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How CPP Starts

Puberty, whether it starts early or at the expected time, starts in the brain. The hypothalamus, a part of the brain, sends a signal to the pituitary gland. This signal—called a gonadotropin releasing hormone, or GnRH, for short—tells the pituitary to release larger amounts of hormones called gonadotropins. Gonadotropins go straight to the ovaries or to the testicles, where they tell the body to produce the sex hormones estrogen (for girls) or testosterone (for boys). This marks the start of puberty.

Modern treatments for CPP are designed to tell the pituitary to ignore the GnRH signal. This ultimately decreases the production of sex steroids.

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Indication

SUPPRELIN® LA (histrelin acetate) implant is used for the treatment of children with central precocious puberty (CPP).

Important Safety Information

SUPPRELIN LA should not be used by women who are or may become pregnant, and in patients who are allergic to gonadotropin releasing hormone (GnRH) or GnRH agonist analogs. Safety and effectiveness in children under 2 years of age has not been determined.

SUPPRELIN LA, like other GnRH agonists, may cause a temporary increase in the blood levels of specific hormones associated with the onset of puberty (estrogen in girls and testosterone in both sexes) during the first week of treatment. This increase may temporarily worsen puberty symptoms during the first week, additionally, you may see new symptoms appear during this period. Within the 4 weeks of treatment with SUPPRELIN LA, hormonal suppression generally occurs and the physical signs of puberty should decrease.

Your doctor should monitor the levels of specific hormones associated with puberty progression, 1 month after starting SUPPRELIN LA and then every 6 months thereafter. Every 6-12 months, height and bone age should be also monitored by your doctor.

During the clinical trial testing of SUPPRELIN LA, the most common side effects involved the implant site and included temporary bruising, pain, soreness, redness of the skin and swelling.

Please talk with your doctor for more information or if you have any questions.

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SUPPRELIN® LA is a registered trademark of Endo Pharmaceuticals.
SP-1007/June 2009

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