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LUPRON:  CARDIAC DISORDERS & SUDDEN DEATH
In 1990, Arber and colleagues reported that electrocardiographic changes and peripheral edema are main side-effects of Lupron.(2)
The 1992 "Manual of Drug Interactions for Anesthesiology" states the following cardiovascular side effects for Lupron: "Cardiac arrhythmia, pericardial effussions, congestive heart failure, and a high incidence of occasional pulmonary embolus have been reported." (5) The manual also states that "the use of halogenated anesthetics should be done with caution, after review of cardiac reserve and dysrhythmias." (5)
In July, 1994 the first reported case of a myocardial infarct in a woman while on Lupron was reported by McCoy in the medical literature.(l) McCoy stated that "in counseling patients on the benefits and risks of the use of leuprolide acetate, a strong family history of heart disease may be of significance in advising even female patients of an increased risk of angina or myocardial infarction. "(1) Yet, most women are never told that Lupron can have any effect on cardiac function.
Cardiac disorders have also been reported to the Food and Drug Administration (FDA) for both men and women exposed to Lupron. Problems reported to the FDA specifically for women include myocardial infarct, sudden death, ventricular fibrillations, ECG abnormalities, angina pectoris, myocarditis, chest pain and substernal chest pain, coronary artery disease and cardiovascular disorder.(3) Chest pain is the 14th most common adverse event reported to the FDA for women on Lupron as of 1994. Tachycardia (the rapid beating of the heart), and hypertension (high blood pressure), tied as the 23rd most common adverse event reported to the FDA for women on Lupron as of 1994. Vasodilation (dilation of the blood vessels), was the 2nd most common adverse event reported to the FDA for women as of 1994. In addition, superventricular tachycardia, ventricular tachycardia, tachycardia, bradycardia, AV block SD, AV block comp., bundle branch block, heart arrest, left heart failure, right heart failure, heart failure, congestive heart failure, arrhythmias, ECG changes, atrial fibrillation, extrasystoles, extrasystoles MF, hypertension, hypotension, postural hypotension, myocardial ischemia, cardiomyopathy,
cardiovascular disease, pericardial effusion, angina, murmur, and palpitations have also been reported to the FDA for Lupron.(3)
In 1990, Thompson and colleagues reported 2 cases of sudden death in men who were taking Lupron for prostate cancer.(4) Thompson et al stated that "the 2 sudden deaths during disease flare" with Lupron are "troublesome."(4) Thompson and colleagues stated that "we are unable to determine the total number of patients treated with leuteinizing hormone-releasing hormone agonist therapy [GnRH-a] alone at our institution during this period but an estimate is a total of less than 30."(4) The 2, out of less than 30, patients represent at least 6.9% that died from sudden death. According to Thompson et al, "in both patients the circumstances of death were consistent with cardiovascular etiology."(4) One patient experienced shortness of breath and asystole on day 26 and the other experienced respiratory arrest on day 5. Furthermore, Thompson and colleagues reviewed the literature and found that their two cases were not unique.(4) Sudden death in women has only been reported to the FDA but has not been addressed in the medical literature.(3)
More To Come

(T-
preferences
1.   McCoy M. Angina and Myocardial Infarction with Use of Leuprolide Acetate. Am J of Obstetrics and Gynecology. 1994; 171:1. p.275-276.
2.   Arber N,Fadia RR, Pinkhas J, Shirin H, Melamed E, Sidi Y. Pseudotumor Cerebri Associated with Leuprorelin Acetate. The Lancet. 1990; p.668.
3.   Adverse Reactions Reported to the US Food and Drug Administration as Part of the Spontaneous Reporting System/Division of Epidemiology.
4.   Thompson IM, Zeidman EJ, Rodriguez FR. Sudden Death Due to Disease Flare with
Leutenizing Hormone-Releasing Hormone Agonist Therapy for Carcinoma of the Prostate. The Journal of Urology. 144: December, 1990, p. 1479-1480.
5.   Mueller RA, Lundberg, DBA. Manual of Drug Interactions for Anesthesiology; 2nd Edition; 1992.
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