No

Gonadotropin; Ovulation Stimulator

Sequentially with hCG to induce ovulation and pregnancy in the infertile woman with functional anovulation or in patients who have previously received pituitary suppression; used with hCG in men to stimulate spermatogenesis in those with primary hypogonadotropic hypogonadism

X

Primary ovarian failure, overt thyroid and adrenal dysfunction, abnormal bleeding, pregnancy, men with normal urinary gonadotropin concentrations, elevated gonadotropin levels indicating primary testicular failure

Advise patient of frequency and potential hazards of multiple pregnancy; to minimize the hazard of abnormal ovarian enlargement, use the lowest possible dose

Male:

>10%: Endocrine & metabolic: Gynecomastia

1% to 10%: Erythrocytosis (shortness of breath, dizziness, anorexia, syncope, epistaxis)

Female:

>10%:

Endocrine & metabolic: Ovarian enlargement

Gastrointestinal: Abdominal distention

Local: Pain/rash at injection site

1% to 10%: Ovarian hyperstimulation syndrome

<1%: Thromboembolism, pain, febrile reactions

Symptoms of overdose include ovarian hyperstimulation

Clomiphene may amount of HMG needed to induce ovulation (Gonadorelin, Factrel®) should not be used with drugs that stimulate ovulation

Lyophilized powder may be refrigerated or stored at room temperature; after reconstitution inject immediately, discard any unused portion

Actions occur as a result of both follicle stimulating hormone (FSH) effects and luteinizing hormone (LH) effects; menotropins stimulate the development and maturation of the ovarian follicle (FSH), cause ovulation (LH), and stimulate the development of the corpus luteum (LH); in males it stimulates spermatogenesis (LH)

Elimination: ~10% of dose is excreted in the urine unchanged

Adults: I.M.:

Female: 1 ampul/day (75 units of FSH and LH) for 9-12 days followed by 10,000 units hCG 1 day after the last dose; repeated at least twice at same level before increasing dosage to 2 ampuls (150 units FSH/150 units LH)

Repronex®: I.M., S.C.:

Infertile patients with oligo-anovulation: Initial: 150 int. units daily for the first 5 days of treatment. Adjustments should not be made more frequently than once every 2 days and should not exceed 75-150 int. units per adjustment. Maximum daily dose should not exceed 450 int. units and dosing beyond 12 days is not recommended. If patient's response to Repronex® is appropriate, hCG 5000-10,000 units should be given one day following the last dose of Repronex®.

Assisted reproductive technologies: Initial (in patients who have received GnRH agonist or antagonist pituitary suppression): 225 int. units; adjustments in dose should not be made more frequently than once every 2 days and should not exceed more than 75-50 int. units per adjustment. The maximum daily doses of Repronex® given should not exceed 450 int. units and dosing beyond 12 days is not recommended. Once adequate follicular development is evident, hCG (5000-10,000 units) should be administered to induce final follicular maturation in preparation for oocyte retrieval.

I.M. or S.C. (Repronex® ONLY) administration. The lower abdomen (alternating sides) should be used for subcutaneous administration.

None reported

None reported

No information available to require special precautions

No effects or complications reported

Self injection: Follow prescriber's recommended schedule for injections. Multiple ovulations resulting in multiple pregnancies have been reported. Male infertility and/or breast enlargement may occur. Report pain at injection site; enlarged breasts (male); difficulty breathing; nosebleeds; acute abdominal discomfort; or fever, pain, redness, or swelling of calves.

Injection:

Follicle stimulating hormone activity 150 units and luteinizing hormone activity 150 units per 2 mL ampul