Common adverse reactions include hormonal sequelae, while rare events involve metabolic and vascular complications.

Clinical and Postmarketing Safety Profile

Frequent adverse reactions (>10% incidence) include hot flashes (64%), sexual dysfunction, and urinary symptoms. Tumor flare manifests as transient pain or disease progression. Radiation combination therapy increases gastrointestinal/bladder toxicity (e.g., rectal bleeding, cystitis). Postmarketing reports note osteoporosis, hypercalcemia, pituitary apoplexy (presenting as sudden headache or vision changes), and psychiatric disorders. Rare cardiovascular events (angina, stroke) and injection-related hemorrhage underscore the need for monitoring. Laboratory anomalies include reversible liver enzyme elevations and lipid changes. Hypersensitivity and QT prolongation are clinically significant but uncommon. Long-term androgen suppression may necessitate bone density management via bisphosphonates.