Looking for feedback - Lupron vs Orgovyx

I changed from Lupron to Orgovyx in March. I was on Lupron for almost 7 years. The only difference I noted was that I stopped getting hot flashes for four months Getting them again after five months at about the same rate I was getting them from Lupron.

Orgovyx does the same thing as Lupron so your issue should not change.

If you are tolerating Lupron then the main difference is that your testosterone will recover much quicker with Orgovyx at the end of your ADT treatment.

As far as I understand, Lupron is a GnRH agonist, while Orgovyx is a GnRH antagonist (like Firmagon). I don't know how big a difference that makes, but you would be switching to ADT that works slightly differently.

For me, moving from Firmagon to Orgovyx, I wasn't too concerned because they're both GnRH antagonists, and I knew Firmagon worked for me.

I had fewer mental health issues about 45 days after I switched from monthly Lutron to Orgovyx. On Lupron I had a lot of suicidal ideation and cried a lot. Orgovyx is no picnic but my mental health is noticeably better.

However, Lupron was the first ADT I took so who knows whether my issues were just due to going from high T to none, ie maybe the same thing would have happened if I started with Orgovyx.

The side effects are generally the same...

I've done both, 18 months of Lupron and later 22 months of Orgovyx.

Both dropped my T to pretty much undetectable, less than the lab could measure. Always fun to go to the portal to check lab results and the T is a bright red....

Side effects I experienced with both:
Fatigue
Hot flashes
Muscle and joint stiffness
Genitalia shrinkage

These were not debilitating, more annoying. I continued to exercise, work, travel for vacations, ski with friends, ride my bike...

The hot flashes may have been fewer and less severe under Orgovyx but that's a qualitative assessment. I base that on fewer "soakers..."

T recovery under Orgovyx was faster in the first three months, after that it evened out based on my labs several days ago.

I did not experience loss of libido on either, much to my wife's dismay, sigh...I did not have any cognitive or psychological issues such as depression either.

There are advantages to Orgovyx such as a lower cardiovascular side effect profile so if you have CV issues (I had Afib) then that may be a factor. It does have a faster to castration and higher sustained castration while on it vice Lupron which has that flare.

As to the faster recovery of T, other factors may come into play, age, length of time on the agents, pre-treatment T levels...I have read where exercise may play a role in T recovery, I'm pretty active, may have been a factor.

It avoids having to go in and get the shot though the converse is true, requires the self discipline and a system to take the pill every day.

There may be the approval and cost issue. I have TRICARE For Life as my Part D so it was $68 for a 90 day prescription.

Another advantage may be in your ability to stop treatment at any time (as always, a decision made in coordination with your medical team!) and have it quickly clear your system vice say a 90 day Lupron shot where you're stuck with it for 3+ months...!

Some good feed back here. Thanks everyone. I’ll be starting Lupron soon and concerned about the side effects. But like everyone else I’ll just have to get rolling and see what happens. Meeting with radiation oncologist in a few weeks to set up radiation schedule and get him to answer a long list of questions I have. I’m a Gleason 7 (4+3) with seminal vesicles invasion. Already wasted 16 weeks getting my insurance to approve a PSMA PET SCAN. I’m 79 and they were hoping I would die before they had to pay🤪. The scan also confirmed I have severe multivessel coronary artery calcifications. More good news, ha. Anyway my cardiologist said okay to proceed with the treatments. Positive attitude matters and I have it!!!! Beat bladder cancer a while back and I’ll beat this. Best of luck to all you wonderful people..

Cardiac health risk is lower w/ Orgovyx (3% vs 6% I think)
73 yrs old had 4+ mos of Orgovyx as part of Salvage Treatment for persistent PSA. 19 following RP.
I would opt for Orgovyx again when needed (if affordable).
Best wishes.

Until Orgovyx became available in Canada earlier this year, I was nervous about switching to any other ADT, because I already knew that Firmagon (together with Erleada) had been keeping my testosterone low and my PSA undetectable for 2½ years with no impact on my heart, kidneys, or liver.

Last March, my RO suggested Orgovyx because it belongs to the same family as Firmagon — it's more-or-less Firmagon as a daily pill instead of a monthly injection — and that made me feel less nervous about the change. As I mentioned in the first post, the impact on my quality of life has been huge.

Thanks to everyone for your feedback. I am stage 4 with mets in my abdominal and chest lymph nodes. My psa has dropped to .01 so I am apprehensive about changing course. I am 64 and currently seven mos into my two year treatment plan of lupron + xtandi. If there are others who have experienced both i would love to here from you. My best wishes to everyone on this roller-coaster ride.