WHAT TO EXPECT FROM YOUR TREATMENT



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WHAT TO EXPECT FROM YOUR TREATMENT FIRMAGON is a prescription medicine used in the treatment of advanced prostate cancer.

INTRODUCTION This brochure will help prepare you for your FIRMAGON (degarelix for injection) treatment Your healthcare provider prescribed FIRMAGON for your advanced prostate cancer. Prostate cancer is cancer of the prostate gland that develops when cells of the prostate show uncontrolled growth. The growth and function of the prostate depend on testosterone, a male sex hormone that is made in the testicles. High levels of testosterone may help fuel prostate cell growth. Androgen deprivation therapy (ADT) is used to lower levels of hormones, like testosterone. FIRMAGON is a medication used in ADT. In clinical studies, FIRMAGON has been shown to lower testosterone levels. Outside support is available This brochure also includes a Resources section which lists professional organizations dedicated to providing men with prostate cancer with information, tools, and support. 3

WHAT IS FIRMAGON (degarelix for injection)? FIRMAGON, is a gonadotropin-releasing hormone (GnRH) receptor blocker, or antagonist, used in ADT. FIRMAGON is the only GnRH antagonist available in the United States for the treatment of advanced prostate cancer. LOW TESTOSTERONE LEVELS: A GOAL OF THERAPY In a clinical study, FIRMAGON began to drive down testosterone on Day 1. Leuprolide raised testosterone before lowering it. FIRMAGON has been shown to quickly lower testosterone levels by blocking the release of hormones that control testosterone production. FIRMAGON is able to decrease testosterone without the initial testosterone increase that is found with other medications used in ADT. Agonists, like leuprolide, are another type of medication used in ADT that works differently than FIRMAGON, by triggering the GnRH receptor. The result is that leuprolide, and therapies like it, initially increase testosterone levels before lowering them. In a clinical study of FIRMAGON versus leuprolide, FIRMAGON was shown to quickly lower testosterone levels from Day 1, whereas leuprolide caused testosterone levels to initially increase before they decreased. DAY 1 RESULTS* WITH FIRMAGON VERSUS LEUPROLIDE Average % change in testosterone levels 100 50 0-50 -100 GOAL testosterone reduction Agonist Leuprolide (n=201) Antagonist FIRMAGON (n=207) * By 28 days of treatment, both therapies lowered testosterone to the levels needed for the treatments to work. Leuprolide (an agonist) causes testosterone levels to initially increase. 5

WHAT IS THE TREATMENT SCHEDULE FOR FIRMAGON (degarelix for injection)? You will begin treatment with a starting dose of 2 injections (120 mg each) that will quickly begin to suppress testosterone. After Day 1, you will receive 1 injection (80 mg) every 28 days. 1 8 2 9 10 CALENDAR 3 4 5 6 7 11 12 13 14 After each injection, always set up an appointment for your next injection Talk to your healthcare provider about how to get your next dose HOW SHOULD I RECEIVE FIRMAGON? FIRMAGON is given as a monthly, deep, subcutaneous (below the skin) injection into your abdomen. The injections will be given by your healthcare provider at an office, hospital, or clinic. Make sure that your injection site is free of any pressure from belts, waistbands, or other types of clothing. The location of the injection site should vary periodically. 15 22 29 16 23 30 17 24 31 18 25 19 26 20 21 27 28 DON T MISS AN INJECTION THINGS MAY COME UP THAT CAUSE YOU TO MISS AN APPOINTMENT. TALK TO YOUR HEALTHCARE PROVIDER ABOUT HOW TO GET YOUR NEXT DOSE. 7

WHAT SIDE EFFECTS MIGHT I EXPERIENCE WITH FIRMAGON (degarelix for injection)? The common side effects of FIRMAGON include: Hot flashes Injection site pain, redness, and swelling (especially with the first dose) Increase in some liver enzymes Back and joint pain Urinary tract infection Tiredness Weight gain Hypertension Chills Decreased sex drive and trouble with erectile dysfunction (impotence) Talk to your healthcare provider if you have any side effects that bother you or that do not go away. You may report side effects to the FDA at 1-800-FDA-1088. WHAT SIDE EFFECTS MIGHT I EXPERIENCE AROUND THE INJECTION AREA? The injection affects people differently. You may experience some pain both during and after the injection. Injection site reactions may get better with each injection Reactions are typically mild to moderate and decrease within 3 days after you receive your dose. Some side effects you may experience at the injection site include: Temporary redness Swelling and/or a lump under the skin Slight pain -This lump is a depot that forms after the injection to supply your body with a continuous release of FIRMAGON over time Further details about these and other potential side effects can be found in the full prescribing information. USE THE TREATMENT PLAN WORKBOOK FOUND IN YOUR STARTER KIT TO KEEP TRACK OF YOUR HEALTH AND SHARE IMPORTANT INFORMATION WITH ALL MEMBERS OF YOUR HEALTHCARE TEAM. 9

HOW SHOULD I TAKE CARE OF THE INJECTION SITE? There are 3 simple steps to taking care of the injection site: Keep the injection site clean Wear comfortable, loose-fitting clothing Avoid rubbing or squeezing the area Tip: Make sure that belts or waistbands do not rub against the injection site. Talk to your healthcare provider to avoid receiving an injection at or near areas where adverse skin reactions occurred in the past. If you would like more information about injection site reactions, talk to your healthcare provider. WHAT SHOULD I TELL MY DOCTOR BEFORE RECEIVING FIRMAGON (degarelix for injection)? It is important to tell your healthcare team about all of your medicines (prescription and over-thecounter) and medical conditions, including if you have any problems with your: Heart Kidney Liver Balance of body salts You should not be given FIRMAGON if: You are allergic to any of the ingredients in FIRMAGON (be sure to tell your healthcare team everything that you are allergic to) You are a woman who is pregnant or may become pregnant. FIRMAGON can harm an unborn baby when given to a pregnant woman 11

PROSTATE CANCER RESOURCES Patient Advocates for Advanced Cancer Treatments (PAACT) Offers practical, up-to-date information for patients and healthcare professionals on the management of prostate cancer, along with links to more resources. www.paactusa.org 1-616-453-1477 The Prostate Cancer Foundation The leading philanthropic organization funding and accelerating prostate cancer research globally. www.pcf.org 1-800-757-CURE (757-2873) Us TOO International Started by prostate cancer survivors, this organization provides useful information about the diagnosis and treatment of prostate cancer. www.ustoo.org 1-800-80-Us-TOO (808-7866) ZERO Provides support patients need to minimize physical and emotional suffering, and cope effectively throughout their cancer journeys. www.zerocancer.org 1-888-245-9455 FIRMAGON (degarelix for injection) PROMISE SUPPORT SERVICES OFFER A RANGE OF PATIENT SUPPORT SERVICES AVAILABLE AROUND THE CLOCK FOR YOU AND YOUR LOVED ONES. SEE THE BROCHURE IN THIS STARTER KIT FOR MORE INFORMATION. CALL TODAY AT. 13

FIRMAGON (degarelix for injection) is a prescription medicine used in the treatment of advanced prostate cancer. NOTES IMPORTANT SAFETY INFORMATION FIRMAGON should not be given to people who are allergic to any of the ingredients in FIRMAGON. Life-threatening allergic reactions have been reported with drugs in this category. It should not be given to women who are pregnant or may become pregnant. FIRMAGON can harm an unborn baby when given to a pregnant woman. Before receiving FIRMAGON, tell your healthcare provider about all your medical conditions, including if you have any heart problems, problems with balance of your body salts or electrolytes (such as sodium, potassium, calcium, and magnesium), or have kidney or liver problems. The common side effects of FIRMAGON include: hot flashes, injection site pain, redness and swelling (especially with the first dose), weight gain, increase in some liver enzymes, tiredness, hypertension, back and joint pain, chills, urinary tract infection, decreased sex drive, and trouble with erectile dysfunction (impotence). You are encouraged to report negative side effects of prescription drugs to the FDA at 1-800-FDA-1088. Please see accompanying full Prescribing Information. 15

FOR MORE INFORMATION ABOUT ADVANCED PROSTATE CANCER AND FIRMAGON (degarelix for injection) PROMISE SUPPORT SERVICES, VISIT FERRINGPROMISE.COM OR CALL. FIRMAGON is a registered trademark of Ferring B.V. 2014 Ferring B.V. FNPR/1023/2013/USb Printed in U.S.A. January 2014