Leuprolide and flutamide

Leuprolide is a superactive GnRH (Gonadotropin releasing hormone) agonist. It can be given with flutamide for prostate cancer. Gonadotropin secretion occurs due to pulsatile secretion of GnRH. But when a long acting GnRH agonist like leuprolide is given, initially there is an increased release of gonadotropins, but soon there is downregulation of GnRH receptors and the release is prevented. This action can be utilized in the treatment of prostatic cancer which is a hormone dependant tumour. But the initial increase in the release of gonadotropins can cause a flaring up of the tumour. This can be prevented by concurrent administration of an anti-androgen such as flutamide.