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Hormonal

Triptorelin

GnRH agonist decapeptide. First gonadotropin stimulation, then pituitary downregulation.

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Triptorelin by the numbers

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Full lexicon entry

For research and educational purposes only. Values from the TPD lexicon, sources linked there.

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Description

Triptorelin is a synthetic decapeptide of ten amino acids and belongs to the class of GnRH agonists (gonadotropin-releasing hormone agonists, also called LHRH agonists). It is derived from endogenous GnRH but differs by a single substitution at position 6: glycine is replaced by D-tryptophan. According to research this modification makes the molecule far more resistant to enzymatic breakdown and increases receptor affinity to roughly one hundred times that of native GnRH.

The mechanism is biphasic and sits at the center of research with this compound. In the first phase Triptorelin acts as an agonist and stimulates the pituitary to release more gonadotropins (LH and FSH) - the so-called flare-up. In animal models an initial testosterone rise was observed after administration, followed by rapid suppression within a few days. Under continuous receptor occupancy the GnRH receptors undergo downregulation and desensitization, which subsequently suppresses gonadotropin release. This switch from stimulation to suppression is the core of research interest in GnRH agonists.

On pharmacokinetics: the native elimination half-life is reported at around five hours. With subcutaneous administration, the biological residence time extends to roughly ten times that of intravenous dosing due to slow release from the depot at the injection site. Peak plasma concentrations are described in the literature after one to three hours. Most studies work with depot formulations whose kinetics differ from immediate-release dosing.

Triptorelin is a research compound from the field of hormone and endocrinology research. At TPD you receive it as a 10-pack with 2mg per vial. The substance is intended exclusively for research and educational purposes.

This information is for research and educational purposes only. Not medical advice.

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FAQ

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Is triptorelin approved?

Yes. In the US triptorelin has been approved since 2000 as a depot (triptorelin pamoate) injected into the muscle for advanced prostate cancer, ChEMBL lists it at the highest stage 4. The vial in the shop, by contrast, is a powder to dissolve, not a depot that releases the drug over weeks.

Why does triptorelin first stimulate and then inhibit?

The pituitary expects GnRH in short pulses. The first dose triggers a burst of LH and FSH, testosterone and estradiol rise. If the stimulus persists, after 2 to 4 weeks the pituitary barely responds, LH and FSH fall and the sex hormones with them. That is why a single dose in a test shows a rise and a depot a reduction.

How reliably does the depot lower testosterone?

In a trial with 284 men testosterone was at castration level on day 29 in 91.2 percent with triptorelin and 99.3 percent with leuprolide, on day 57 in 97.7 versus 97.1 percent. In a pooled analysis of 920 men 91 percent were even below the stricter threshold of 20 ng/dl after 12 months.

What is tumour flare?

The short rise in testosterone after the first dose can temporarily worsen hormone-dependent prostate cancer, up to pressure on the spinal cord or urinary obstruction. The prescribing information warns of this explicitly. After that testosterone usually falls to castration level within four weeks.

What else is triptorelin studied for?

In endometriosis continuous dosing lowers estradiol, a review describes less pain and smaller lesions. As a single dose it distinguishes delayed puberty from hypogonadism. The registry lists trials on precocious puberty in children, on protecting the ovaries during chemotherapy and on breast cancer before menopause.

Which side effects are known?

On the monthly depot 58.6 percent of men had hot flushes, 12.1 percent skeletal pain, 7.1 percent impotence and 5 percent headache. The prescribing information also lists changes in blood sugar and blood lipids, cardiovascular risks, seizures and a possible prolongation of the QT interval.

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