The following is an excerpt from millican 03-27-03 congressional testimony:

The following incomplete list of off-label uses of lupron/leuprolide is an excerpt from within Millican‟s 03-27-03 Congressional Testimony: ------------ “GnRH and its analogs have led to exciting new avenues of therapy in virtually every subspecialty of internal medicine as well as in gynecology, pediatrics, and urology . virtually every subspecialty of medicine will be touched by the GnRH analogues .” (Conn, Crowley;; 1994). The following is a fairly comprehensive, alphabetical list of clinical uses, case reports, or studies involving Lupron‟s use in unapproved and off-label indications. These uses were mostly found within published medical literature, although some were noted within patents, or advertisements for clinical trials, and one was a personal clinical observation. Citations have been omitted for brevity, but are available upon request. A: adjuncts for IVF; adjunct to fibroid surgery; anovulation; autism [management of sexual behaviors]; acute intermittent porphyria; Alzheimer; adenomyosis; severe adenomyosis; adhesions; amenorrhea [functional]; angiomyxoma of vulva; autoimmune disease; autonomic neuropathies; „add-back‟ regimen [estrogen/progestin with lupron]; advanced breast cancer. B: before hysterectomy for leiomyomas; benign prostatic hyperplasia; benign prostatic hypertrophy; birth control; breast cancer; breast cancer prevention; bioavailability following nasal and inhalation delivery to healthy humans. C: catamenial insulin reaction; catamenial pneumothorax; chronic intestinal pseudo obstruction [in patient with heart-lung transplant]; cluster headaches; colorectal cancer, congenital adrenal hyperplasia with oligomenorrhea; contraception; cryptorchidism; controlled ovarian hyperstimulation in normal, abnormal and poor responders; combination therapy with flutamide and castration; colonic endometriosis; comparison of suppressive capacity of different GnRHa‟s in women; comparison of hCG versus lupron for releasing oocytes. D: dysfunctional uterine bleeding prior to hysterectomy, dyspepsia. egg donation; endometrial ablation; endometrial cancer, endometrial glandular hyperplasia; endometrial hyperplasia without atypia; endometrial cancer; endometrial stromal sarcoma; epithelial ovarian cancer; exhibitionism; effect of very high dose in prostate cancer; effects in animal and man; effect on embryos (”accelerated development”); endometrial preparation for transfer of frozen-thawed pre-embryos in patients with anovulatory or irregular cycles; effects on follicular fluid hormone composition at oocyte retrieval for IVF; effect on hair growth and hormone levels in hirsute women; effects on glucose metabolism in a diabetic patient; equivalency of hMG and FSH stimulation following suppression; effect on LH surge ; effect on adrenocorticotropin and cortisol secretion in premenopausal women; effect on seminal vesicles; effects of lupron on luteal-phase hyperprolactinemia during ovarian stimulation. F: fallopian tube obstruction; functional ovarian hyperandrogenism, functional abdominal pain from functional bowel disease; fibrocystic breast disease; first cycles of IVF/GIFT; follicular development and oocyte maturation. G: Headache, Huntington‟s Disease (for exhibitionism), hyperandrogenism, hysteroscopic surgery; hilus cell hyperplasia within ovarian cyst wall; hypermenorrhea in premenopausal women with acute leukemia; hypermenorrhea with severe thrombocytopenia; hypogonadotrophic hypogonadism; hypergonadotropic hypogonadism; hypergonadotropic amenorrhea; hypothalamic-pituitary axis disease; hypothalamic hamartomas and sexual precocity; hirsutism; moderate and severe hirsutism; hysteroscopic surgery; benign symptomatic hyperandrogenism in a postmenopausal woman; hidradenitis suppurativa. I: infertility; IUI; IVF; IVF-ET in insulin-dependent diabetics; irritable bowel syndrome; intravenous leiomyomatosis with cardiac extension; intranasal lupron for endometriosis; intranasal/sc lupron for fibroids. K: leuprolide flare regime for IVF/GIFT & embryo cryopreservation; lupron screening test for IVF; luteal phase lupron flare protocol; luteinized unruptured follicle syndrome; leiomyosarcoma; leiomyomatosis peritonealis disseminata. M: male contraception; *male* factor infertility (female is treated - male is not); Meniere‟s Disease; menstrual migraines; motility disorders. O: ovarian cysts; ovarian cysts after ovarian transposition; ovarian epithelial tumors; ovarian granulosa cell tumor; ovarian hyperthecosis; advanced epithelial ovarian carcinoma; ovulation induction; ovarian stimulation; ovarian stimulation with lupron and norethindrone in IVF/GIFT; ovarian hyperstimulation; oocyte release; ovarian hyperstimulation syndrome; severe ovarian hyperstimulation; oocyte donation, oocyte donation [post-menopausal]; operable breast cancer; ovarian carcinoma [refractory]; ovarian remnant syndrome [diagnostic]. pancreatic cancer; paraphilias; Parkinson‟s Disease symptoms, pedophilia, pelvic pain not associated with endometriosis; pituitary metastatic mass; polycystic ovarian disease; PMS; protection against chemotherapy-induced testicular damage; postpartum depression; premenopausal breast cancer; post-menopausal breast cancer [advanced]; pre-implantation [embryonic] diagnosis; prevention of hypermenorrhea in premenopausal women undergoing bone marrow transplantation; prostate cancer (Stage C adenocarcinoma]; endometroid adenocarcinoma of prostate; pseudo intestinal blockage, psychosis in PMS, resistant paraphilia, pulmonary endometriosis; pulmonary tuberous sclerosis; pulmonary delivery of leuprolide in health male volunteers; pre-myomectomy; poor prognosis patients for IVF/poor responders ; preservation of fertility in a woman with menorrhagia; pharmacokinetic studies in humans [iv and sc]; preoperative treatment of complicated myomata; pre-surgical treatment of fibroids. R: resectoscopic endometrial ablation; rectal endometriosis; routine pituitary suppression before ovarian stimulation. S: sexual offenders; sexual precocity; Sickle-cell anemia associated priapism; surrogacy, SUZI; steroid-cell tumor (advanced); systemic lupus erythematosus; submucous myomas; sexual behavior disorders; syndrome of familial virilization, insulin resistance, and acanthosis nigricans; stimulation test in Tourette‟s syndrome; small cell carcinoma of prostate. T: transgender adjunct, testicular function effects; transdermal vs. subcutaneous leuprolide - a comparison; triggering follicular maturation. U: urinary retention in prostate cancer; ureteral obstruction caused by endometriosis; urinary retention due to benign prostatic hyperplasia. W: with or without medroxyprogesterone in treatment of fibroids.



PAGE 54 / MAY 25, 2008 S C R I P T D O C T O R : M E D I C I N E I N T H E M E D I A Dateline Nigeria (Part 3): Creating Solutions When Despite Public Service Announcements, Ads, & Documentaries, Many Women Were Still Not Seeking Life-Saving Treatment that was created aftera well-meaning health Andrew Holtz, MPH, is a “S ànnu.” former CNN Medical Corresponden

loss. A spinal tap yielded an opening pressure of 17 cm Intracranial Pressure Returns to Normal H2O. Acetazolamide treatment was discontinued and fol- About a Month After Stopping low-up examinations showed eventual resolution of the Tetracycline Antibiotics Case 2 . An 18-year-old woman received minocyclinefor 2 months. This was stopped when she developed head- T etracyclineantib

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