What is buserelin (Suprefact®)?

Buserelin is a hormonal therapy drug. It is also called Suprefact®. It is used to treat advanced prostate cancer.

It is best to read this information with our general information about hormonal therapy and the type of cancer you have.

Your cancer team will talk to you about this treatment and its possible side effects before you agree (consent) to have treatment.

More information about this treatment

This information is correct at time of publishing. But sometimes the types of cancer this treatment is used for, or treatment side effects, may change between revision dates.

You can talk to your cancer team if you want more detailed information about this treatment. Or visit the electronic Medicines Compendium (eMC) website, which has patient information leaflets (PIL) for individual drugs.

How buserelin works

Hormones are chemicals that our bodies make. They act as messengers and help control how cells and organs work. Hormonal therapy drugs change how hormones are made or work in the body.

Most prostate cancers need the hormone testosterone to grow. Almost all testosterone is made by the testicles. Buserelin stops the testicles from making testosterone. This reduces testosterone levels and may shrink the prostate cancer or stop it growing.

How buserelin is given

You have buserelin as a combination of injections and nasal sprays.

During your treatment, you will meet someone from your cancer team, such as a:

  • cancer doctor
  • specialist nurse
  • specialist pharmacist.

This is who we mean when we mention doctor, nurse or pharmacist in this information.

You will have regular blood tests to check the level of testosterone in your blood. You may also have blood tests to check:

  • the number of blood cells in your blood
  • how well your liver and kidneys are working
  • your general health.

You may have buserelin with other cancer drugs. Your cancer team will discuss your treatment plan with you.

They may give you other medicines to take home. Take all your medicines exactly as they tell you to. Do not stop taking any of your medicines unless your doctor tells you to.

Buserelin injection

For the first 7 days, buserelin is given as an injection under the skin (subcutaneously). You have the injections 3 times each day, usually about 8 hours apart.

The injection can be given by your GP, practice nurse or at your local hospital. You may be shown how to give yourself the injection.

The skin in the area that was injected may become:

  • painful
  • swollen
  • red, if you have white skin
  • darker, if you have black or brown skin.

If this happens, let your doctor know. Painkillers may help.

If you are taking any medicines to thin your blood, tell your doctor or nurse. This may increase your bruising.

Buserelin nasal spray

From day 8, you take buserelin as a spray into your nostrils (nasal spray). You use the spray 6 times a day.  Your doctor, nurse or pharmacist will explain how to use the spray and when you should take it.

Here are some important things to remember:

  • Avoid using nasal decongestants for 30 minutes before and after using the nasal spray.
  • If you forget to take your buserelin spray, take it as soon as you remember it. But if is nearly time for the next dose, skip the missed dose. Take your next dose at the normal time. Do not take a double dose to make up for the forgotten dose.
  • Keep buserelin in a safe place, where children cannot see or reach them.
  • Get a new prescription before you run out, and make sure you have plenty for holidays.
  • Do not throw away unused buserelin. Return it to a pharmacy.

Your cancer team may also give you other medicines to take home. Take all your medicines exactly as they tell you to. Do not stop taking any of your medicines unless your doctor tells you to.

About side effects

We explain the most common side effects of this treatment here. We also include some that are less common.

You may get some of the side effects we mention, but you are unlikely to get all of them. And you may have some side effects, including rarer ones, that we have not listed here. 

Other cancer treatments may cause different side effects. If you are also having other cancer treatment, you may have other side effects.

When you have this treatment, you will have regular appointments with a doctor, nurse or pharmacist. Always tell them about any side effects you have. They can give you: 

  • drugs to help control most side effects 
  • advice about managing side effects. 

Most side effects can be managed. But sometimes side effects are harder to control. It is important not to stop taking hormonal therapy without telling your doctor. If side effects cannot be managed, your doctor may suggest a different type of hormonal therapy.

Serious and life-threatening side effects

Some cancer treatments can cause serious side effects. Sometimes, these may be life-threatening. Your doctor, nurse or pharmacist can explain the risk of these side effects to you.

Contact the hospital

Your doctor, nurse or pharmacist will give you 24-hour contact numbers for the hospital. If you feel unwell or need advice, you can call at any time of the day or night. Save these numbers in your phone or keep them somewhere safe.

Common side effects

Tumour flare

When you start taking this treatment your testosterone levels may go up for a very short time. This could cause any symptoms to get temporarily worse. This is sometimes called tumour flare. To prevent this, your doctor gives you another tablet to take before you start and for the first few weeks of treatment. Your doctor, nurse or pharmacist will explain more about this.

Weight changes

You may gain or lose weight when you are having this treatment. Eating healthily and being active can help you keep to a healthy weight. Your doctor, nurse or dietitian can give you more advice.

Hot flushes and sweats

Hot flushes are a common side effect of this treatment. During a flush, your neck and face may feel warm. If you have white skin, your skin may look red. If you have black or brown skin, your skin colour may deepen. Flushes can last up to 5 minutes. You might also have sweats or feel anxious or irritable during a flush. 

Here are some things you can do to reduce the effects of hot flushes:

  • Wear natural fabrics, such as cotton.
  • Wear layers so you can remove clothes as needed. 
  • Use cotton sheets and layers of bedding you can remove. 
  • Try cooling pads or pillows to keep you cool.
  • Keep rooms cool or use a fan.
  • Have cold drinks and avoid caffeine and alcohol. 

You might have fewer hot flushes as your body adjusts to this treatment. You could try therapies to help you cope with hot flushes, such as:

  • talking therapies like cognitive behaviour therapy (CBT)
  • controlled breathing exercises
  • yoga
  • acupuncture. 

If they do not improve, talk to your doctor. Certain drugs can help to improve hot flushes. 

Flushes usually stop a few months after treatment ends. But some people continue to have them.

Feeling tired (fatigue)

Feeling tired is a common side effect. Try to pace yourself and plan your day so you have time to rest between activities.

Being physically active can help to manage tiredness and give you more energy. It also:

  • helps you sleep better
  • reduces stress
  • improves your bone health.

If you feel sleepy, do not drive or operate machinery.

Mood changes

You may feel low or depressed, or have mood swings, during this treatment. Talking to family and friends about how you feel might help. If mood changes last for more than a few weeks, tell your doctor, nurse or pharmacist. They can talk to you about different ways to manage low mood or depression.

Muscle or joint pain

You may get pain in your muscles or joints. If this happens, tell your doctor or nurse. They can give you advice and painkillers or other drugs to help. Being physically active and keeping to a healthy weight may help with the pain. It can keep your joints flexible and reduce stress on them. If the pain does not get better, tell your doctor or nurse. They may talk to you about changing to a different hormonal drug.

Sexual effects

It is common to lose your sex drive and have erection difficulties with hormonal therapy. Hormonal therapy may also make your penis shorter and your testicles smaller. 

Your doctor can prescribe drugs and treatments to help with erection difficulties. These will not increase your sex drive. But they might work, even with a low sex drive. 

Things can improve a few months after you stop taking the drug. But it depends on how long you take hormonal therapy, and what other treatments you have had. Some people continue to have problems after treatment ends.

Nasal problems

The nasal spray may cause temporary irritation to the lining of your nose. Some people have nosebleeds or notice changes in their sense of smell. If you notice any of these symptoms, tell your doctor, nurse or pharmacist.

Feeling sick and tummy pain

Buserelin can make you feel sick (nauseous) or give you abdominal (tummy) pain. This is usually mild. If it does not improve, your doctor can give you anti-sickness medicines to help.

Constipation

This treatment can cause constipation. Constipation means that you are not able to pass stools (poo) as often as you normally do. It can become difficult or painful. Here are some tips that may help:

  • Drink at least 2 litres (3½ pints) of fluids each day.
  • Eat high-fibre foods, such as fruit, vegetables and wholemeal bread.
  • Do regular gentle exercise, like going for short walks.

If you have constipation, contact the hospital on the 24-hour number for advice. They can give you drugs called laxatives to help. 

If you have not been able to pass stools for over 2 days and are being sick, contact the 24-hour number straight away. 

Diarrhoea

This treatment may cause diarrhoea. Diarrhoea means passing more stools (poo) than is normal for you, or having watery or loose stools. You may also have stomach cramps. If you have a stoma, it may be more active than usual. 

If you are passing loose stools 3 or more times a day and this is not normal for you, contact the hospital as soon as possible on the 24-hour number. Follow the advice they give you about:

  • taking anti-diarrhoea medicines 
  • drinking enough fluids to keep you hydrated and to replace lost salts and minerals
  • any changes to your diet that might help. 

They might also ask you for a specimen of your stool to check for infection.

Skin changes

This treatment can affect your skin. It may cause a rash, which may be itchy. Your doctor or nurse can tell you what to expect. If your skin feels dry, try using soap-free cleansers and unperfumed moisturising cream every day. 

Always tell your doctor or nurse about any skin changes. They can give you advice and may prescribe creams or medicines to help. Changes to your skin usually improve when treatment ends.

Hair and nail changes

Your hair may become thinner when you are taking this treatment. This is usually mild. Some people notice more hair growth. Ask your nurse for advice if you are worried about this. 

You may also notice your nails break more easily. It might be helpful to wear gloves when washing up or cleaning to protect your skin and nails.

Bone thinning (osteoporosis)

Taking this treatment for several months or more can increase the risk of bone thinning. This is called osteoporosis. It can make you more likely to get a broken bone (fracture). 

You may have bone density scans to check your bone health before and during treatment. These scans can diagnose osteoporosis or osteopenia (low bone density) so that it can be monitored. If your scan shows osteoporosis, your doctor usually prescribes:

  • drugs to protect your bones called bisphosphonates
  • calcium and vitamin D supplements. 

Regular exercise where you support your body weight, like walking, running and dancing, can help look after your bones. This is called weight-bearing exercise. Other types of strength exercises are also helpful. If you have any bone thinning or the cancer is affecting your bones, get advice from your cancer team first. 

Eating a healthy diet and not smoking also helps take care of your bones.

Breast swelling or tenderness

This treatment may cause swelling and tenderness of your breast tissue. This is called gynaecomastia. To prevent this, some people have 1 or more low-dose radiotherapy treatments to the chest before treatment starts. Another type of hormonal drug might be used to treat the breast swelling. Your doctor can give you more advice.

Effects on the nervous system

Buserelin can affect the nervous system. Occasionally, buserelin can cause dizziness, drowsiness, or sleep problems. If you feel like this, do not drive or operate machinery.

You may have pins and needles or feel tingling in your arms and legs. These symptoms are usually mild. If you notice any of these symptoms, tell your doctor or nurse straight away.

Fluid build-up

Sometimes fluid can build up in your face, hands and feet. This can cause swelling. This is known as oedema. If you have any swelling, tell your doctor or nurse. If your ankles and legs swell, it can help to put your legs up on a foot stool or cushion.

Memory and concentration

You may notice changes in your memory. You may also find it harder to concentrate. 

To help you remember things, try using: 

  • reminder alarms or notes on your phone 
  • a diary, calendar or phone app 
  • a notebook you carry with you.

Eye changes

Occasionally, this treatment causes dry eyes, blurry vision, or a feeling of pressure behind the eyes. If you notice this, tell your doctor or nurse. They may suggest treatments to help. If your vision is affected, do not drive or operate machinery.

Headaches

This treatment may cause headaches. If you have headaches, tell your doctor, nurse or pharmacist. They can give you advice about painkillers that may help. Tell them if the headache does not get better, or gets worse.

Anaemia (low number of red blood cells)

This treatment can reduce the number of red blood cells in your blood. Red blood cells carry oxygen around the body. If the number of red blood cells is low, this is called anaemia. You may feel:

  • very low in energy
  • breathless 
  • dizzy and light-headed. 

If you have these symptoms, contact the hospital straight away on the 24-hour number. You may need treatment for anaemia. If you are very anaemic, you may need a drip to give you extra red blood cells. This is called a blood transfusion.

Effects on the liver

This treatment may affect how your liver works. This is usually mild. You will have blood tests to check how well your liver is working.

Less common side effects

Allergic reaction

This treatment might cause an allergic reaction. But this is not common. Signs of a reaction can include: 

  • a skin rash or itching
  • feeling breathless or wheezy
  • swelling of your face, mouth or throat.

If you feel unwell or have any of these signs, contact the hospital straight away on the 24-hour number. Do not take any more of this treatment until you have checked with them.

Effects on the heart

This treatment might increase certain risk factors for heart problems. Tell your doctor if you have:

  • had any problems with your heart
  • high blood pressure
  • high levels of cholesterol – a fatty substance in your blood. 

They can monitor or treat these if needed. Talk to your doctor if you are worried about this. 

Things you can do to take care of your heart include:

  • not smoking
  • maintaining a healthy weight 
  • being physically active.

Raised blood sugar levels

This treatment can raise your blood sugar levels and increase the risk of diabetes. 

Signs of raised blood sugar include:

  • feeling thirsty
  • needing to pass urine (pee) more often than usual
  • feeling more tired than usual. 

Tell your doctor or nurse if you have these symptoms. They can do tests to check your blood sugar level and give you advice.

If you already have diabetes, your blood sugars may be higher than usual. You may need to check them more often, or make changes to your diabetic treatment. Your diabetic doctor or nurse will talk to you about how to manage this.

Hearing changes

Rarely, this treatment can cause ringing in the ears (tinnitus). Tell your doctor or nurse if you notice this.

Other important information

Blood clot risk

Cancer and some cancer treatments can increase the risk of a blood clot. Contact the hospital straight away on the 24-hour number if you have any of these symptoms during or after treatment:

  • throbbing pain or swelling in a leg or arm
  • reddening of the skin in the area – if you have black or brown skin, this can be harder to notice, but the skin might become darker
  • suddenly feeling breathless or coughing.

Always call 999 if you have:

  • chest pain
  • difficulty breathing.

A blood clot is serious, but it can be treated with drugs called anticoagulants. These thin the blood. Your doctor, nurse or pharmacist can give you more information about preventing and treating blood clots.

Fertility

Some cancer drugs can affect whether you can get pregnant or make someone pregnant. If you are worried about this, it is important to talk with your doctor before you start treatment.

Contraception

Your doctor, nurse or pharmacist will advise you not to make someone pregnant while having this treatment. The drug may harm the developing baby. It is important to use effective contraception during treatment and for a while after it finishes.

Other medicines

Some medicines can affect how this treatment works or be harmful while you are having it. Always tell your cancer doctor, nurse or pharmacist about any drugs you are taking or planning to take, such as: 

Medical and dental treatment

If you need medical treatment for any reason other than cancer, always tell the healthcare professional that you are having cancer treatment. Give them the contact details for your cancer doctor or cancer team so they can ask for advice.

If you have appointments with a dentist, always tell them you are having cancer treatment. Talk to your cancer team before you have any dental treatment.

About our information

  • Reviewers

    This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert health professionals and people living with cancer.

    Our cancer information has been awarded the PIF TICK. Created by the Patient Information Forum, this quality mark shows we meet PIF’s 10 criteria for trustworthy health information.

The language we use

We want everyone affected by cancer to feel our information is written for them.

We want our information to be as clear as possible. To do this, we try to:

  • use plain English
  • explain medical words
  • use short sentences
  • use illustrations to explain text
  • structure the information clearly
  • make sure important points are clear.

We use gender-inclusive language and talk to our readers as ‘you’ so that everyone feels included. Where clinically necessary we use the terms ‘men’ and ‘women’ or ‘male’ and ‘female’. For example, we do so when talking about parts of the body or mentioning statistics or research about who is affected.

You can read more about how we produce our information here.

About our information

This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer.

Date reviewed

Reviewed: 01 September 2024
|
Next review: 01 September 2026
Trusted Information Creator - Patient Information Forum
Trusted Information Creator - Patient Information Forum

Our cancer information meets the PIF TICK quality mark.

This means it is easy to use, up-to-date and based on the latest evidence. Learn more about how we produce our information.

The language we use


We want everyone affected by cancer to feel our information is written for them.


We want our information to be as clear as possible. To do this, we try to:

  • use plain English
  • explain medical words
  • use short sentences
  • use illustrations to explain text
  • structure the information clearly
  • make sure important points are clear.

We use gender-inclusive language and talk to our readers as ‘you’ so that everyone feels included. Where clinically necessary we use the terms ‘men’ and ‘women’ or ‘male’ and ‘female’. For example, we do so when talking about parts of the body or mentioning statistics or research about who is affected.


You can read more about how we produce our information here.