Supprelin LA is a brand-name prescription drug. It’s approved for use in children with central precocious puberty (CPP). With this condition, children have an early onset of puberty. For girls with CPP, puberty starts before the age of 8 years. And for boys with CPP, puberty starts before the age of 9 years.

Supprelin LA can be used in both boys and girls with CPP. However, the drug isn’t recommended for use in children younger than 2 years of age.

This medication contains the drug histrelin acetate. It belongs to a class of drugs called gonadotropin-releasing hormone agonists. (A drug class describes a group of medications that work in the same way.)

Supprelin LA comes as an implant that’s placed under the skin by a healthcare provider. It’s available in one strength: 50 mg. The implant delivers 65 mcg of histrelin acetate each day over a period of 12 months.

Effectiveness

In clinical studies, Supprelin LA was effective in treating CCP. For information about the drug’s effectiveness, see the section “Supprelin LA uses” below.

Supprelin LA is available only as a brand-name medication. It’s not currently available in generic form. (A generic drug is an exact copy of a brand-name medication.)

Supprelin LA contains one active drug ingredient: histrelin acetate.

Supprelin LA can cause mild or serious side effects. The following lists contain some of the key side effects that may occur while taking Supprelin LA. These lists don’t include all possible side effects.

For more information on the possible side effects of Supprelin LA, talk with your child’s doctor or pharmacist. They can give you tips on how to deal with any side effects that may be bothersome.

Note: The Food and Drug Administration (FDA) tracks side effects of drugs it has approved. If you would like to report to the FDA a side effect your child has had with Supprelin LA, you can do so through MedWatch.

More common side effects

The more common side effects of Supprelin LA can include:

  • reactions at the site of your implant, such as:
    • redness
    • pain
    • swelling
    • bruising
    • itching
  • initial worsening of central precocious puberty (CPP)* signs, which can include:
    • light vaginal bleeding
    • breast enlargement in girls
    • other signs or changes caused by puberty

Side effects related to implant placement or location may go away within a few days. New or worsened symptoms of CPP will likely go away within 4 weeks of treatment. If your child has side effects that are either severe or don’t go away, talk with your child’s doctor or pharmacist.

* With CPP, children have an early onset of puberty. For girls with CPP, puberty starts before the age of 8 years. And for boys with CPP, puberty starts before the age of 9 years.

Serious side effects

Serious side effects from Supprelin LA aren’t common, but they can occur. Call your child’s doctor right away if your child has serious side effects. Call 911 if their symptoms seem life threatening or if you think they’re having a medical emergency.

Serious side effects, which are discussed below in the “Side effect details” section, can include:

  • severe allergic reaction
  • emotional changes
  • seizures

Side effect details

You may wonder if certain side effects occur with this drug. Here’s some detail on several of the side effects Supprelin LA may cause.

Allergic reaction

As with most drugs, some people can have an allergic reaction after taking Supprelin LA. But it’s not known for sure how many people using Supprelin LA have had an allergic reaction to the drug.

Symptoms of a mild allergic reaction can include:

  • skin rash
  • itchiness
  • flushing (warmth and redness in the skin)

A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include:

  • swelling under the skin, typically in the eyelids, lips, hands, or feet
  • swelling of the tongue, mouth, or throat
  • trouble breathing

Call your child’s doctor right away if they have a severe allergic reaction to Supprelin LA. But call 911 if their symptoms seem life threatening or if you think they’re having a medical emergency.

Implant removal side effects

It’s possible to have side effects and complications related to removal of Supprelin LA implants. But it’s not known for sure how often these problems occur. Because of possible risks, it’s very important that Supprelin LA implants only be inserted and removed by trained healthcare providers.

Having a Supprelin LA implant removed can cause bruising, swelling, redness, pain, and scarring around the removal site. These symptoms should go away within days to weeks after the removal. However, scarring may take longer to heal. If your child is having bothersome symptoms after implant removal, talk with your doctor.

Keep in mind that in some cases, redness, swelling, and pain that doesn’t get better could be a sign of infection. Be sure to watch for fever, chills, or any pus from the removal site, as these symptoms may also indicate infection. If your child has any of these symptoms, call your doctor right away.

Other possible complications can also occur with Supprelin LA implant removal. These complications include:

  • Implant movement or expulsion. If a Supprelin LA implant falls out on its own (either partly or completely), tell your doctor right away. They can check to make sure that the implant is fully removed, and they’ll recommend if your child needs to have another implant placed.
  • Trouble finding the implant. In some cases, finding Supprelin LA implants prior to removal can be difficult. To locate the implant, your doctor may use imaging tests such as ultrasound, CT scan, or MRI scan. Then your doctor can recommend how to safely remove the implant.
  • Implant breaking. Some children have had their implant break into pieces. If your child’s implant breaks, your doctor will remove the implant, making sure that all of the pieces are removed. Then they’ll recommend if your child needs to have another implant placed.

If you have questions about side effects and complications related to implant removal, talk with your child’s doctor.

If you’d like to know more about the hormonal changes that occur after a Supprelin LA implant is removed, see the section “Common questions about Supprelin LA” below.

Weight gain

It’s possible for children to gain weight while they’re using Supprelin LA. Clinical studies showed that 2% of children had weight gain during treatment. But the amount of weight they gained wasn’t reported. In these studies, there weren’t any children taking a placebo (no active drug).

If you have concerns about weight gain in your child, or you notice a sudden change in their weight, talk with your doctor. They can recommend if your child needs any changes to their treatment plan.

Emotional changes

You may notice that your child has emotional changes while they’re using Supprelin LA. It’s not known for sure how many children using this drug have had emotional changes. But this side effect can happen because of a couple of reasons.

First, when your child begins treatment with Supprelin LA, their signs of puberty may get worse initially. This may lead to emotional instability (having ups and downs), crying, irritability, or anger. If these symptoms are related to Supprelin LA’s initial effects, the symptoms should resolve within 4 weeks of the start of treatment.

Another reason for emotional changes during Supprelin LA treatment is that the drug may cause behavioral health conditions to arise. This is especially seen in children who are more prone to such conditions or in children who’ve had these problems in the past. Examples of behavioral health conditions include depression, anxiety, and suicidal thoughts or behavior.

If you have concerns about emotional changes in your child, or if your child’s symptoms are troublesome or severe, call your doctor right away. Your doctor will recommend if your child needs any additional treatment. And they’ll advise whether your child should continue to use Supprelin LA.

Seizures

Although not considered a common side effect, seizures are a possible side effect of Supprelin LA. However, it’s not known for sure how many people using Supprelin LA have seizures during treatment.

Seizures can happen in people who don’t have any risk factors for the condition. However, seizures may be more likely to occur in people who’ve had seizures in the past or in people who have certain health conditions. These conditions include:

  • seizure disorders
  • problems with blood vessels in their brain (cerebrovascular disorders)
  • tumors or other abnormalities in their brain or spinal cord

Seizures may also be a more common side effect in people who are taking certain other drugs. These drugs include an anxiety medication called bupropion (Wellbutrin). The drugs also include antidepressants called selective serotonin reuptake inhibitors (SSRIs). Examples of SSRIs include escitalopram (Lexapro), fluoxetine (Prozac), and sertraline (Zoloft).

If you’re concerned about your child’s risk of seizures while they’re using Supprelin LA, talk with your doctor. They can discuss ways to help you monitor for this side effect. And they can recommend what you should do if your child does have a seizure.

Supprelin LA is inserted into the inner side of the upper arm by a healthcare provider. Each implant releases medication over a 12-month period.

Implant insertion procedure

To insert a Supprelin LA implant, your child’s doctor will perform a simple surgical procedure. And they’ll take steps to minimize discomfort and reduce the risk of infection.

Prior to the insertion, your child’s doctor will review options with you for pain prevention. Medication that’s used to numb an area and minimize pain is called local anesthesia. It’s commonly used during implant placement. With local anesthesia, numbing medication is injected with a needle into the area where the implant will be placed. For Supprelin LA, this area is typically on the inner side of the upper arm.

After the area is numb, a small incision (cut) is made in the skin and the implant is inserted. Then the cut is closed with stitches or surgical tape, and the area is covered with a bandage.

The arm with the newly placed implant shouldn’t get wet or dirty for at least 24 hours after implant placement. And your child should avoid doing a lot of physical activity with that arm for about 1 week after the insertion. This allows the implant site to heal properly.

After insertion, it’s not likely that you’ll be able to see the implant though the skin that’s covering it. But you may be able to feel the implant under the skin.

When to get a new implant

Unless your doctor decides to change your child’s treatment plan, Supprelin LA is typically removed 12 months after it was placed. The implant may be replaced with a new implant if your doctor recommends that your child should continue treatment.

If your child’s implant breaks or comes out (either partly or completely) before 12 months has passed, call your doctor right away. They may need to remove the implant and replace it with a new one.

Other drugs are available that can treat central precocious puberty (CPP).* Some may be a better fit for your child than others. If you’re interested in finding an alternative to Supprelin LA, talk with your child’s doctor. They can tell you about other medications that may work well for your child.

Other drugs may be used to treat CPP. Like Supprelin LA, these drugs also belong to a class of medications called gonadotropin-releasing hormone agonists. (A drug class describes a group of medications that work in the same way.)

Examples of these drugs include:

  • leuprolide acetate (Lupron Depot-Ped)
  • triptorelin (Triptodur)
  • narfarelin acetate (Synarel)

If you’d like to know more about alternative treatments for CPP, talk with your child’s doctor.

* With CPP, children have an early onset of puberty. For girls with CPP, puberty starts before the age of 8 years. And for boys with CPP, puberty starts before the age of 9 years.

You may wonder how Supprelin LA compares to other medications that are prescribed for similar uses. Here we look at how Supprelin LA and Lupron Depot-Ped are alike and different.

Ingredients

Supprelin LA contains the active drug histrelin acetate, while Lupron Depot-Ped contains the active drug leuprolide acetate. Both medications belong to a class of drugs called gonadotropin-releasing hormone agonists. (A drug class describes a group of medications that work in the same way.)

Uses

Supprelin LA and Lupron Depot-Ped are both approved to treat central precocious puberty (CPP) in children. These drugs are each recommended for use in children ages 2 years and older.

With CPP, children have an early onset of puberty. For girls with CPP, puberty starts before the age of 8 years. And for boys with CPP, puberty starts before the age of 9 years.

Drug forms and administration

Supprelin LA comes as an implant that’s placed under the skin by a healthcare provider. It’s given once every 12 months.

Lupron Depot-Ped comes as a liquid solution that’s given by intramuscular injection (an injection into the muscle). It’s given by a healthcare provider either once each month or once every 3 months.

Both drugs are given for as long as your doctor recommends. Typically, treatment for CPP is continued until your child reaches a healthy age for puberty to begin.

Side effects and risks

Supprelin LA and Lupron Depot-Ped both belong to the same class of drugs. These medications can cause similar and different side effects. Below, we describe some of the more common side effects and some of the serious side effects of each medication.

More common side effects

These lists contain examples of more common side effects that can occur with Supprelin LA, with Lupron Depot-Ped, or with both drugs (when taken individually).

Note: If your child is taking Lupron Depot-Ped, their side effects may vary from those listed below depending on whether they’re receiving the drug monthly or every 3 months.

  • Can occur with Supprelin LA:
    • reactions at your implant site, which may cause redness, pain, swelling, and bruising
  • Can occur with Lupron Depot-Ped:
    • reactions at your injection site, which may cause pain or swelling
    • acne and oily skin
    • rash, which may or may not include seborrhea (white scales)
    • general pain in your body
    • vasodilation (widening of your blood vessels), which may lead to problems such as hot flashes
    • vaginal swelling, bleeding, or discharge
    • weight gain
    • headache
  • Can occur with both Supprelin LA and Lupron Depot-Ped:
    • initial worsening of CPP symptoms, which should resolve after 4 weeks of treatment; these symptoms may include light vaginal bleeding, breast enlargement in girls, and other signs or changes caused by puberty

Serious side effects

The serious side effects that may occur with either Supprelin LA or Lupron Depot-Ped include:

  • Seizures. Symptoms can include:
    • shaking or trembling
    • loss of consciousness
    • uncontrollable jerking movements of your arms or legs
    • dizziness
    • changes in eyesight
  • Emotional changes. Symptoms can include:
    • irritability or moodiness
    • anger
    • crying
  • Allergic reactions. Symptoms can include:
    • hives or skin rash
    • itching
    • swelling of your lips, hands, face, feet, tongue, mouth, or throat
    • flushing (warmth and redness in the skin)
    • trouble breathing

Effectiveness

The only condition that both Supprelin LA and Lupron Depot-Ped are used to treat is central precocious puberty (CPP). These drugs haven’t been directly compared in clinical studies. But separate studies have found both Supprelin LA and Lupron Depot-Ped to be effective in treating CPP.

Costs

Supprelin LA and Lupron Depot-Ped are both brand-name drugs. There are currently no generic forms of either drug. Brand-name medications usually cost more than generics.

According to estimates on WellRx.com, Supprelin LA generally costs less than Lupron Depot-Ped. This is because Supprelin LA is typically given less often than Lupron Depot-Ped is. The actual price you’ll pay for either drug depends on your insurance plan, your location, and the medical office where you receive treatment.

Like Lupron Depot-Ped (discussed above), Triptodur has uses similar to those of Supprelin LA. Here’s a comparison of how Supprelin LA and Triptodur are alike and different.

Ingredients

Supprelin LA contains the active drug histrelin acetate, while Triptodur contains the active drug triptorelin. Both medications belong to a class of drugs known as gonadotropin-releasing hormone agonists. (A drug class describes a group of medications that work in the same way.)

Uses

Supprelin LA and Triptodur are both approved to treat central precocious puberty (CPP) in children. These drugs are each recommended for use in children ages 2 years and older.

With CPP, children have an early onset of puberty. For girls with CPP, puberty starts before the age of 8 years. And for boys with CPP, puberty starts before the age of 9 years.

Drug forms and administration

Supprelin LA comes as an implant that’s placed under the skin by a healthcare provider. It’s given once every 12 months.

Triptodur comes as a powder that’s mixed with water to form a liquid solution. It’s given by intramuscular injection (an injection into the muscle) by a healthcare provider. Triptodur injections are given once every 24 weeks (about every 6 months).

Both drugs are given for as long as your doctor recommends. Typically, treatment for CPP is continued until your child reaches a healthy age for puberty to begin.

Side effects and risks

Supprelin LA and Triptodur both belong to the same class of drugs. These medications can cause similar and different side effects. Below, we describe some of the more common side effects and some of the serious side effects of each medication.

More common side effects

These lists contain examples of more common side effects that can occur with Supprelin LA, with Triptodur, or with both drugs (when taken individually).

  • Can occur with Supprelin LA:
    • reactions at your implant site, which may cause redness, pain, swelling, and bruising
  • Can occur with Triptodur:
    • reactions at your injection site, which may cause pain or swelling
    • vaginal bleeding
    • hot flushes
    • headache
    • cough
  • Can occur with both Supprelin LA and Triptodur:
    • initial worsening of CPP symptoms, which should resolve after 4 weeks of treatment; these symptoms may include light vaginal bleeding, breast enlargement in girls, and other signs or changes caused by puberty

Serious side effects

The serious side effects that may occur with either Supprelin LA or Triptodur include:

  • Seizures. Symptoms can include:
    • shaking or trembling
    • loss of consciousness
    • uncontrollable jerking movements of your arms or legs
    • dizziness
    • changes in eyesight
  • Emotional changes. Symptoms can include:
    • irritability or moodiness
    • anger
    • crying
  • Allergic reactions. Symptoms can include:
    • hives or skin rash
    • itching
    • swelling of your lips, hands, face, feet, tongue, mouth, or throat
    • flushing (warmth and redness in the skin)
    • trouble breathing

Effectiveness

The only condition that both Supprelin LA and Triptodur are used to treat is central precocious puberty (CPP). These drugs haven’t been directly compared in clinical studies. But separate studies have found both Supprelin LA and Triptodur to be effective in treating CPP.

Costs

Supprelin LA and Triptodur are both brand-name drugs. There are currently no generic forms of either drug. Brand-name medications usually cost more than generics.

According to estimates on WellRx.com, Supprelin LA and Triptodur generally cost about the same. The actual price you’ll pay for either drug depends on your insurance plan, your location, and the medical office where you receive treatment.

The Food and Drug Administration (FDA) approves prescription drugs such as Supprelin LA to treat certain conditions. Supprelin LA may also be used off-label for other conditions. Off-label use is when a drug that’s approved to treat one condition is used to treat a different condition.

Supprelin LA for central precocious puberty

Supprelin LA is FDA-approved to treat central precocious puberty (CPP) in children. With this condition, children have an early onset of puberty. For girls with CPP, puberty starts before the age of 8 years. And for boys with CPP, puberty starts before the age of 9 years.

Supprelin LA can be used in both boys and girls with CPP. However, the drug isn’t recommended for use in children under 2 years of age.

In children with CPP, their brain releases signals to their body telling it to mature earlier than it normally would. Their brain does this by increasing the levels of certain hormones. In addition to causing typical changes of puberty, such as increased body hair growth and breast development, CPP can have long-lasting effects. These effects include increased bone age.

With increased bone age, the age of your bones appears older than the age expected based on your birth date. Increased bone age can lead to children’s bone growth stopping earlier than it should. This means that people who had CCP during childhood may have decreased height as adults.

Supprelin LA treats CPP by helping to slow down or even stop the brain signals that cause the condition. The drug does this by decreasing the level of certain hormones.

Effectiveness for central precocious puberty

To assess Supprelin LA’s effectiveness, clinical studies were done in children ages 3 to 11 years with CPP. In these studies, there weren’t any children taking a placebo (treatment with no active drug).

The studies looked at whether certain hormone levels were lowered during 12 months of treatment with Supprelin LA. These hormones included luteinizing hormone (LH), estradiol, and testosterone. The studies showed that with treatment, the children’s hormone levels were lowered. And the children’s signs and changes caused by puberty were either slowed or kept stable.

Also, in the studies, the children’s bone age was compared with their age based on their birth date. With Supprelin LA treatment, their ratio of their bone age to their chronological age was decreased. This meant that Supprelin LA was effective in slowing bone growth in the children.

In addition, a longer-term study was done in some children following the first 12 months of Supprelin LA treatment. In this study, Supprelin LA was given once every 12 months for up to 6 years.

The children’s CPP was successfully treated over the length of the study. Their hormone levels were lowered and their predicted adult heights were increased to bring them closer to normal.

Off-label use for Supprelin LA

In addition to the use listed above, Supprelin LA may be used off-label. Off-label drug use is when a drug that’s approved for one use is used for a different one that’s not approved. Below, we describe one example of an off-label use of Supprelin LA.

Supprelin LA for gender dysphoria

Supprelin LA isn’t FDA-approved to treat gender dysphoria, but sometimes it’s used off-label for this condition.

Gender dysphoria happens when a person’s gender assigned at birth conflicts with the gender they identify with. Sometimes certain medications (including Supprelin LA) are used to slow down or stop puberty changes in people with gender dysphoria.

One study, which was done between 2004 and 2016, looked at how often Supprelin LA is used in children with gender dysphoria. The study found that this drug is being used more often over time for gender dysphoria.

Another study looked at using Supprelin LA and other drugs from the same medication class in people with gender dysphoria. (A medication class describes drugs that work in the same way.) The initial results of the study show that these drugs may help people with gender dysphoria function better in their daily lives. But more research is needed to know how effective these drugs are in people with gender dysphoria.

If you’d like to know about treatment options for gender dysphoria, talk with your doctor.

This section describes the typical dosage of Supprelin LA that’s commonly used or recommended. However, your child should use Supprelin LA as their doctor has prescribed the drug for them.

The number of Supprelin LA dosages that your child’s doctor recommends will depend on several factors. These include your child’s age and any other medical conditions they may have. Their doctor will determine the dosage that’s best for your child’s needs.

Drug forms and strengths

Supprelin LA comes as an implant that’s given subcutaneously (under the skin) by a healthcare provider.

Supprelin LA contains the drug histrelin acetate. It’s available in one strength: 50 mg.

Dosage for central precocious puberty

They typical dosage of Supprelin LA for central precocious puberty (CPP)* is one implant, placed once every 12 months. The implant releases about 65 mcg of drug each day over a 12-month period.

* With CPP, children have an early onset of puberty. For girls with CPP, puberty starts before the age of 8 years. And for boys with CPP, puberty starts before the age of 9 years.

Will my child need to use this drug long term?

Yes, possibly. Supprelin LA is meant to be used as a long-term treatment. In fact, Supprelin LA can be given for as long as your doctor recommends. Typically, treatment for CPP is continued until your child reaches a healthy age for puberty to begin.

This means Supprelin LA can be given until the expected age of puberty onset, which is about 11 years of age for females and about 12 years of age for males.

The number of Supprelin LA doses that a child receives may differ from one child to another. And the number of doses depends on several things, including:

  • whether a child has signs or changes caused by puberty
  • their rate of growth
  • their level of certain hormones

If you have questions about how long your child needs to use Supprelin LA, talk with your doctor.

It’s not known whether alcohol interacts with Supprelin LA. But keep in mind that Supprelin LA is only approved for use in children. And in general, alcohol should be avoided by children because it can have harmful effects on them.

Studies haven’t been done to know whether other drugs, foods, or herbal supplements interact with Supprelin LA. However, it’s possible that Supprelin LA may interact with other substances that your child is taking.

Before your child starts using Supprelin LA, be sure to talk with a doctor and pharmacist. Tell them about all the prescription, over-the-counter, and other drugs your child takes. Also tell them about any vitamins, herbs, or supplements your child uses. Sharing this information can help your child avoid potential interactions.

If you have questions about drug interactions that may affect your child, ask their doctor or pharmacist.

Supprelin LA and lab tests

Supprelin LA may affect the results of certain lab tests.

For example, in one study, children using the drug had lower blood levels of a hormone called insulin-like growth factor-1 (IGF-1).* During treatment, the children’s IGF-1 levels were about 11% lower than they were before treatment.

In another study, 22% of children using Supprelin LA had increased blood levels of a hormone called dehydroepiandrosterone (DHEA).**

But it’s not known for sure what effect, if any, these changes in lab tests may have on a child taking Supprelin LA.

If your child’s doctor orders certain lab tests during Supprelin LA treatment, the drug may affect the results of those tests. Be sure to discuss this with your child’s doctor if any lab tests are ordered for your child during treatment.

* IGF-1 is a hormone that’s found in both adults and children. In children, it helps regulate growth.

** DHEA is a hormone that’s used to make other hormones, including male and female sex hormones.

As with all medications, the cost of Supprelin LA can vary. To find current prices for Supprelin LA in your area, check out WellRx.com.

The cost you find on WellRx.com is what you may pay without insurance. The actual price you’ll pay depends on your insurance plan, your location, and the medical office where you receive treatment.

Your insurance plan may require you to get prior authorization before approving coverage for Supprelin LA. This means that your child’s doctor will need to send a request to your insurance company asking them to cover the drug. The insurance company will review the request and let you and your child’s doctor know if your plan will cover Supprelin LA.

If you’re not sure if you’ll need to get prior authorization for Supprelin LA, contact your insurance company.

Financial and insurance assistance

If you need financial support to pay for Supprelin LA, or if you need help understanding your child’s insurance coverage, help is available.

Endo Pharmaceuticals Solutions, Inc., the manufacturer of Supprelin LA, offers a program called Supprelin LA SHARES Copay Assistance Program. This program may help lower the cost of Supprelin LA. For more information and to find out if your child is eligible for support, visit the program website.

If you’d like help in understanding your insurance coverage for Supprelin LA, visit the Supprelin LA Support Center website.

For more information about financial assistance and for help understanding your insurance, you can also call 855-270-0123.

Supprelin LA is approved to treat central precocious puberty (CPP) in children.

What is central precocious puberty?

With CPP, children have an early onset of puberty. For girls with CPP, puberty starts before the age of 8 years. And for boys with CPP, puberty begins before the age of 9 years.

In children with CPP, their brain releases signals to their body to mature earlier than it normally should. The brain does this by increasing the levels of certain hormones.

Most often, it’s not known what causes CPP. But in some cases, the condition may be caused by tumors or injuries affecting the brain or spinal cord. CPP may also be related to hypothyroidism (a thyroid condition) or fluid buildup around a child’s brain at the time of their birth.

What does Supprelin LA do?

Supprelin LA belongs to a class of drugs called gonadotropin-releasing hormone agonists. (A drug class describes a group of medications that work in the same way.) It works to treat CPP by decreasing certain hormone levels in the body. Examples of hormones affected include luteinizing hormone (LH), estradiol, and testosterone.

By lowering these hormone levels, Supprelin LA slows down or even stops signs and changes caused by puberty.

Supprelin LA can be used for as long as your child’s doctor recommends. Typically, treatment for CPP is continued until your child reaches a healthy age for puberty to begin.

How long does it take to work?

Supprelin LA usually takes about 4 weeks to begin slowing down puberty. But at first, before 4 weeks have passed, the medication can have the opposite effect. During this time, the drug may actually worsen puberty symptoms. (See the “Supprelin LA side effects” section above for more details).

After 4 weeks of treatment, your child’s puberty changes may either slow down or stop altogether.

Supprelin LA shouldn’t be used by females who are pregnant or could become pregnant while taking the drug.

Animal studies show that Supprelin LA can cause harm to fetuses when the drug is given to pregnant females. It’s also possible that Supprelin LA could cause pregnancy loss.

Keep in mind that animal studies don’t always predict what will happen in people. And it’s not known if Supprelin LA causes harm if used during human pregnancies. However, it’s recommended that the drug not be used during pregnancy because of the possible risks.

If you have questions about the safety of using Supprelin LA during pregnancy, talk with your child’s doctor.

Supprelin LA shouldn’t be used during pregnancy. If your child is sexually active, and they or their partner can become pregnant, talk with your child’s doctor. They can recommend birth control options for your child during Supprelin LA treatment.

It’s not known for sure whether it’s safe to use Supprelin LA while breastfeeding. But until more information is available, Supprelin LA should be avoided while breastfeeding.

If you have questions about the safety of using Supprelin LA while breastfeeding, talk with your child’s doctor.

Here are answers to some frequently asked questions about Supprelin LA.

How long does the Supprelin LA implant last?

Each implant lasts 12 months. A Supprelin LA implant contains 50 mg of histrelin acetate. It releases about 65 mcg of medication each day over a 12-month period.

Supprelin LA implants are placed by a healthcare provider once every 12 months. At the 12-month point, your child’s healthcare provider will remove the implant. It can be replaced then if needed. Treatment with the drug can be continued for as long as your child’s doctor recommends.

Will my child need any tests during Supprelin LA treatment?

Yes, your child’s doctor will monitor your child routinely during treatment. Some of this monitoring is done using lab tests.

During treatment, your child’s doctor will check the following:

  • Signs of puberty. If Supprelin LA is working properly, your child’s physical changes caused by puberty will be slowed down or even stopped.
  • Growth measurements. Your child’s height and bone age with both be measured during Supprelin LA treatment. These growth measurements are usually checked every 6 to 12 months.
  • Hormone levels. Your child’s doctor will order blood tests to check certain hormone levels during treatment. Typically, levels of luteinizing hormone (LH), follicle stimulating hormone (FSH), and either testosterone or estradiol will be checked every 6 months.

Keep in mind that your child’s doctor may monitor your child more often or less often than what’s listed above. And they’ll recommend a treatment plan that’s best for your child.

When will puberty occur after the implant is removed?

After stopping treatment with Supprelin LA, your child’s changes caused by puberty may come back within a few weeks.

Typically, your child’s doctor will recommend that treatment with Supprelin LA be stopped when puberty would generally be expected. For girls, the typical age of puberty is about 11 years. And for boys, the typical age of puberty is about 12 years.

One study looked at the length of time following removal of Supprelin LA implants until girls started having periods. In this study, it took about 9 months on average after Supprelin LA was removed for the girls to begin having periods. But the exact length of time will vary from person to person.

What’s a good way to explain Supprelin LA to my child?

In some cases, explaining central precocious puberty (CPP)* to a child can be challenging. How well your child is able to understand the condition depends on their age and their ability to grasp tough topics.

To help with this discussion, the manufacturer of Supprelin LA has published a children’s book that assists parents in explaining CPP to their children. It’s important to tell your child they’re not alone and that there are treatments available to help their condition.

If you or your child is having a hard time understanding CPP or available treatment options, talk with your child’s doctor. They can help you better understand this condition.

* With CPP, children have an early onset of puberty. For girls with CPP, puberty starts before the age of 8 years. And for boys with CPP, puberty starts before the age of 9 years.

How is Supprelin LA different from Vantas?

Supprelin LA and Vantas both contain the same active drug: histrelin acetate. But these two medications are approved for different uses.

Supprelin LA is approved to treat central precocious puberty (CPP) in children. (With CPP, children have an early onset of puberty). However, Vantas is approved for palliative treatment of advanced prostate cancer in men. (With palliative treatment, the drug provides relief of pain from the condition.)

Both medications comes as implants that are placed under the skin. And they’re each given once every 12 months. However, the strength of each medication varies as follows:

  • Supprelin LA is available as a 50-mg implant. It delivers 65 mcg of histrelin acetate each day over a 12-month period.
  • Vantas is also available as a 50-mg implant. But it delivers 50 mcg of histrelin acetate each day over a 12-month period.

If you’d like to know more about the differences between Supprelin LA and Vantas, talk with your doctor.

This drug comes with several precautions. Before taking Supprelin LA, talk with your child’s doctor about your child’s health history. Supprelin LA may not be right for your child if they have certain medical conditions or other factors affecting their health. These conditions and factors are described below.

Note: For more information about the potential negative effects of Supprelin LA, see the “Supprelin LA side effects” section above.

Allergic reaction

If your child has had a previous allergic reaction to histrelin acetate (the active drug in Supprelin LA) or to any of Supprelin LA’s inactive ingredients, they should not use Supprelin LA. Doing so could cause them to have a severe allergic reaction. If you’re not sure whether your child is allergic to this medication, talk with your doctor.

Emotional changes

Some people who use Supprelin LA have emotional changes such as ups and downs, anger, frustration, and irritability. For some people, it’s also possible to have suicidal thoughts or behavior while using this drug.

If your child already has a behavioral health condition, such as depression or anxiety, tell your doctor before your child uses Supprelin LA. Your doctor may recommend a different treatment option, or they may monitor your child more closely than usual for emotional changes during treatment.

Seizures

Taking Supprelin LA can increase the risk of seizures. This can also be increased in people who have:

  • a history of seizures
  • cerebrovascular problems (conditions affecting the blood vessels in their brain)
  • certain other conditions affecting their brain or spinal cord

The risk of seizures is also increased in people who take certain medications that increase the risk for seizures. But an increased risk of seizures has also occurred in people without previous seizures or who don’t have the conditions listed above.

Before your child starts using Supprelin LA, tell your doctor about all of the medications your child takes. Also tell them about any medical conditions that your child has. Your doctor will recommend if Supprelin LA is a safe treatment option for your child.

Certain eye conditions

During clinical studies, one person using Supprelin LA who also had Stargardt’s disease developed a lazy eye while taking Supprelin LA. (Stargardt’s disease is an eye condition that causes loss of vision.)

If your child has any eye problems, talk with their doctor before they begin Supprelin LA treatment. Your doctor will recommend whether Supprelin LA is a safe treatment option for your child.

Pregnancy

It’s recommended that Supprelin LA be avoided during pregnancy. For more information, please see the “Supprelin LA and pregnancy” section above.

Breastfeeding

It’s not known whether it’s safe to take Supprelin LA while breastfeeding. For more information, please see the “Supprelin LA and breastfeeding” section above.

The following information is provided for clinicians and other healthcare professionals.

Indications

Supprelin LA is approved by the Food and Drug Administration (FDA) for treating central precocious puberty (CPP) in children ages 2 years and older.

Mechanism of action

Supprelin LA is a gonadotropin-releasing hormone agonist. Initially, it triggers an initial increase in blood levels of luteinizing hormone (LH) and follicle stimulating hormone (FSH).

However, when the drug is delivered consistently, as it is with the Supprelin LA implant, it decreases the response of receptors in the pituitary gland. This decreases steroid production from the ovaries and testes, which results in decreased levels of FSH and LH.

Pharmacokinetics

In a 12-month study of 47 children using Supprelin LA, histrelin acetate concentrations were steady throughout the study period. Observed histrelin serum concentrations would be expected to keep gonadotropin hormones at prepubertal levels.

Contraindications

Supprelin LA should not be used in people with the following conditions:

  • Hypersensitivity.Use of Supprelin LA is contraindicated in people with prior hypersensitivity reactions to gonadotropin-releasing hormone or gonadotropin-releasing hormone agonists.
  • Pregnancy. The use of Supprelin LA is contraindicated in people who are pregnant or could become pregnant while using this medication. Supprelin LA can cause fetal harm or spontaneous abortion. Precautionary steps should be taken to ensure that children using Supprelin LA do not become pregnant during treatment.

Storage

Supprelin LA is supplied as two components: the drug implant and the implant kit.

The drug implant must be refrigerated at a temperature of 36°F to 46°F (2°C to 8°C) until the expiration date provided or insertion of the implant, whichever date is sooner. Temperature excursions of up to 77°F (25°C) are permitted for 7 days. If implants are exposed to these temperatures for longer than 7 days, call the drug’s manufacturer for recommendations for use.

Do not freeze Supprelin LA implants. In addition, the implants should be protected from light.

Implant kits can be stored at room temperature until their expiration date. Do not refrigerate the implantation kit.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.