I started on Firmagon (Degarelix) in 2021 because I was in a precarious situation after my PCa spread rapidly to my spine and paralysed me, and we needed to bring my testosterone down as fast as possible with no initial testosterone flare and minimal extra meds (I was already on a witches brew of steroids, blood thinners, insulin, etc trying to bring down the swelling in my spine, control DVT in my legs, and manage the steroid-induced diabetes).

Firmagon+Erleada (Apalutamide) have been working remarkably well to keep my mCSPC in full remission, but the immediate side effects from each monthly Firmagon shot were tough.

Orgovyxv (Relugolix) is a GnRH receptor antagonist just like Firmagon, but in daily pill form, and costs the same (about CA $325/month, though I haven't had to pay), so I wasn't nervous that I was taking a risk by switching.

Orgovyx seems to have become the standard ADT in the U.S. In Canada, it's still very new (Pfizer just got Health Canada approval less than a year ago), but they've priced it the same as Firmagon, and have a patient-access. programme to cover the cost until it gets added to the provincial formularies.