A nine-amino-acid copy of GnRH, the brain hormone that tells the pituitary to drive the testes and ovaries, altered to be more potent and longer-acting. After a brief surge, steady exposure shuts the pituitary down, cutting testosterone to castration levels and estrogen to postmenopausal levels.
Evidence. FDA-approved since 1985 for advanced prostate cancer (now as Lupron Depot, Eligard, Camcevi and daily injections), and as Lupron Depot for endometriosis and for anemia from fibroids before surgery; children’s forms treat early puberty. The UK also licenses it for breast cancer before menopause. Its use in IVF is off-label in the US.
What it’s used for
Approved uses first, then uses tested in people, then claims that rest on animal studies or user reports.
Advanced prostate cancer
LabelApproved as depots every 1–6 months and as daily injections. Testosterone reached castrate level within about a month in 94–98.5% of men; in 1984, daily injections matched diethylstilbestrol with fewer side effects.
Endometriosis
LabelLupron Depot is approved for pain and lesions, for up to 6 months alone or 12 with add-back hormone. In trials, pain relief matched danazol, and periods stopped in 98% by the second month.
Uterine fibroids with anemia before surgery
LabelApproved with iron for up to 3 months: at 12 weeks, 75% reached normal hemoglobin and hematocrit vs 49% on iron alone. The uterus regrew to its old size in about 8 months.
Early puberty in children
LabelLupron Depot-PED, Fensolvi and, since August 2026, Vobrig are approved in the US for central precocious puberty, puberty that starts too early. Doses are set by a pediatric specialist.
Breast cancer before menopause
LabelLicensed in the UK with tamoxifen or an aromatase inhibitor, not in the US. In the TABLE trial (599 women), a 3-month depot matched CMF chemotherapy for recurrence-free survival over 5.8 years.
IVF and assisted reproduction
TrialOff-label in the US. A single dose can replace hCG to mature eggs; in a Cochrane review, this cut ovarian hyperstimulation syndrome (OHSS) but lowered live births in fresh-embryo cycles.
Protecting the ovaries during chemotherapy
LabelLicensed in the UK (Prostap SR). In a trial of 330 women with breast cancer, goserelin or leuprorelin during chemotherapy cut ovarian failure at 12 months to 10.3% from 44.5%.
Label: an approved use. Trial: tested in people, with the result.
Approved in the US for advanced prostate cancer (Lupron Depot, Eligard, Camcevi, Camcevi ETM and daily generic injections) and for endometriosis and anemia from fibroids (Lupron Depot 3.75 and 11.25 mg). Lupron Depot-PED, Fensolvi and, since August 2026, Vobrig are approved for central precocious puberty in children.
Approval history
1985US FDA: Lupron: daily injection for advanced prostate cancer
1989US FDA: Lupron Depot: monthly depot for advanced prostate cancer
1990US FDA: Lupron Depot 3.75 mg: endometriosis
1993US FDA: Lupron Depot-PED: central precocious puberty in children
2002US FDA: Eligard: depot injected under the skin, for advanced prostate cancer
2022EU (EMA): Camcevi: first centrally authorized leuprorelin, for advanced prostate cancer
European Union
Prescription only. Camcevi is the one centrally authorized leuprorelin product (EMA, 2022); Eligard, Enantone and other depots are licensed country by country.
United Kingdom
Prescription-only (MHRA): Prostap SR and Prostap 3 (prostate cancer, endometriosis, breast cancer; Prostap SR also fibroids and ovarian protection), Eligard, Staladex implant, and Prostap PD for children.
Canada
Prescription drugs: Lupron Depot (marketed since 1989; 45 mg 6-month since January 2026) and Eligard (since 2003). Camcevi is approved, not marketed; daily Lupron was cancelled in 2022.
Australia
Prescription only (Schedule 4). Lucrin Depot and Eligard are registered for prostate cancer (Eligard also in a pack with bicalutamide), and Lucrin Depot Paediatric for early puberty.
Sport (WADA 2026)
Restricted in sportS2.2.1 testosterone-stimulating peptides in males: GnRH and its agonist analogues, with leuprorelin named. Banned at all times in males; not prohibited for female athletes.
Sport status follows the WADA Prohibited List in force since January 1, 2026; athletes should confirm with their anti-doping organization. Checked October 5, 2026. Status outside the US checked October 7, 2026 against EMA, MHRA, Health Canada and TGA records. By country: EU, UK, Canada, Australia. Status of every compound.
How it works
Leuprolide is a lab-made, more potent form of GnRH, the brain hormone that tells the pituitary gland to release LH and FSH, which drive the testes and ovaries. The first doses cause a surge, so testosterone or estrogen briefly rises. With steady exposure from a depot, LH and FSH fall within 2–4 weeks, taking testosterone down to castration levels and estrogen to postmenopausal levels. Normal function usually returns within about 3 months of stopping.
LabelBased on the product label.
Not known
The labels don’t explain why GnRH agonists are linked to heart attacks, diabetes and fatty liver. Some bone lost by women on leuprolide alone hadn’t returned 12 months after stopping.
Protocol
Label
Lupron Depot, Eligard, Camcevi
Advanced prostate cancer: Lupron Depot 7.5 mg every 4 weeks, 22.5 mg every 12 weeks, 30 mg every 16 weeks or 45 mg every 24 weeks into muscle. Eligard gives the same strengths under the skin, and Camcevi 42 mg every 6 months or 21 mg every 3 months. Daily injections: 1 mg under the skin.
Label
Lupron Depot 3.75 and 11.25 mg
Endometriosis: 3.75 mg monthly or 11.25 mg every 3 months into muscle, for up to 6 months alone or 12 months in all with norethindrone acetate 5 mg daily (add-back). Fibroids with anemia: the same doses for up to 3 months, with iron, before surgery.
Trial
Fauser 2002; Singh 2023
IVF egg-maturation trigger (off-label in the US): a single 0.5 mg injection after ganirelix cotreatment, or 1 mg given together with hCG.
Frequency
Once every 4 to 24 weeks, or daily (label)
Route
Depot injection into muscle (Lupron Depot) or under the skin (Eligard, Camcevi); daily injection under the skin (label)
Cycle
Continuous for prostate cancer, for as long as it is needed (label). For endometriosis, up to 6 months alone or 12 months in total with add-back; for fibroids, up to 3 months before surgery.
Week 15913172125
Continuous, shown over 26 weeks
Common protocols
The ways Leuprolide is most often run, each tagged with where it comes from.
Prostate cancer depot
Label
Dose
7.5, 22.5, 30 or 45 mg
How often
Every 4, 12, 16 or 24 weeks
How long
Ongoing; usually continued even once the cancer becomes castration-resistant
Lupron Depot goes into muscle, Eligard under the skin. Camcevi gives 42 mg every 6 months or, as Camcevi ETM, 21 mg every 3 months under the skin. Strengths aren’t interchangeable.
Endometriosis
Label
Dose
3.75 mg monthly or 11.25 mg every 3 months
How often
Into muscle
How long
Up to 6 months alone; 12 months in all with add-back
Add-back is norethindrone acetate 5 mg daily. Over a year, spine density fell 6.3% without it and about 1% with it. A second course needs add-back and a bone density check first.
Fibroids with anemia
Label
Dose
3.75 mg monthly, or 11.25 mg once
How often
Into muscle, with iron
How long
Up to 3 months, before surgery
At 12 weeks, 75% reached hemoglobin 12 g/dL and hematocrit 36% or more vs 49% on iron alone. The label suggests trying a month of iron alone first.
IVF trigger (off-label in the US)
Trial
Dose
0.5 mg once, or 1 mg with hCG
How often
Single injection under the skin at the end of ovarian stimulation
How long
One cycle
It works only if the pituitary hasn’t been shut down, so it follows antagonist protocols. In 47 women, 0.5 mg matured as many eggs as hCG. Daily injections are also used to suppress the pituitary in long protocols.
Taking it
Where it goes
Lupron Depot: into the buttock, front thigh or upper-arm muscle, alternating sites (label). Eligard: under the skin, in trials the upper or mid belly, away from belts and waistbands. Camcevi: under the skin. Daily injections: under the skin, varying the site.
If you miss a dose
The labels give no missed-dose rule; depots are scheduled and given by a clinician. Lupron Depot 3.75 mg must not be given more often than monthly, and strengths can’t be split or doubled. Ask the prescriber how to resume.
Testosterone rises about 50% above baseline (from a mean 435 to 608 ng/dL in the 45 mg trial), and prostate cancer symptoms can flare.
Label
Weeks 2–4
Testosterone falls to castrate level (under 50 ng/dL): within 30 days in 94% of men on 7.5 mg; on 45 mg it stayed there from week 4 to week 48 in 93.4%.
Label
Months 1–2 (women)
Periods stopped in 74% after the first 3.75 mg dose and 98% after the second; normal cycles returned in 95% by the third month after stopping.
Label
Weeks 24–52 (women)
Spine bone density fell 3.2% by week 24 and 6.3% by week 52 on 3.75 mg alone, vs 0.3% and 1.0% with add-back; some loss remained a year after stopping.
Label
Side effects and what to do
Hot flashes (label: 84% vs 29% on placebo in endometriosis; 57% of men on 7.5 mg monthly)
The most common effect, from low sex hormones. With add-back, fewer women still had them at week 24 (58% vs 86%).
Headache 32% vs 6%, and depression or mood swings 22% vs 3% (label, endometriosis vs placebo)
The label warns depression can start or worsen, and suicidal thoughts have been reported. Mood changes are worth raising early.
Bone loss (label: spine density down 6.3% after a year on 3.75 mg alone)
Why women’s courses are time-limited. Heavy drinking, smoking and long-term steroid or seizure drugs add to the risk.
Higher blood sugar, blood fats and blood pressure (label; hypertension 15% in the Camcevi trial)
The labels advise periodic glucose or HbA1c and lipid checks, and watching for signs of heart disease.
Injection-site reactions (label: 11% on Camcevi)
Pain, redness or hardening; rarely an abscess or tissue damage after a depot (label).
Stop and get medical help
Get emergency help for face or throat swelling, trouble breathing, or a rash with fever, blistering or peeling. A sudden severe headache with vomiting or vision change can mean bleeding into the pituitary. New leg weakness or numbness, or trouble passing urine, in the first weeks needs urgent care, as do chest pain or a seizure.
Can it cause …?
The side effects people ask about most, answered one by one. Each answer says where it comes from.
Tiredness
LabelWeakness (asthenia): 8% vs 5% on placebo in fibroid trials and 18% over 6 months on 3.75 mg alone in endometriosis; fatigue 10% in men on Camcevi.
Headache
LabelHeadache: 32% vs 6% on placebo in endometriosis trials and 26% vs 18% in fibroid trials. Rarely, a sudden severe headache with vomiting signals bleeding into the pituitary.
Nausea or vomiting
LabelNausea or vomiting: 13% vs 3% on placebo in endometriosis trials and 5% vs 4% in fibroid trials.
Diarrhea or constipation
LabelStomach or bowel upsets: 7% vs 3% on placebo in endometriosis trials. Constipation or diarrhea: 14% over the first 6 months on 3.75 mg alone in a year-long study.
Dizziness
LabelDizziness: 11% vs 0% on placebo in endometriosis trials and 5% in men on Camcevi. Low blood pressure has been reported after approval.
Trouble sleeping
LabelInsomnia or sleep problems: 31% over 6 months on 3.75 mg alone vs 13% with add-back hormone; under 5% in shorter placebo-controlled endometriosis trials.
Hair loss
LabelHair loss was reported in under 5% of women in the endometriosis trials, and hair disorders in under 5% of men on the monthly depot.
Acne, rash or skin changes
LabelAcne 10% vs 0% and skin reactions 10% vs 3% on placebo in endometriosis trials. Rare severe reactions (SJS/TEN, DRESS, AGEP) mean stopping it if confirmed.
Water retention or swelling
LabelSwelling (edema): 7% vs 3% on placebo in endometriosis trials and 5% vs 1% in fibroid trials; 14% of men on the monthly depot.
Joint or muscle pain
LabelJoint problems: 8% vs 0% on placebo in endometriosis and 8% vs 3% in fibroid trials; musculoskeletal pain 11% on Camcevi. Bone pain can flare in the first weeks.
Anxiety, low mood or irritability
LabelDepression or mood swings: 22% vs 3% on placebo in endometriosis trials. Suicidal thoughts and attempts have been reported; FDA had them added to GnRH agonist labels in 2026.
Low or high blood sugar
LabelRaises blood sugar: the labels warn of new or worsening diabetes in men on GnRH agonists and advise periodic glucose or HbA1c checks.
Fast heartbeat or blood pressure changes
LabelLabels warn of more heart attacks, sudden cardiac deaths and strokes in men, and QT prolongation. In HERO, major heart events: 6.2% on leuprolide vs 2.9% on relugolix.
More hunger
LabelAppetite changes were reported in under 5% of women; weight gain or loss in 13% vs 0% on placebo in endometriosis trials.
Liver strain
LabelALT, a liver enzyme, rose above twice normal in 2% of women over a year with add-back. Serious liver injury and fatty liver disease, including cirrhosis, have been reported.
Kidney problems
LabelThe early surge in prostate cancer can block urine flow. BUN and creatinine rose in at least 5% of men on the monthly depot; the label calls the link unclear.
Cancer risk
LabelIn prostate cancer, the first-week surge can worsen the disease. Rats on high daily doses for 2 years had more benign pituitary tumors; mice didn’t, and gene-damage tests were negative.
Label: from the prescribing information. A side effect that hasn’t been reported can still happen, especially with long or high-dose use. Any of these across every compound: the side-effect finder.
Who should avoid it
What its label rules out or warns about, most important first.
Allergy to GnRH drugs or their ingredients
LabelRuled out by all the labels. Anaphylaxis has been reported with GnRH agonists, and asthma-like reactions in women with a history of asthma or allergies.
Pregnancy
LabelRuled out by the women’s labels: it may harm a fetus, and caused malformations and fetal loss in rabbits. It isn’t a contraceptive, so non-hormonal birth control is advised during treatment.
Unexplained abnormal vaginal bleeding
LabelRuled out for the women’s monthly and 3-month doses until the cause is known.
Spinal metastases or blocked urine flow
LabelThe testosterone surge in the first weeks can worsen prostate cancer, causing spinal cord compression with paralysis or urinary blockage; the labels say to watch these men closely.
Diabetes, heart disease or long QT
LabelThe labels warn of raised blood sugar and new diabetes, more heart attacks, sudden cardiac deaths and strokes in men on GnRH agonists, and QT prolongation, and advise monitoring.
Risk factors for osteoporosis
LabelBone loss on the women’s doses adds to risk from heavy drinking (over 3 units a day), smoking, a family history, or long-term steroids or seizure drugs, the label says.
Past depression or seizures
LabelDepression may start or worsen, the women’s label warns. Convulsions have been reported, including in people with epilepsy or brain disorders and in those taking bupropion or SSRIs.
Interactions
Only interactions stated on a product label or measured in a human study are listed.
Drugs that prolong the QT interval (such as amiodarone, sotalol, methadone or moxifloxacin)
LabelLowering testosterone can itself lengthen QT, a measure of the heart’s electrical recovery, so the prostate cancer labels advise weighing the risk and considering ECG and blood salt checks.
Drugs linked to seizures (such as bupropion and SSRI antidepressants)
LabelConvulsions on leuprolide have been reported in people taking these, the labels say.
Norethindrone acetate add-back (with the women’s doses)
LabelCombined on purpose to limit bone loss and hot flashes; the progestin’s own contraindications and warnings then apply, and the pair lowered HDL cholesterol by about 15–19%.
Hormone and pituitary blood tests (LH, FSH, testosterone, estradiol)
LabelNot a drug, but results during treatment and for up to 3 months after stopping may mislead, the labels say.
Drugs cleared by liver CYP450 enzymes
LabelNo interaction studies were done. Leuprolide is broken down by peptidases, not CYP450 enzymes, so the label doesn’t expect interactions of that kind.
Label: a product label rules it out, warns about it or lists the interaction. This isn’t a complete list: a pharmacist or doctor can check a specific medicine or condition. Every documented interaction, by medicine: drug interactions.
Special situations
What the label and studies say about pregnancy, breastfeeding, kidney and liver problems, age and surgery.
Pregnancy
LabelRuled out by the women’s labels: it may harm a fetus, and caused malformations and fetal loss in rabbits. It isn’t a contraceptive, so non-hormonal birth control is advised during treatment.
Breastfeeding
LabelNo data on whether it passes into milk. The prostate cancer label says to choose between breastfeeding and the drug; the women’s label says to weigh breastfeeding’s benefits against the mother’s need.
Kidney problems
LabelNot studied in kidney impairment, and the labels give no dose change. Under 5% of a dose appeared in urine as the drug or its main breakdown product.
Liver problems
LabelNot studied in liver impairment. Serious drug-induced liver injury and fatty liver disease, including cirrhosis, have been reported after approval.
Older adults
Label80% of men in the Lupron Depot prostate cancer trials were 65 or older, so the label reflects that group. The women’s doses aren’t meant for use after menopause and weren’t studied there.
Children and teens
LabelLupron Depot-PED (from age 1), Fensolvi (from age 2) and Vobrig are approved for central precocious puberty. For endometriosis and fibroids, the label expects similar results in teens after puberty.
Surgery and anesthesia
PrecautionNo label advice on surgery. A depot keeps working for 1–6 months and can’t be removed, and lowering testosterone can lengthen the QT interval; tell the surgical team.
Label: what the prescribing information says. Precaution: not studied, so the caution follows from how it works or from a related drug. Ages are given as approved or studied; this site never gives doses for children. Across every compound: pregnancy, breastfeeding, kidney disease, liver disease, older adults and surgery.
Tracking and pairing
Worth tracking
Testosterone (label: confirm it falls under 50 ng/dL) and PSA
Blood sugar or HbA1c, and blood lipids
ECG and blood salts when QT risk is high
Bone density before a second course for endometriosis
Paired as an IVF “dual trigger”: in a 100-woman trial, leuprolide 1 mg plus hCG gave more mature eggs than hCG alone (7.8 vs 5.9), with similar pregnancy rates (21% vs 19.6%).
An agonist trigger needs a pituitary that hasn’t been shut down, so it follows antagonist protocols; in a 47-woman trial after ganirelix, 0.5 mg matured as many eggs as hCG.
Human studies
5 key published human studies, with how many people took part. Animal studies aren’t listed here.
2020930 people
Testosterone stayed castrate in 88.8% on leuprolide vs 96.7% on relugolix; major heart events 6.2% vs 2.9% (HR 0.46); 90 days after stopping, testosterone averaged 58.6 vs 288.4 ng/dL.
Design
Randomized phase 3 trial (HERO) in advanced prostate cancer, leuprolide vs oral relugolix
Dose
Leuprolide injections every 3 months (308 men) vs relugolix 120 mg daily (622)
Length
48 weeks
Shore et al., N Engl J Med 2020, PMID 32469183
1984199 people
Objective response 86% vs 85%, and 1-year survival 87% vs 78% (not significant); DES caused more painful breast growth, nausea, swelling and clots, leuprolide more hot flashes.
Design
Randomized trial vs diethylstilbestrol (DES) in untreated metastatic prostate cancer
Dose
1 mg under the skin daily vs DES 3 mg by mouth daily
Length
Until progression or intolerance; survival reported at 1 year
Leuprolide Study Group, N Engl J Med 1984, PMID 6436700
1995309 people
74% in each leuprolide group vs 46% on iron alone reached hemoglobin 12 g/dL and hematocrit 36%; uterine and fibroid volume shrank; hot flashes and vaginitis were more common.
Design
Randomized double-blind placebo-controlled phase 3 trial in women with anemia from fibroids, before surgery
Dose
3.75 or 7.5 mg monthly, or placebo, all with oral iron
Length
12 weeks
Stovall et al., Obstet Gynecol 1995, PMID 7784025
1998201 people
Pelvic pain improved in all groups by week 8; bone density fell 6.3% after a year without add-back but was preserved in all three add-back groups.
Design
Randomized double-blind trial of hormone add-back regimens in endometriosis
Dose
3.75 mg monthly, with placebo, norethindrone acetate 5 mg daily, or norethindrone plus conjugated estrogens
Length
52 weeks
Hornstein et al., Obstet Gynecol 1998, PMID 9464714
200247 people
LH peaked 4 hours after leuprorelin (median 107 IU/L) and was back to baseline by 24 hours; 85% of retrieved eggs were mature vs 86% after hCG, with similar fertilization.
Design
Randomized multicenter study of egg-maturation triggers after ganirelix cotreatment in IVF
Dose
Single leuprorelin 0.5 mg (15 women) vs triptorelin 0.2 mg or hCG 10,000 IU
Length
One cycle
Fauser et al., J Clin Endocrinol Metab 2002, PMID 11836309
Registered trials that are still running, or that finished without published results, most important first. Checked on ClinicalTrials.gov, October 7, 2026.
Phase 3NCT04906395
TOL2506, a 3-month 30 mg leuprolide depot under the skin, with hormone therapy to suppress the ovaries in 250 premenopausal women (and some men) with HR-positive breast cancer
Active, not recruiting; completion expected November 2026
Phase 3NCT06449027
A 42 mg leuprolide emulsion every 24 weeks vs 11.25 mg microspheres every 12 weeks, both with tamoxifen, in 211 premenopausal women with breast cancer: estrogen suppression
Active, not recruiting; completion was expected March 2026, no results posted
Phase 3NCT06650579
REVELUTION-2: leuprolide vs relugolix, each with abiraterone, in 72 men with advanced prostate cancer: blood pressure and heart effects
Recruiting since January 2025; completion expected July 2029
Phase 2NCT07158021
Lower-dose and higher-dose leuprolide vs goserelin for suppressing the ovaries in 75 pre- or perimenopausal women with breast cancer
Recruiting since January 2026; completion expected January 2028
Phase 2NCT01746849
Palifermin with leuprolide (or degarelix) to speed immune recovery in 82 people after a T-cell-depleted stem cell transplant
Active, not recruiting; completion expected December 2026
Most label evidence comes from single-arm studies of 49–151 men followed for 24–48 weeks that measured testosterone, not survival; the only survival comparison is a 1984 trial against diethylstilbestrol. Women’s trials ran 3–12 months. The heart, diabetes and fatty-liver warnings rest on reports across the GnRH agonist class. IVF use is off-label in the US, and trials used varying trigger doses.
How it’s supplied
Depot kits: Lupron Depot 3.75–45 mg (powder and diluent in one syringe), Eligard 7.5–45 mg, Camcevi 21 or 42 mg; daily injection, 5 mg/mL in 2.8 mL vials. Depots are injected into muscle or under the skin by a clinician every 1–6 months; the daily solution is drawn up and injected under the skin by the patient. It’s used as supplied, so the calculator and dose log don’t apply.
Not a research powder. Each depot kit is mixed exactly as its label says and injected at once: Lupron Depot within 2 hours, Eligard within 30 minutes. The strengths release at different rates, so they can’t be split, combined or swapped. The daily solution needs no mixing.
Datasheet
Half-life
about 3 hoursLabelTerminal half-life after a 1 mg IV dose in healthy men. This is the peptide itself: depots keep releasing it for 1 to 6 months, so their effect lasts far longer.
Type
Peptide, 9 amino acids
Molecular weight
1,209.4 g/mol
Formula
C59H84N16O12
Sequence
(pGlu)-HWSY-(D-Leu)-LRP-NHEtProline ethylamide replaces the final glycine amide of GnRH
Storage before use
Lupron Depot kits: 20–25 °C, excursions 15–30 °C. Eligard and Camcevi: refrigerated at 2–8 °C; Eligard may then be kept in its pack at 15–30 °C for up to 8 weeks, Camcevi at 25 °C for up to 6 days. Daily vials: below 25 °C, protected from light, never frozen.
After mixing or opening
Mixed depots are injected right away (Lupron Depot within 2 hours, Eligard within 30 minutes) and nothing is kept. The daily multi-dose vial holds a 14-day supply.
Half-life: Lupron Depot prescribing information, section 12.3 (DailyMed, March 2026); the Eligard and Camcevi labels give the same figure
Molecule: PubChem CID 657181 and FDA GSRS (UNII EFY6W0M8TG), free peptide; chemical name in the Lupron Depot label. The acetate used in most products is C61H88N16O14, 1,269.5 (GSRS).
Storage:Label Lupron Depot (March 2026 and September 2025), Eligard (April 2026), Camcevi (February 2026) and leuprolide acetate injection kit (May 2026) labels, section 16, DailyMed
Most products hold leuprolide acetate, with doses stated as the salt; Camcevi holds the mesylate, labeled as leuprolide itself (42 mg is about 48 mg of salt). Depot strengths release at different rates and can’t be split, combined or swapped.
Cautions
Label: an initial flare. Testosterone rises about 50% in the first weeks, which can worsen bone pain or urinary blockage; with spinal metastases, cord compression and paralysis have happened.
Label: raised blood sugar and new diabetes, raised blood fats and fatty liver, QT prolongation, and a higher risk of heart attack, sudden cardiac death and stroke in men on GnRH agonists.
Bone loss in women: spine density fell 6.3% after a year on 3.75 mg alone, so the label limits endometriosis treatment to 6 months, or 12 with add-back hormone.
Label: depression and, rarely, suicidal thoughts; convulsions; severe skin reactions (SJS/TEN, DRESS, AGEP); and bleeding into a pituitary tumor, usually within 2 weeks of a first dose.
Can harm a fetus: ruled out in pregnancy, and it isn’t a contraceptive.
Questions
What is leuprolide?
A nine-amino-acid copy of GnRH, the brain hormone that tells the pituitary to drive the testes and ovaries, altered to be more potent and longer-acting. After a brief surge, steady exposure shuts the pituitary down, cutting testosterone to castration levels and estrogen to postmenopausal levels.
How does leuprolide work?
Leuprolide is a lab-made, more potent form of GnRH, the brain hormone that tells the pituitary gland to release LH and FSH, which drive the testes and ovaries. The first doses cause a surge, so testosterone or estrogen briefly rises. With steady exposure from a depot, LH and FSH fall within 2–4 weeks, taking testosterone down to castration levels and estrogen to postmenopausal levels. Normal function usually returns within about 3 months of stopping. The labels don’t explain why GnRH agonists are linked to heart attacks, diabetes and fatty liver. Some bone lost by women on leuprolide alone hadn’t returned 12 months after stopping.
Is leuprolide FDA-approved?
Approved in the US for advanced prostate cancer (Lupron Depot, Eligard, Camcevi, Camcevi ETM and daily generic injections) and for endometriosis and anemia from fibroids (Lupron Depot 3.75 and 11.25 mg). Lupron Depot-PED, Fensolvi and, since August 2026, Vobrig are approved for central precocious puberty in children.
What is the usual leuprolide dose?
From the label (Lupron Depot, Eligard, Camcevi): Advanced prostate cancer: Lupron Depot 7.5 mg every 4 weeks, 22.5 mg every 12 weeks, 30 mg every 16 weeks or 45 mg every 24 weeks into muscle. Eligard gives the same strengths under the skin, and Camcevi 42 mg every 6 months or 21 mg every 3 months. Daily injections: 1 mg under the skin. Endometriosis: 3.75 mg monthly or 11.25 mg every 3 months into muscle, for up to 6 months alone or 12 months in all with norethindrone acetate 5 mg daily (add-back). Fibroids with anemia: the same doses for up to 3 months, with iron, before surgery (Lupron Depot 3.75 and 11.25 mg). These are the amounts sources reference, not recommendations.
How is leuprolide given?
Depots are injected into muscle or under the skin by a clinician every 1–6 months; the daily solution is drawn up and injected under the skin by the patient.
Who should avoid leuprolide?
Allergy to GnRH drugs or their ingredients: Ruled out by all the labels. Anaphylaxis has been reported with GnRH agonists, and asthma-like reactions in women with a history of asthma or allergies. Pregnancy: Ruled out by the women’s labels: it may harm a fetus, and caused malformations and fetal loss in rabbits. It isn’t a contraceptive, so non-hormonal birth control is advised during treatment. Unexplained abnormal vaginal bleeding: Ruled out for the women’s monthly and 3-month doses until the cause is known. The “Who should avoid it” section lists 4 more groups and 5 interactions.
What is the half-life of leuprolide?
About 3 hours, according to the prescribing information. Terminal half-life after a 1 mg IV dose in healthy men. This is the peptide itself: depots keep releasing it for 1 to 6 months, so their effect lasts far longer.
How should leuprolide be stored?
Before mixing: Lupron Depot kits: 20–25 °C, excursions 15–30 °C. Eligard and Camcevi: refrigerated at 2–8 °C; Eligard may then be kept in its pack at 15–30 °C for up to 8 weeks, Camcevi at 25 °C for up to 6 days. Daily vials: below 25 °C, protected from light, never frozen. Mixed depots are injected right away (Lupron Depot within 2 hours, Eligard within 30 minutes) and nothing is kept. The daily multi-dose vial holds a 14-day supply.
Is leuprolide banned in sport?
In some cases. S2.2.1 testosterone-stimulating peptides in males: GnRH and its agonist analogues, with leuprorelin named. Banned at all times in males; not prohibited for female athletes.
Has leuprolide been studied in people?
Yes. The human studies section lists 5 published studies. The largest, from 2020, included 930 people. Testosterone stayed castrate in 88.8% on leuprolide vs 96.7% on relugolix; major heart events 6.2% vs 2.9% (HR 0.46); 90 days after stopping, testosterone averaged 58.6 vs 288.4 ng/dL.
How long has leuprolide been studied in people?
Label The labels note castrate testosterone held for more than 5 years in men with prostate cancer, and daily doses up to 10 mg for 3 years without pituitary changes.
Does leuprolide come in other forms, like a pill or nasal spray?
Label Injections only: depots into muscle (Lupron Depot) or under the skin (Eligard, Camcevi, Fensolvi), daily injections, and a 3-month implant in the UK. Swallowed, it is inactive, the label says.
Can you drink alcohol while taking leuprolide?
Label The women’s labels list heavy drinking (over 3 units a day) as a major risk factor for bone loss that may add to leuprolide’s own effect. No other alcohol advice is given.
Can leuprolide be taken with semaglutide or tirzepatide?
Label No study has combined them, and neither drug’s label lists an interaction. Leuprolide’s labels warn it can raise blood sugar and call for glucose or HbA1c checks.
What happens if you take too much leuprolide?
Label No overdoses were seen in trials; daily doses up to 20 mg for 2 years caused nothing beyond the effects of 1 mg, the label says. Call Poison Help (1-800-222-1222), or emergency services for severe symptoms.
Sources
Lupron Depot 7.5, 22.5, 30 and 45 mg prescribing information (AbbVie, DailyMed, label effective March 15, 2026)
Lupron Depot 3.75 mg and 11.25 mg prescribing information (AbbVie, DailyMed, September 2025)
Eligard prescribing information (Tolmar, DailyMed, April 30, 2026); Camcevi ETM and Camcevi prescribing information (Accord, rev. 7/2026)
Leuprolide acetate injection 14-day kit prescribing information (Sandoz, DailyMed, May 2026)
Drugs@FDA: Lupron (NDA 019010, April 9, 1985), Lupron Depot (NDA 019732, January 26, 1989; NDA 020011, October 22, 1990), Lupron Depot-PED (NDA 020263, April 16, 1993), Eligard (NDA 021343, January 23, 2002), Camcevi (NDA 211488, May 25, 2021), Camcevi ETM (NDA 219745, August 25, 2025), Vobrig (NDA 213225, August 26, 2026)
EMA medicines data: Camcevi authorized May 24, 2022 (checked October 8, 2026)
Leuprolide Study Group, leuprolide vs diethylstilbestrol in metastatic prostate cancer (N Engl J Med 1984) PMID 6436700
Shore et al., HERO trial of relugolix vs leuprolide in advanced prostate cancer (N Engl J Med 2020) PMID 32469183
For the protocol details
Lupron Depot 3.75 mg and 11.25 mg prescribing information, sections 2, 5, 6 and 14 (DailyMed, September 2025)
Lupron Depot 7.5–45 mg prescribing information, sections 2, 5, 6, 12 and 14 (DailyMed, March 2026)
Camcevi ETM and Camcevi prescribing information (Drugs@FDA, rev. 7/2026)
Fauser et al., GnRH agonist trigger after ganirelix cotreatment in IVF (J Clin Endocrinol Metab 2002) PMID 11836309
Singh et al., dual trigger with leuprolide and hCG vs hCG alone in IVF (JBRA Assist Reprod 2023) PMID 37698459
Youssef et al., GnRH agonist vs hCG for egg-maturation triggering, Cochrane review (Cochrane Database Syst Rev 2014) PMID 25358904
Shore et al., phase 3 trial of 6-month leuprolide mesylate, the basis of Camcevi (World J Urol 2020) PMID 30941562
For how it works, who should avoid it and the limits of the evidence
Lupron Depot 7.5, 22.5, 30 and 45 mg prescribing information, sections 4, 5, 7, 8 and 12 (AbbVie, DailyMed, March 2026)
Lupron Depot 3.75 mg and 11.25 mg prescribing information, sections 4, 5, 6, 7, 8 and 12 (AbbVie, DailyMed, September 2025)
Eligard prescribing information (Tolmar, DailyMed, April 2026) and leuprolide acetate injection kit prescribing information (Sandoz, DailyMed, May 2026)
Hornstein et al., leuprolide depot with hormonal add-back in endometriosis, 12-month trial (Obstet Gynecol 1998) PMID 9464714
For uses, the side-effect questions, special situations, trials, identifiers and status outside the US
Lupron Depot 7.5–45 mg prescribing information, sections 1, 5, 6, 8, 10, 12, 13 and 14 (AbbVie, DailyMed, March 2026)
Lupron Depot 3.75 mg and 11.25 mg prescribing information, sections 1, 5, 6, 8, 12 and 14 (AbbVie, DailyMed, September 2025)
Eligard (Tolmar, April 2026), Camcevi (Accord, February 2026), Lupron Depot-PED (AbbVie, November 2025), Fensolvi (Tolmar, September 2025) and leuprolide acetate injection kit (Sandoz, May 2026) prescribing information, DailyMed
Vobrig prescribing information and approval letter, NDA 213225 (Drugs@FDA, August 26, 2026)
FDA safety labeling change letters for Lupron injection, NDA 019010: S-043 (SCARs, September 23, 2025) and S-044 (suicidal ideation and attempt, May 6, 2026)
Prostap SR DCS 3.75 mg and Prostap 3 DCS 11.25 mg UK summaries of product characteristics, sections 4.1 and 5.1 (Takeda UK, revised June 12, 2025); Eligard and Staladex UK summaries of product characteristics
Stovall et al., leuprolide and iron vs iron alone for anemia from fibroids (Obstet Gynecol 1995) PMID 7784025
Schmid et al., TABLE trial of 3-month leuprorelin vs CMF in premenopausal breast cancer (J Clin Oncol 2007) PMID 17577027
Zong et al., GnRH agonists to protect ovarian function during chemotherapy for breast cancer (JAMA Oncol 2022) PMID 34967844
Fujino et al., LH-RH analogs substituted in positions 6 and 10 (Biochem Biophys Res Commun 1974) PMID 4608231
FDA Global Substance Registration System records for leuprolide, leuprolide acetate and leuprolide mesylate; PubChem compound records; WHO ATC index
EMA medicines data (Camcevi, May 24, 2022) and French public medicines database entries for Eligard and Enantone (checked October 8, 2026)
Health Canada Drug Product Database entries for Lupron, Lupron Depot, Eligard and Camcevi (checked October 8, 2026)
TGA product information for Lucrin Depot and Lucrin Depot Paediatric, Eligard and BI Eligard CP; Poisons Standard, October 2026 (leuprorelin in Schedule 4)
ClinicalTrials.gov registry entries for the trials listed (checked October 8, 2026)