Pros and cons from changing from Degeralix to Orgovyx

Posted by cheriekhan @cheriekhan, 3 days ago

My husband after his loading dose of degeralix with no side effects is thinking about changing to Orgovyx for the less heart issues, time of T after he stops ADT. Since he is supposed to be on ADT and Zytiga for 18 months. And the current medication is suiting him I was wondering what the pros and cons of switching would be? Our insurance surprisingly is covering the Orgovyx in full so both meds will
Not cost us out of pocket. TIA for your comments.

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I switched to Orgovyx a couple of months ago, and it made a huge difference for me. The chronic side-effects are the same (hot flushes, reduced libido, etc), but not having the acute symptoms after each monthly Degarelix injection (swelling, rash, and 2-3 days of flu-like symptoms) has been a game-changer.

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Is the joint and bone pain more severe in Orgovyx?

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@cheriekhan

Is the joint and bone pain more severe in Orgovyx?

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It's hard for me to know, because I took severe nerve damage from my metastasised spinal lesion (I was paraplegic for months), so I don't have complete sensation below my ribs, and when I do feel pain, I don't know if it's from the meds or just neuropathy.

That said, any chronic symptoms you get all month or Firmagon I'd expect you to get on Orgovyx as well, since they work the same way. It's just the acute reaction to the monthly injection that you get to avoid.

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I can't speak to the pros and cons of switching from Degarelix to Orgovyx...but...when I went back on treatment in April 23 after PSA increases and a PSMA PET showed a single PLN my radiation oncologist and oncologist both agreed to my request to do Orgovyx vice Lupron in conjunction with SBRT. I was 67 at the time, no more than the usual cardiovascular symptoms issues for that age but I did have Afib, had to do a cardio conversion and when the medications couldn't get rhythm or rate under control, cardio ablation.

So, given that CV history, Orgovyx was a no brainer. That and the other demonstrated advantages - faster and higher sustained castration, faster recovery of T when stopping...the side effects pretty much the same, fatigue, muscle and joint stiffness, hot flashes, genitalia shrinkage, no loss of libido though. Were they less severe than when I did 18 months of Lupron, yes but that's a qualitative judgement.

Like when I was on Lupron, the side effects did not interfere with living, I still went to the gym, rode my bike, did the lawn and garden work, went on vacations, went to concerts...

As others have alluded, the key to mitigating the side effects are likely:

Diet
Exercise
Managing stress.

Those are things he controls...

Kevin

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