# Degarelix

Source: https://onco.cc/drugs/degarelix/  
OnCo record `degarelix` (Treatment). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

An injectable hormone blocker for prostate cancer that lowers testosterone within days without the initial surge caused by agonists.

## Summary

Degarelix is a competitive GnRH receptor antagonist given as a monthly subcutaneous depot for advanced prostate cancer. Because it blocks rather than stimulates the receptor, it lowers testosterone within days without the initial surge, or flare, caused by GnRH agonists, so no antiandrogen cover is needed. The CS21 trial (2008) showed testosterone suppression non-inferior to leuprolide with faster onset and lower PSA rebound, supporting US approval in 2008 and EU approval in 2009. A possible cardiovascular advantage over agonists in men with pre-existing heart disease was suggested by observational data, but the PRONOUNCE trial was inconclusive. Injection-site reactions are common and the monthly schedule is less convenient than three- or six-monthly agonist depots. For a newcomer, degarelix switches testosterone off quickly and cleanly.

## Fields

- Kind: Treatment
- Status: approved
- Last checked: 2026-09-08
- Tags: gap-fill
- Brand: Firmagon
- Modality: GnRH antagonist depot
- Mechanism: Competitive GnRH receptor antagonist producing rapid testosterone suppression without flare.
- Approvals: US 2008: Advanced prostate cancer; EU 2009: Same

## Notes

- NICE TA404 recommends degarelix for advanced hormone-dependent prostate cancer only in people with spinal metastases, and only if the commissioner can achieve at least the same discounted drug cost as that available to the NHS in June 2016. The restriction to spinal metastases reflects the avoidance of the testosterone flare that a gonadotrophin-releasing hormone agonist can cause, which matters most where a flare could precipitate cord compression.

## Sources

- Wikipedia: https://en.wikipedia.org/wiki/Degarelix
- Label (DailyMed): https://dailymed.nlm.nih.gov/dailymed/search.cfm?labeltype=all&query=degarelix
- NICE TA404: degarelix for treating advanced hormone-dependent prostate cancer: https://www.nice.org.uk/guidance/ta404

## Connected records

- cancers: [Localised prostate cancer, high and very high risk](https://onco.cc/cancers/prostate-high-risk/), [Metastatic hormone-sensitive prostate cancer](https://onco.cc/cancers/prostate-mhspc/), [Prostate cancer](https://onco.cc/cancers/prostate/)
- technologies: [Androgen deprivation & AR pathway inhibitors](https://onco.cc/technologies/androgen-deprivation/)
- targets: [Androgen receptor](https://onco.cc/targets/androgen-receptor/), [GnRH receptor (GNRHR)](https://onco.cc/targets/gnrhr/)
- companies: [Ferring Pharmaceuticals](https://onco.cc/companies/ferring/)
- terms: [Androgen deprivation therapy (ADT)](https://onco.cc/terms/adt/), [Prostate cancer drugs in England: what NICE recommends, and what it refuses](https://onco.cc/terms/prostate-uk-drug-approvals/), [What androgen deprivation costs: the side of hormone therapy the survival curves do not show](https://onco.cc/terms/prostate-adt-burden/)
- trials: [A Trial Comparing Cardiovascular Safety of Degarelix Versus Leuprolide in Patients With Advanced Prostate Cancer and Cardiovascular Disease](https://onco.cc/trials/nct02663908/), [Assessing Efficacy of Neoadjuvant ADT in Localized High-Risk Prostate Cancer Patients Utilizing 18F-Flotufolastat PSMA PET/CT](https://onco.cc/trials/nct07455903/), [Investigation of the Effect of Degarelix in Terms of Prostate Volume Reduction in Prostate Cancer Patients](https://onco.cc/trials/nct00884273/), [Neoadjuvant Study Investigating Degarelix in Patients Suffering From Prostate Cancer](https://onco.cc/trials/nct00833248/), [Radiation Therapy With or Without Androgen-Deprivation Therapy in Treating Patients With Prostate Cancer](https://onco.cc/trials/nct00936390/), [RADICALS-HD](https://onco.cc/trials/radicals-hd/), [Standard Systemic Therapy With or Without Definitive Treatment in Treating Participants With Metastatic Prostate Cancer](https://onco.cc/trials/nct03678025/), [Treating Prostate Cancer That Has Come Back After Surgery With Apalutamide and Targeted Radiation Based on PET Imaging](https://onco.cc/trials/nct04423211/), [Two Studies for Patients With High Risk Prostate Cancer Testing Less Intense Treatment for Patients With a Low Gene Risk Score and Testing a More Intense Treatment for Patients With a High Gene Risk Score, The PREDICT-RT Trial](https://onco.cc/trials/nct04513717/)
- drugs: [Abarelix](https://onco.cc/drugs/abarelix/)
- roadmaps: [Hormonal therapy roadmap: removing the ovaries → tamoxifen → oral degraders switched by a blood test](https://onco.cc/roadmaps/hormonal-therapy-roadmap/)

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JSON: https://onco.cc/api/v1/entities/degarelix.json