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Dr. Andrew Rynne

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What is Lupride injection prescribed for?

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Dr. Purushottam Neurgaonkar

OBGYN

Practicing since :1992

Answered : 2177 Questions

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Posted on Wed, 21 Oct 2015 in Women's Health
Question: my friend who is an unmarried 30 yr old female had been suffering from pain in the abdomen during menses, nausea + and acidity +, since past 6 mnths. After consulting a gynaecologist, she was advised to have a USG done, which showed a small complex left ovarian cyst and mild hepatomegaly. The doctor also advised a CA-125 test, which was borderline positive with a reading of 43.68.
she decided to get a surgical removal of the cyst done.

Laparoscopy with adhesiolysis with ovarian cystectomy was performed.
The operative notes read as follows:
Fibroid in the left fundal region
Endo-adhesion present at the right tubo-ovarian region
Right ureter was closed to scarry fibrotic area of endometriosis
Left ovarian endo-cyst was ruptured during manipulation
Left ovariaon cystectomy was performed
Right and left ovary polycystic
Rest of abdominal cavity WND

She has recovered well post-operatively over the last 10 days. the histopathology report shows benign hemorrhagic cyst.

Her gynaec is now suggesting that she take 2 injections of Lupride 375 mg.

Would like to know if this is the right course of treatment for her and the reasoning for this injection.
What would be her chances of being able to carry a full-term pregnancy without any complications in the future?
Any other issues she should be concerned about, since she is engaged to be married in the next six months.

Appreciate your detailed response.

doctor
Answered by Dr. Purushottam Neurgaonkar 1 hour later
Brief Answer:
Continue with LUPRIDE injection and pregnancy should be uneventful.

Detailed Answer:
Hi Dear,
Dr. Purushottam welcomes you to HCM virtual clinic!
Thanks for consulting at my virtual clinic. I have carefully gone through your case, and I think I have understood your concern. I will try to address your medical concerns and would suggest you the best of the available treatment options.
1] From your narration and findings of surgical procedure, there seems to be presence of a condition called as endometriosis,especially on right side.
Endometrium (lining of the uterus) is present in the abdominal cavity, it bleeds during menses and gives a lot of discomfort.
2] Also left ovarian cyst had blood in it. As per histopath report.
3] considering these conditions treating doctor might have prescribed LUPRIDE injection. This medicine helps by suppressing abnormal endometrium and cure of the condition. This injection is given at monthly intervals.
4] Once patient manages to conceive , the course of pregnancy is like any other patient. This condition has no effect on progress and out come of pregnancy.
I hope my answer helps you.
Thanks.

Above answer was peer-reviewed by : Dr. Neel Kudchadkar
doctor
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Follow up: Dr. Purushottam Neurgaonkar 19 hours later
Many thanks for your reply Doctor.

My follow-up query would be that are these injections to be given every month till pregnancy OR just for two/three months now as a preventive?

It is likely that she would get married in the near future in about six months, so pregnancy would not be possible for at least 15-18 months from now. She has shared that she has undergone this surgery with her fiancé, but would like to be sure that she will not face any difficulty in conceiving. Difficulty in conception would be a major issue and hence marriage would have to be re-considered in such circumstances. Hence, most important would be her ability to conceive, since she also has polycystic ovaries as well as fibroid in left fundal region.

Any side-effects of the medicine that she should keep in mind? She is currently also on anti-depressant medication Stalopam 10 mg. Other that this, she is on no other medication.

Any follow-up tests that she must get done at intervals in the future.

Appreciate you taking the time to respond to my queries.

Many thanks and regards,
XXXXX
doctor
Answered by Dr. Purushottam Neurgaonkar 1 hour later
Brief Answer:
Lupride for 3/4 months, Fretilty issues can be tackled later on

Detailed Answer:
hi XXXXXXX
I am Dr Purushottam, I have gone through your follow up query.

Please find the answer for your query.

1] The injections are meant to suppress growth of abnormal endometrium inside abdomen. They are given monthly for 3 to 4 months. They will also suppress her menses. This will help body to clear up the bleeding inside abdomen.

2] Regards her fertility - PCOS is a life style disorder and can be treated with life style modifications like proper diet and exercise regimen. It has good pregnancy rates if treatment is taken properly. As laparoscopy findings are suggestive of right side tubo-ovarian adhesions, she might need help in the form of ART (artificial reproductive technique), to conceive, if she finds difficulty to get pregnancy. But these issues can be handled by expert infertility consultant.

3] LUPRIDE injection will not have major side effects over 3 to 4 months period. She should have good calcium intake, regular walking and proper exercise.

4] Also it is suggested to get ultrasound done at regular interval of 3 months, as follow up.
Hope I have answered your doubts.

If needed please refer back to us.
Thanks.
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Purushottam Neurgaonkar 43 hours later
Dear Dr. XXXXXXX

Thanks for your detailed responses. You have answered most of my queries. As I gather, from your response, as well as my research online, my friend should go ahead with the Lupride injections under the guidance of her current doctor to control her endometriosis. From her history and reports, will you be able to stage her endometriosis or are there any other tests to be done for that??

She could have difficulty in conceiving naturally. In that case she could take the advice of a fertility expert in future, when the need arises. I know I am putting you in a bit of a spot, but could you give me a probability of her chances of being able to conceive naturally?? That will guide her decision in the matter of her fiancé and marriage.

The Lupride side-effects are many. I believe one could get all or none or some. Any side-effect that one must be particularly concerned about - besides informing the doctor about bleeding while on the medication?

One last query - should she continue taking tab Stalopam 10 mg - can you answer that question for me or should she consult her psychiatrist?

Also, if one needs to consult you in future, since you are aware of this case, how does one reach you??

Many thanks for the guidance.

Regards,
XXXXX
doctor
Answered by Dr. Purushottam Neurgaonkar 28 hours later
Brief Answer:
grade 2 endometriosis, consult psychiatrist.

Detailed Answer:
Hi, Dr Purushottam here again.
1] From history and reports it can be Stage 2 Endomotriosis.
But impression of the surgeon at the time of surgery matters most.
2] Secondly,about chances of getting natural pregnancy- as right tube and ovary show adhesions, less chances from right side. If left ovary becomes normal after treatment she has good chances of getting pregnancy from that side. But certainly, it can't be predicted.
3] As far as LUPRIDE side effects are concerned; she might get none , but she should be guided about weight bearing exercises and calcium and vitamin D 3 to prevent bone loss.
4] She must consult psychiatrist and or counsellor, before taking decision about anti stress medication.
5] You can get my contact details from my profile on the HCM website.
I hope I have cleared your doubts .
Thanking you, and wishing all the best to the patient.

Above answer was peer-reviewed by : Dr. Neel Kudchadkar
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