and note that the fatigue and muscle aches seem to subside somewhat 2 and a bit weeks after the implant. It’s a nice respite ! 


 


The question is do others notice this and is it something that is real or psychological? My issue is that 3 monthly might not give the same respite - or at least only after many more weeks. 


 


I know it’s a bit unusual to have the monthly ones for long but it just happened with me as they weren’t sure if I could cope with the standard 18-24 months ADT due to my other conditions but seems I am probably able to - so going for it, given my G9 locally contained high risk having had radiotherapy last December l. 

User
Posted 24 Feb 2023 at 11:03

It's unusual, but not unheard of to observe side effects which are cyclic with the hormone therapy injections.


The drug release profile is very different for the two doses. The 12-weekly has a peak release rate at the point of injection which decreases throughout the 12 weeks, but should be high enough in most cases to maintain castrate or lower levels of Testosterone for the whole 12 weeks. The 4-weekly peaks in the middle of the 4 weeks, but the peak is lower than for the 12-weekly. Men can use either the 4-weekly or 12-weekly doses - sometimes the first one is 4-weekly in case you are allergic, but usually 12-weekly injections are used. 4-weekly works out cheaper for the drug, but not if you include the cost of the appointment to inject it.


I'm not sure why, but originally, the 12-weekly was only licensed for men, and women had to always use the 4-weekly (it's also used for estrogen driven cancers), but it does seem the 12-weekly is licensed for women too in some cases now in some countries.

User
Posted 24 Feb 2023 at 11:32

I had three monthly injections and I did feel there was some respite towards the end of the cycle, at least for the first year or so. In the second year, maybe less so. There is also a sort of cumulative effect of living with your system modified like that for a longish period. Paradoxically, towards the end of 2 years I felt simultaneously as though I really wanted to be off Zoladex but also that I'd learned to live with it and could have kept going if needed.


Jules

User
Posted 01 Mar 2023 at 11:34
I've had the monthly once and the 3 monthly once since I'm at the start of my treatment. I did notice the spike at the start of the 3 monthly but only for a few days then I couldn't tell the difference between either type.

Hot flushes during the day and night, and constant back of the throat taste issues are my main irritations from it. I also had dry mouth when I first started on it but that seems to have gone away now.

I personally will likely be going ahead with surgical castration since I already had issues that put a stop to my sex life before my cancer, and I hope the side effects of that will be less than being on Zoladex for the rest of my life.
 
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