Buserelin (Suprefact)
Buserelin is a hormone therapy drug. It is also known as Suprefact or Suprecur.
It is a treatment for prostate cancer.
You pronounce buserelin as bue-se-rel-in.
How does buserelin work?
Buserelin is a type of hormone therapy known as a LH (luteinising hormone) blocker. It stops the pituitary gland releasing luteinising hormone. This stops the testicles producing testosterone.
Most prostate cancers need testosterone to grow. By reducing testosterone levels, the prostate cancer may shrink and stop growing.
How do you have buserelin?
You have buserelin as an injection under the skin. After several injections you have it as a nasal spray.
You usually have injections under the skin (subcutaneous injection) into the stomach, thigh or top of your arm.
You might have stinging or a dull ache for a short time after this type of injection, but they don't usually hurt much. The skin in the area may go red and itchy for a while.
The video below shows you how to inject just under your skin (subcutaneously).
Nurse: This is a short film showing you how to give an injection just under your skin. This is called a subcutaneous or sub cut injection. This does not replace what your doctors and nurses tell you, so always follow their advice.
Voiceover: Subcutaneous injections may be part of your cancer treatment. Or, you may need them to prevent side effects of treatment, such as blood clots after surgery. Or to help control cancer symptoms, such as pain or sickness.
Most injections come in prefilled syringes.
Nurse: So, today I am going to show you how to give a subcutaneous injection. I am going to start by giving it into a practice cushion and then you can have a go at giving one yourself. Before you start, you need to get your equipment together. What you are going to need is an alcohol wipe to clean your skin, some cotton wool, a prefilled syringe and a sharps bin. It is important that you wash your hands with soap and water and dry them thoroughly before you start. Check that you have got the correct drug and that it is in date.
You can give the injection into the back of your arm, your tummy, your thigh or the outer part of your bottom. It is important that you vary where you give the injection. So it may be that you give it one day in your tummy and the next in your thigh.
So you start by cleaning the skin with the alcohol wipe and allowing it to air dry. Then you take the cover off the needle and pinch the skin up and hold it a bit like a pen and in an upright position, in a quick dart like motion pop it straight down into the skin. Then you press the plunger right to the end, quickly pull the needle out, dab it with cotton wool, pop the needle into the sharps bin. And then you need to wash your hands again.
So here’s what you are going to need. If you start by checking the drug and the expiry date. And then with the alcohol wipe give your skin a clean. That’s it give it a few seconds for the air to dry it. Ok and then if you want to pick up the syringe and take the cover off the needle. Then pinch your skin up and at a ninety degree angle gently push the needle in...then press the plunger...and then quickly remove it... dab your skin with the cotton wool and put the syringe in the sharps bin.
How often do you have buserelin?
You have buserelin as an injection 3 times a day for 7 days. On the 8th day you start using buserelin as a nasal spray.
You spray the drug into each nostril 6 times a day. One way of remembering to do this is to use the spray before and after each meal. So you can have the treatment before and after breakfast, lunch and your evening meal.
You continue taking buserelin for as long as it is working.
Tests
You have blood tests before starting treatment and during your treatment. They check your levels of testosterone every 3 months. They also check the levels of blood cells and other substances in the blood. Other tests see how well your liver and kidneys are working.
At the start of treatment
When you start treatment with buserelin, testosterone can temporarily rise, before it drops to low levels. This is called tumour flare.
This might cause temporary worsening of side effects such as bone pain or weakness.
What are the side effects of buserelin?
How often and how severe the side effects are can vary from person to person. They also depend on what other treatment you are having.
When to contact your team
Your doctor, nurse, or pharmacist will go through the possible side effects. They will monitor you closely during treatment and check how you are at your appointments. Contact your advice line as soon as possible if:
- you have severe side effects
- your side effects aren’t getting any better
- your side effects are getting worse
We haven't listed all the side effects here. Remember it is very unlikely that you will have all of these side effects, but you might have some of them at the same time.
You might have one or more of these side effects. They include:
Tummy (abdominal) pain
Tell your treatment team if you have this. They can check the cause and give you medicine to
Muscle or bone pain
You might feel some pain from your muscles and bones, including pain in your jaw or back. Speak to your doctor or nurse about what painkillers you can take to help with this.
Constipation
Constipation is easier to sort out if you treat it early. Drink plenty of fluids and eat as much fresh fruit and vegetables as you can. Try to take gentle exercise, such as walking. Tell your doctor, nurse or pharmacist if you are constipated for more than 3 days. They can prescribe a laxative.
Diarrhoea
Contact your advice line if you have diarrhoea, such as if you've had 4 or more loose watery poos (stools) in 24 hours. Or if you can't drink to replace the lost fluid. Or if it carries on for more than 3 days.
Your doctor may give you anti diarrhoea medicine to take home with you after treatment. Eat less fibre, avoid raw fruits, fruit juice, cereals and vegetables, and drink plenty to replace the fluid lost.
Feeling or being sick
Feeling or being sick is usually well controlled with anti sickness medicines. Avoiding fatty or fried foods, try eating small meals and snacks, drinking plenty of water, and relaxation techniques can all help.
It is important to take anti sickness medicines as prescribed even if you don’t feel sick. It is easier to prevent sickness rather than treat it once it has started.
Swollen hands and feet
You may have swelling of your hands, feet, legs and face due to a build up of fluid (oedema).
Hot flushes
We have some tips for coping with hot flushes and the possible treatments for men. Talk to your doctor if your hot flushes are hard to cope with. They might be able to prescribe you some medicines.
Fast heart beat
Your heart might feel like it is beating faster than usual (palpitations).
Skin rash
A rash can also be itchy. Tell your doctor or nurse if you have a skin rash. They can prescribe medicine to stop the itching and soothe your skin.
Less interest in sex (low libido)
Talk to your doctor if you have this. You might be able to have some treatments to help with low libido.
Increased breast size
You might experience swollen or tender breasts (gynaecomastia).
Loss of appetite and weight changes
You might lose your appetite for various reasons when you are having cancer treatment. Sickness, taste changes or tiredness can put you off food and drinks.
You might also lose or gain weight. Tell your healthcare team if you are finding it difficult to control your weight.
Changes in blood pressure
During treatment, your blood pressure may be lower or higher than normal. Tell your nurse if you feel dizzy, faint, or if you have headaches, nosebleeds, blurred or double vision, or shortness of breath. Your blood pressure usually goes back to normal while you are on treatment or when treatment ends.
Tiredness and weakness (fatigue)
You might feel very tired and as though you lack energy.
Various things can help you to reduce tiredness and cope with it, for example exercise. Some research has shown that taking gentle exercise can give you more energy. It is important to balance exercise with resting.
Smaller testicles
Your testicles may become smaller (atrophy).
Mood changes
You might feel depressed or anxious. Speak to your doctor if your mood is low.
Inflammation around the injection site
Tell your nurse if you notice any signs of redness or irritation around the injection site.
Headaches or dizziness
Let your doctor or nurse know if you have headaches. They can give you painkillers. Don’t drive or operate machinery if you feel dizzy.
Weak bones
Your bones may become thinner. This can increase your risk of bone fractures.
Hair changes
You may find that your hair becomes thinner or thicker.
Numbness or tingling in fingers or toes
Numbness or tingling in fingers or toes is often temporary and can improve after you finish treatment. Tell your healthcare team if you're finding it difficult to walk or complete fiddly tasks such as doing up buttons.
Difficulty sleeping
If you have difficulty sleeping, it can help to change a few things about how you try to sleep. Try to go to bed and get up at the same time each day and spend some time relaxing before you go to bed. Some light exercise each day may also help.
Liver changes
You might have liver changes that are usually mild and unlikely to cause symptoms. They usually go back to normal when treatment finishes. You have regular blood tests to check for any changes in the way your liver is working.
Nail problems
Your nails may become dry, brittle or split.
Eye problems
You might have eye problems including blurred vision, sore, red, itchy, dry eyes (conjunctivitis) or an infection. Tell your healthcare team if you have this. They can give you eye drops or other medication to help.
Feeling thirsty
You might feel more thirsty than usual
Memory problems
You may have trouble concentrating or have problems with your memory.
Hearing changes
You might have ringing in your ears (tinnitus) or problems with your hearing.
Second cancers
There is a small risk that you may get a second cancer some years after this treatment. Your doctor will discuss this with you.
Allergic reaction
A small number of people have an allergic reaction while having this treatment. Symptoms can include a rash, shortness of breath, redness or swelling of the face, feeling hot, dizziness, and a sudden need to pass urine.
Changes in blood sugar levels
You might have regular blood and urine tests to check this. Some people develop 
. You might need to have blood sugar lowering treatment.
If you have diabetes already, you might need to check your blood sugar levels more often than usual.
Increased risk of getting an infection
This side effect is very rare.
Increased risk of getting an infection is due to a drop in white blood cells. Symptoms include a change in temperature, aching muscles, headaches, feeling cold and shivery and generally unwell. You might have other symptoms depending on where the infection is.
Bruising, bleeding gums or nose bleeds
This side effect is very rare.
This is due to a drop in the number of platelets in your blood. These blood cells help the blood to clot when we cut ourselves. You may have nosebleeds or bleeding gums after brushing your teeth. Or you may have lots of tiny red spots or bruises on your arms or legs (known as petechiae).
Coping with side effects
We have more information about side effects and tips on how to cope with them.
What else do you need to know?
Other medicines, foods and drink
Cancer drugs can interact with medicines, herbal products, and some food and drinks. We are unable to list all the possible interactions that may happen. An example is grapefruit or grapefruit juice which can increase the side effects of certain drugs.
Tell your healthcare team about any medicines you are taking. This includes vitamins, herbal supplements and over the counter remedies. Also let them know about any other medical conditions or allergies you may have.
Treatment for other conditions
Always tell other doctors, nurses, pharmacists or dentists that you’re having this treatment. For example, if you need treatment for anything else, including teeth problems.
Contraception
It is important not to father a child while you are having treatment with this drug and for a few months afterwards. This drug may harm a baby developing in the womb. Talk to your doctor or nurse about effective contraception before starting treatment.
Other medical conditions
If you have diabetes, high blood pressure or depression, tell your doctor. All of these conditions can be affected by buserelin treatment.
More information about this treatment
For further information about this treatment and possible side effects go to the electronic Medicines Compendium (eMC) website. You can find the patient information leaflet on this website.
You can report any side effect you have to the Medicines Health and Regulatory Authority (MHRA) as part of their Yellow Card Scheme.
