Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes Trelstar (Triptorelin). If you are concerned about side effects, discuss the risks and benefits of Trelstar (Triptorelin) with your doctor.

The following side effects have been reported by at least 1% of people taking Trelstar (Triptorelin). Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

• breast enlargement (for men)
• Constipation
• coughing
• Diarrhea
• difficulty getting or maintaining an erection
• dizziness
• fatigue or weakness
• headache
• hot flashes (sudden sweating and feeling of warmth)
• increased blood pressure
• nausea
• pain, redness, swelling, or itching at the place of injection
• reduced genital size
• reduced sex drive
• skin rash
• trouble sleeping

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not check with your doctor or seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

• bone pain
• breathing problems
• difficult or painful urination
• eye pain
• leg cramps
• loss of appetite
• pain in the leg, back, breast, muscles, or joints
• pain, swelling, numbness, or weakness of the limbs
• signs of Depression (e.g., poor concentration, changes in weight, changes in sleep, decreased interest in activities, thoughts of suicide)
• swelling of the arms or legs
• symptoms of high blood sugar (e.g., frequent urination, increased thirst, excessive eating, unexplained weight loss, poor wound healing, infections, fruity breath odour)
• symptoms of liver problems (such as yellow eyes or skin, abdominal pain, loss of appetite, pale stools, itchy skin, or dark urine)
• symptoms of a urinary tract infection (e.g. pain when urinating, urinating more often than usual, low back or flank pain)

Stop taking the medication and seek immediate medical attention if any of the following side effects occur:

• chest pain
• racing or abnormal heartbeat
• symptoms of a serious allergic reaction (such as swelling of the face or throat, skin rash, Hives, or difficulty breathing)

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking Trelstar (Triptorelin).

Trelstar (1 month slow release) 3.75 mg Trelstar (Triptorelin) per vial

Each vial of sterile lyophilized microgranules contains Trelstar (Triptorelin) pamoate equivalent to 3.75 mg of Trelstar (Triptorelin) peptide base. Nonmedicinal ingredients: poly-d,l-lactide-co-glycolide (170 mg), mannitol USP (85 mg), carboxymethylcellulose sodium USP (30 mg), and polysorbate 80 USP (2 mg). When 2 mL Sterile Water for Injection is added to the microgranules and mixed, a suspension is formed, which is intended as a single, monthly intramuscular injection.

Trelstar (3 month slow release) 11.25 mg triptorelin/vial

Each vial of sterile lyophilized microgranules contains Trelstar (Triptorelin) pamoate equivalent to 11.25 mg of Trelstar (Triptorelin) peptide base. Nonmedicinal ingredients: poly-d,l-lactide-co-glycolide (145 mg), mannitol USP (85 mg), carboxymethylcellulose sodium USP (30 mg), and polysorbate 80 USP (2 mg). When 2 mL Sterile Water for Injection is added to the microgranules and mixed, a suspension is formed, which is intended as a single, 3 month intramuscular injection.

Trelstar (6 month slow release) 22.5 mg triptorelin/vial

Each vial of sterile lyophilized microgranules contains Trelstar (Triptorelin) pamoate equivalent to 22.5 mg of Trelstar (Triptorelin) peptide base. Nonmedicinal ingredients: poly-d,l-lactide-co-glycolide, mannitol USP, carboxymethylcellulose sodium USP, and polysorbate 80 NF. When 2 mL Sterile Water for Injection is added to the microgranules and mixed, a suspension is formed, which is intended as a single, intramuscular injection administered every 6 months.

Do not use Trelstar (Triptorelin) if you:

• are allergic to Trelstar (Triptorelin) or any ingredients of the medication
• are allergic to medications called GnRH agonists or LHRH agonists (such as Buserelin or Goserelin)
• are breast-feeding
• are pregnant or may become pregnant while taking Trelstar (Triptorelin)

There may be an interaction between Trelstar (Triptorelin) and any of the following:

• Amiodarone
• anti-psychotics (e.g., Aripiprazole, Clozapine, Haloperidol, Olanzapine, Quetiapine, Risperidone)
• Asenapine
• beta-2 agonists (salbutamol, salmeterol)
• Buprenorphine
• diabetes medications (e.g., Canagliflozin, Gliclazide, Glyburide, insulin, Metformin, Rosiglitazone, Sitagliptin)
• Disopyramide
• Domperidone
• efavirenz
• lopinavir
• macrolide antibiotics (e.g., clarithromycin, erythromycin)
• Methadone
• mifepristone
• procainamide
• quinidine
• quinine
• quinolone antibiotics (e.g., ciprofloxacin, Norfloxacin, Ofloxacin)
• saquinavir
• selective serotonin reuptake inhibitors (SSRIs; e.g., Citalopram, Duloxetine, Fluoxetine, Paroxetine, Sertraline)
• serotonin antagonists (e.g., Granisetron, Ondansetron)
• Sotalol
• Tetrabenazine

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with Trelstar (Triptorelin). Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications that you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the Nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

Before you begin using a medication, be sure to inform your doctor of any medical conditions or Allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use Trelstar (Triptorelin).

Anemia: Trelstar (Triptorelin) may cause low levels of red blood cells. If you experience symptoms of reduced red blood cell count (anemia) such as shortness of breath, feeling unusually tired or pale skin, contact your doctor as soon as possible.

Your doctor will do blood tests regularly to monitor the number of specific types of blood cells, including red blood cells, in your blood.

Depression: GnRH medications have been known to cause mood swings and symptoms of depression. If you have depression or a history of depression, discuss with your doctor how Trelstar (Triptorelin) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Trelstar (Triptorelin), and whether any special monitoring is needed. If you experience symptoms of depression such as poor concentration, changes in weight, changes in sleep, decreased interest in activities, or notice them in a family member who is taking Trelstar (Triptorelin) contact your doctor as soon as possible.

Diabetes: Trelstar (Triptorelin) may cause an increase in blood sugar levels and glucose tolerance may change. People with diabetes may find it necessary to monitor their blood sugar more frequently while using Trelstar (Triptorelin).

If you have diabetes or are at risk for developing diabetes, discuss with your doctor how Trelstar (Triptorelin) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Trelstar (Triptorelin), and whether any special monitoring is needed.

Drowsiness/reduced alertness: Trelstar (Triptorelin) may affect the mental or physical abilities needed to drive or operate machinery. Avoid driving, operating machinery, or performing other hazardous tasks until you have determined how Trelstar (Triptorelin) affects you.

Heart rhythm: Trelstar (Triptorelin) can cause changes to the normal rhythm of the heart, as a result of reducing the testosterone in the body. An irregular heartbeat called QT prolongation is possible. QT prolongation is a serious life-threatening condition that can cause fainting, seizures, and sudden death. If you are at risk for heart rhythm problems (e.g., people with heart failure, Angina, low potassium or magnesium levels, taking certain medications), discuss with your doctor how Trelstar (Triptorelin) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Trelstar (Triptorelin), and whether any special monitoring is needed.

Kidney function: Kidney Disease or reduced kidney function may cause Trelstar (Triptorelin) to build up in the body, causing side effects. If you have reduced kidney function or kidney disease, discuss with your doctor how Trelstar (Triptorelin) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Trelstar (Triptorelin), and whether any special monitoring is needed.

If you have reduced kidney or liver function, discuss with your doctor how Trelstar (Triptorelin) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Trelstar (Triptorelin), and whether any special monitoring is needed.

Liver function: Liver disease or reduced liver function may cause Trelstar (Triptorelin) to build up in the body, causing side effects. If you have liver problems, discuss with your doctor how Trelstar (Triptorelin) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Trelstar (Triptorelin), and whether any special monitoring is needed. Your doctor may want to test your liver function regularly with blood tests while you are taking Trelstar (Triptorelin).

Men and the heart: There may be an increased risk of heart-related events (e.g., heart attacks, Stroke, heart-related death) in men being treated for prostate cancer with GnRH medications. Before you start treatment, tell your doctor if you have diabetes, heart disease, had a previous Heart Attack or stroke, or have cardiovascular risk factors (e.g., high blood pressure, smoking, or cholesterol). If you have any of these conditions, discuss with your doctor how Trelstar (Triptorelin) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Trelstar (Triptorelin), and whether any special monitoring is needed.

Osteoporosis: Trelstar (Triptorelin) can cause your bones to lose thickness. If you are at risk for osteoporosis (thin bones) or are taking other medications that tend to thin bones, discuss with your doctor how Trelstar (Triptorelin) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Trelstar (Triptorelin), and whether any special monitoring is needed.

Short-term worsening of symptoms: When Trelstar (Triptorelin) is first used, an increase in testosterone occurs in the body. For some people, their symptoms may temporarily worsen during the first weeks of treatment with Trelstar (Triptorelin). If your medical condition appears to worsen or you experience bone pain, numbness or tingling in the hands or feet, blood in the urine or difficulty urinating, contact your doctor as soon as possible.

Pregnancy: Trelstar (Triptorelin) should not be used during pregnancy. A non-hormonal method of birth control (such as condoms, diaphragms, or IUDs) should be used during treatment. If you become pregnant during treatment, contact your doctor immediately.

Breast-feeding: It is not known if Trelstar (Triptorelin) passes into breast milk. Breast-feeding is not recommended for women taking Trelstar (Triptorelin).

Children: The safety and effectiveness of using Trelstar (Triptorelin) have not been established for children.