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Degarelix (Firmagon ®) is a gonadotrophin releasing hormone (GnRH) antagonist indicated for treatment of adult male patients with advanced hormone-dependent prostate cancer.

Degarelix (Firmagon) competitively binds to and blocks the GnRH receptors in the anterior pituitary gland, reducing the release of the gonadotrophins – LH and FSH, leading to a rapid decrease in the production of testosterone. Testosterone suppression to castration levels (≤0.5ng/ml) is achieved within 1-3 days of administration compared with 1-2 weeks for agonist therapy.

Significantly, in contrast with GnRH agonists, Degarelix does not induce a testosterone surge with potential symptomatic flare after the initiation of treatment. Therefore the major added clinical value of this product is avoidance of testosterone flare (without the need for concomitant anti-androgen treatment) and suggests that Degarelix (Firmagon®) is especially useful when a rapid reduction in testosterone levels is of critical importance.

Degarelix is administered as a subcutaneous injection in the abdominal region. The starting dose of Degarelix should be 240 mg, administered as two 120 mg injections, followed by a monthly maintenance dose of 80 mg. The first maintenance dose should be given one month after the starting dose.