Triptorelin Reconstitution Calculator

Triptorelin is a synthetic GnRH (gonadotropin-releasing hormone) agonist: it initially stimulates ("flare") then, with continuous depot exposure over roughly 2–4 weeks, suppresses pituitary LH/FSH release and gonadal steroid production (mechanistic). An intramuscular depot delivery system was approved in the US in 2008. Core indications are central precocious puberty (CPP), advanced prostate cancer, and endometriosis, plus ovarian stimulation in assisted reproduction (RCT/observational). Off-label use for gender-affirming testosterone suppression is documented, e.g., combined with estradiol in a transgender woman.

Depot dosing is fixed, not weight-based, and varies by indication (RCT/observational):

12-weekly and 24-weekly regimens give equivalent HPG-axis suppression and height velocity; the 6-monthly 22.5 mg depot suppressed LH in 100% of girls through 36 months; pamoate and acetate salts perform similarly. Pediatric PK modeling found ~1.7–2× higher exposure in lighter children (20–30 kg), judged clinically irrelevant given the wide therapeutic plateau.

Depot microsphere and pamoate formulations are given IM (practitioner consensus). For the 100 mcg diagnostic stimulation test, an RCT showed IM and SC were equivalent: peak LH at 30 minutes in both, diagnosis confirmed within 30 minutes in 96.7% (IM) vs 96.8% (SC). With SC testing, serial sampling to 120 minutes is used and a peak LH ≥6 IU/L provides 89% sensitivity / 91% specificity for CPP.

In a prostate cancer RCT, triptorelin pamoate 3.75 mg reached castrate testosterone (<1.735 nmol/L) more slowly than leuprolide 7.5 mg on day 29 (91.2% vs 99.3%) but was equivalent from day 57 onward, and 9-month survival significantly favored triptorelin (97.0% vs 90.5%). In CPP, 3-monthly triptorelin pamoate matched leuprolide acetate for LH suppression and predicted adult height (observational). In PCOS IVF, a network meta-analysis ranked leuprorelin higher for clinical pregnancy/live birth; for OHSS reduction, triptorelin ranked lowest (15.7%), below leuprorelin (21.2%), while cetrorelix ranked highest and is recommended for high-OHSS-risk patients.

Chronic use produces expected sex-steroid suppression effects: hot flushes, reduced libido, and menstrual changes (mechanistic/practitioner consensus). Injection-site sterile abscesses occurred in 0.68% (2/290) of treated children; topical hydrocortisone butyrate 0.1% for 5 days post-injection resolved lesions without discontinuing therapy (case series). Anaphylaxis can occur at the first injection, likely from a formulation excipient (polysorbate 80) rather than the peptide (case report). In pubertal rats, females gained body weight with delayed hyperphagia while males gained less weight and moved more, with sex-specific hypothalamic gene changes (animal). CPP girls on treatment matched age-matched controls on cognitive/psychosocial testing, with higher emotional reactivity on one task.

CPP: treatment runs for years, efficacy data extend to 36 months with a mean predicted adult height gain of 5.4 cm (range up to 18 cm). Prostate cancer: continuous until progression; 96% of men reached a testosterone nadir <0.35 nmol/L (10 ng/dL), and a lower nadir predicted better overall and disease-specific survival. Endometriosis: courses are typically 3–6 months; a 3 mg depot resolved pulmonary endometriosis within a 6-month course (case report). In IVF, triptorelin exposure is per-cycle only.

Yes, within assisted reproduction: 0.2 mg triptorelin is a standard final oocyte maturation trigger. In women with diminished ovarian reserve, a dual trigger (triptorelin 0.2 mg + HCG 10,000 IU) significantly increased total oocytes, mature (MII) oocytes, good-quality embryos, and implantation versus HCG alone (RCT). In good-prognosis elective fertility preservation, adding HCG to the triptorelin trigger added no benefit over triptorelin 0.2 mg alone, with zero OHSS in either arm (RCT). Agonist-only triggering is the preferred strategy for OHSS risk reduction. Direct exposure during an established pregnancy is not described in the published literature; within these protocols triptorelin is administered only pre-conception (practitioner consensus).