How to inject Menopur 75 into the stomach. Menopur is an effective remedy for infertility. Menopur, instructions for use: method and dosage

One bottle includes 75 IU follicle-stimulating hormone (FSH) and 75 IU luteinizing hormone (LG).

Additionally: sodium hydroxide, lactose monohydrate, hydrochloric acid, polysorbate 20.

One ampoule with solvent includes: saline solution (0.9%) sodium chloride .

Release form

Menopur is produced in the form of an injection lyophilisate (powder) in 2 ml bottles No. 5 or No. 10 complete with a solvent in 1 ml ampoules No. 5 or No. 10.

pharmachologic effect

Gonadotropic.

Pharmacodynamics and pharmacokinetics

Menopur belongs to the group of medicinal products menopausal gonadotropin human, includes as active ingredients menothotropines FSH And LH (75 IU:75 IU) and has a high degree of purification. The basis for obtaining the drug is women's urine , allocated during the period postmenopausal .

Administration of the drug to men stimulates secretion, increasing its plasma level, and activates spermatogenesis , by acting in the seminiferous tubules on Sertoli cells .

With intramuscular administration of Menopur, plasma Cmax FSH observed after 6-24 hours, after which it gradually decreases. T1/2 menotropins takes 4-12 hours.

Indications for use

Women are prescribed Menopur for:

• diagnosed due to disorders in (to stimulate growth dominant follicle );
• carrying out additional reproductive methods stimulation development multiple follicles for the purpose of conception.

For men, the drug is indicated for:

• oligoasthenospermia or, due to primary or secondary hypogonadotropic hypogonadism , for stimulation spermatogenesis (in combination with human medicinal preparations, for example, with).

Contraindications

Before injecting Menopur, you need to make sure that the patient does not have:

• pathologies of the adrenal glands and/or thyroid gland ;
• pregnancy;
• tumors localized in the hypothalamic-pituitary region;
• lactation;
• personal hypersensitivity to menotropins (means including FSH and/or LH ), as well as other ingredients of the lyophilisate;
• persistent ovarian enlargement or availability , not associated with ;
• or others androgen-dependent tumor formations in men;
• uterine fibroids or developmental anomalies of the female genital organs incompatible with the possibility of conception;
• vaginal bleeding unknown origin;
• primary ovarian failure ;
• , ovaries .

Side effects

Sometimes during Menopur therapy the following was observed:

• colicky pain;
• mastalgia ;
• multiple pregnancy ;
• a sharp increase in renal excretion;
• weight gain;
• uncomplicated moderately severe ovarian enlargement ;
• decrease in blood pressure ;
• education ovarian ;
• oliguria ;
• arthralgia ;
• nausea/vomiting;
• redness, edema / in the injection area;
• manifestations hypersensitivity (including temperature rise and skin rash );
• gynecomastia in men;
• education , reducing the effectiveness of the drug (very rarely with prolonged use);
• ovarian hyperstimulation syndrome : (strong stomach pain e; weight gain; nausea /vomit ; hypovolemia ; increased plasma level due to decreased plasma volume; ascites ; electrolyte disturbances; hemoperitoneum ; thromboembolic syndrome ; hydrothorax ).

Menopur, instructions for use (Method and dosage)

Instructions for use of Menopur allow for subcutaneous (s.c.) or intramuscular (i.m.) administration of the drug, after diluting the lyophilisate in the supplied solvent (immediately before injection).

Women

When diagnosed, due to disturbances in hypothalamic-pituitary system (to stimulate growth dominant follicle ), the dosage regimen is set individually. The optimal dosage and duration of treatment is selected based on Ultrasound of the ovaries , blood concentrations estrogen and further clinical picture. About maturation dominant follicle can be judged based on the increase in plasma levels estrogen .

The initial daily dosage of Menopur is 75-150 IU. In case of no response ovaries a gradual increase in Menopur doses is indicated until the plasma level increases estrogen or trackable growth follicles . In this case, the administration of the drug is continued in the dosages currently used until estrogens level corresponding preovulatory period . With a rapid increase in level estrogen observed at the beginning of stimulation, the dose of Menopur should be reduced. To activate ovulation , after 1-2 days after the last dose of Menopur, a single injection of 5000-10000 IU is performed human chorionic gonadotropin (Horagon ).

For men

For stimulation of spermatogenesis preliminary administration of 1000-3000 IU 3 times a week is indicated human chorionic gonadotropin person, up to normalization of plasma levels testosterone . After achieving adequate plasma levels testosterone for several months, injections of 75-150 IU of Menopur are carried out three times a week.

Overdose

There have been no reports of overdose with Menopur.

Interaction

The drug Menopur can be prescribed in combination with a human medicinal product to activate ovulation in women, after stimulation of follicular growth and activation spermatogenesis in men.

Terms of sale

Menopur is a prescription drug.

Storage conditions

The lyophilisate with solvent must be stored at temperatures up to 25°C.

Best before date

2 years from the date of issue.

special instructions

If the patient has tumors of the hypothalamic-pituitary system , insufficiency of the adrenal cortex, hyperprolactinemia , hemoconcentration, appropriate therapy should be carried out before using Menopur.

During treatment infertility it is necessary to conduct a preliminary assessment of the condition ovaries . The criteria for such an assessment are: Ultrasound and determination of plasma level estradiol . Throughout the course of treatment, similar studies must be initiated daily or every other day.

In women: Anovulation (including polycystic ovary syndrome (PCOS) when clomiphene therapy is ineffective. Controlled ovarian hyperstimulation to induce the growth of multiple follicles during the following assisted reproductive technologies (ART): in vitro fertilization with embryo transfer (IVF/ET), gamete transfer into fallopian tube (GIFT) and intracytoplasmic sperm injection (ICSI). In men: Stimulation of spermatogenesis in azoospermia or oligoasthenospermia caused by primary or secondary hypogonadotropic hypogonadism (in combination with hCG drugs).

Contraindications Menopur lyophilized powder for the preparation of injection solution 75ME

Hypersensitivity to the components of the drug and solvent. Tumors of the pituitary gland and hypothalamus. Children under 18 years of age. Impaired liver or kidney function. In women: Cancer of the ovaries, uterus or breast. Pregnancy and breastfeeding period. Vaginal bleeding of unknown etiology. Presence of cysts or enlarged ovaries not associated with PCOS. Primary ovarian failure. Anomalies of the development of the genital organs, incompatible with pregnancy. Uterine fibroids incompatible with pregnancy. In men: Prostate cancer. Testicular tumor. Primary failure of testicular function. With caution In women - the presence of risk factors for the development of thromboembolic complications (individual or family predisposition, obesity with a body mass index (BMI) > 30 kg/m2, thrombophilia); history of fallopian tube diseases. Use during pregnancy and breastfeeding The use of Menopur® is contraindicated during pregnancy and breastfeeding.

Method of use and dosage Menopur lyophilized powder for the preparation of injection solution 75ME

The drug Menopur® is administered intramuscularly or subcutaneously after dissolving the lyophilisate in the included solvent. Treatment with Menopur® should only be carried out under the supervision of a physician with appropriate specialization and experience in the treatment of infertility. The dose of the drug is the same for both subcutaneous and intramuscular routes of administration. It has been established that the ovaries respond differently to the administration of gonadotropins. For this reason, it is impossible to develop a universal dosing regimen. The dose should be adjusted individually depending on the response of the ovaries. Menopur® is used as monotherapy or in combination with gonadotropin-releasing hormone (GnRH) agonists or antagonists. Recommended doses and duration of therapy depend on the treatment regimen used. In women: Anovulation (including PCOS) The goal of treatment with Menopur® is the development of one mature follicle, from which an oocyte will be released after administration of human chorionic gonadotropin (hCG). Treatment usually begins in the first 7 days of the menstrual cycle. The recommended starting dose of Menopur® is 75-150 IU per day for at least 7 days. A further treatment regimen is selected after monitoring the ovarian response to therapy based on the results of ultrasound examination (ultrasound) in combination with determining the concentration of estradiol in the blood plasma. In the absence of an ovarian response, the dose is increased by 37.5 IU (one injection) no more than once a week, each subsequent increase should not exceed 75 IU. The maximum daily dose should not exceed 225 IU. If a therapeutic response is not achieved within 4 weeks, treatment should be discontinued and a new cycle should be started with higher initial doses. When an adequate ovarian response is achieved, the next day after the last injection of Menopur®, 5000-10000 IU of hCG is administered once to induce ovulation. The patient is recommended to have sexual intercourse on the day of hCG administration and the day after administration. As an alternative method, intrauterine insemination is possible. The patient should be under constant observation for at least 2 weeks after hCG administration. If the ovaries react excessively to the administration of Menopur®, the course of therapy should be stopped and the administration of hCG should be discontinued. The patient is recommended to use barrier methods of contraception or abstain from sexual intercourse until menstruation occurs. Controlled ovarian hyperstimulation to induce the growth of multiple follicles during ART According to the protocol for the use of GnRH agonists in accordance with the feedback principle, treatment with Menopur® should be prescribed approximately 2 weeks after the start of treatment with GnRH agonists. If the treatment regimen does not require prior use of GnRH agonists, administration of Menopur® should begin on the 2nd or 3rd day of the menstrual cycle together with GnRH antagonists. The recommended initial daily dose of Menopur® is 150-225 IU for at least the first 5 days of treatment. A further treatment regimen is selected after monitoring the ovarian response to therapy based on the results of ultrasound in combination with determining the concentration of estradiol in the blood plasma. The recommended booster dose should not exceed 150 IU. The maximum daily dose of Menopur® should not exceed 450 IU. The total duration of therapy should not exceed 20 days. When an optimal ovarian response is achieved after the last injection of Menopur®, one injection of hCG at a dose of 10,000 IU is prescribed to induce the final maturation of the follicles and induce the release of the oocyte. The patient should be under constant observation for at least 2 weeks after hCG administration. If the ovaries react excessively to the administration of Menopur®, the course of therapy should be stopped and the administration of hCG should be discontinued. The patient is advised to use barrier methods of contraception or abstain from sexual intercourse until menstruation occurs. In men: In men, to stimulate spermatogenesis in hypogonadotropic hypogonadism, Menopur® is recommended to be used in a dose of 75 IU to 150 IU 3 times a week together with hCG injections in a dose of 1500 IU 3 times a week, if previous therapy with hCG drugs (administration of 1500- 5000 IU of hCG 3 times a week) for 4-6 months led to normalization of testosterone concentrations in the blood plasma. Treatment according to this regimen should be continued for at least 4 months until spermatogenesis improves. If there is no positive effect during this time, combination therapy can be continued until a positive result of therapy is obtained. According to studies, it may take at least 18 months of treatment to improve spermatogenesis. Recommendations for preparing the solution The solution for injection should be prepared immediately before administration using the supplied solvent. It is not recommended to dissolve more than 3 bottles of lyophilisate in 1 ml of the supplied solvent. General instructions Shaking should be avoided. If the solution becomes cloudy or contains particles, it should not be used. Use in special clinical groups Impaired liver or kidney function. Clinical studies have not been conducted in patients with impaired liver or kidney function. Children under 18 years of age. There are no indications for the use of Menopur® in children and adolescents under 18 years of age.

Instructions for use
Menopur Liof. IM 75IU FSH + 75IU LH No. 10

Dosage forms
lyophilized powder for the preparation of injection solution 75ME

Synonyms
Gonadotropin menopausal
Menogon
Menopur Multidose
Merional
Pergonal
HuMoG

Group
Gonadotropins and antigonadotropins

International nonproprietary name
Menotropins

Compound
The active ingredient is menotropins.

Manufacturers
Ferring GmbH (Germany)

pharmachologic effect
Gonadotropic. Increases the level of sex hormones in the blood plasma. In women, it stimulates the maturation of follicles in the ovaries (up to the preovulatory stage), increases estrogen levels, and activates endometrial proliferation; in men, it affects the Sertoli cells of the seminiferous tubules and induces spermatogenesis. Enhances the production of steroid hormones by the sex glands. The effectiveness is mainly due to the action of FSH. Cmax FSH is achieved 6-24 hours after intramuscular administration. T1/2 - 4-12 hours.

Side effect
Ovarian hyperstimulation syndrome (with the possible development of large ovarian cysts, ascites, hydrothorax, thromboembolism, oliguria, hypotension), multiple pregnancy, dyspeptic symptoms (nausea, vomiting), fever, arthralgia, mastalgia, gynecomastia (in men), skin rash, urticaria ( formation of antibodies with long-term use).

Indications for use
In women: infertility caused by hypothalamic-pituitary disorders (hypogonadotropic hypogonadism), defective follicle maturation (insufficiency of the corpus luteum), controlled superovulation during in vitro fertilization (in combination with human hCG). In men: inhibition of spermatogenesis (azoospermia, oligoasthenospermia, caused by primary or secondary hypogonadotropic hypogonadism).

Contraindications
Hypersensitivity, tumors of the hypothalamic-pituitary region, hyperprolactinemia, kidney and pancreas diseases; for women - pregnancy, ovarian hypertrophy and cysts, polycystic ovaries, uterine bleeding of unknown etiology, estrogen-dependent tumors of the uterus, ovaries, mammary glands, uterine fibroids, primary ovarian failure, abnormal development of the genital organs; for men - prostate cancer or other androgen-dependent tumors.

Directions for use and dosage
IM or s.c. Infertility in women caused by hypothalamic-pituitary disorders: usually start with a dose of 75-150 IU (1-2 ampoules) per day, in the absence of ovarian response, the dose is gradually increased until an increase in the level of estrogen in the blood or follicular growth is registered and maintained until the preovulatory level is reached estrogens. To induce ovulation, 5000-10000 IU is administered once 1-2 days after the last injection. In men, in order to stimulate spermatogenesis, 1000-3000 IU of human chorionic gonadotropin (hCG) is pre-administered 3 times a week; after normalization of testosterone levels in the blood, Menopur is administered at a dose of 75-150 IU (1-2 ampoules) 3 times a week for several months.

Overdose
No data.

Interaction
The effect is weakened by gonadotropin-releasing hormone agonists. Clomiphene increases follicular response.

special instructions
Before starting treatment, it is necessary to exclude extragenital endocrinopathies. During the therapy period, daily hormonal monitoring and ultrasound of developing follicles are required (the ovarian response can be assessed by the cervical index). If there is a threat of ovarian hyperstimulation syndrome, menotropins are discontinued. It should not be mixed with other medications in the same syringe. In men with high blood levels of FSH, menotropins are ineffective. The prepared drug solution is used immediately.

Storage conditions
List B. In a place protected from light, at a temperature not exceeding 25 °C.

Infertility is one of the problems that has plagued women for more than a hundred years, but with the deterioration of the environment, the harmful effects of external factors and poor heredity, more and more patients are suffering from this problem.

But medicine also does not stand still, inventing more and more drugs for treatment.

One of them is the drug "Menopur", which is one of the ten most popular in the CIS countries.

pharmachologic effect

A drug such as Menopur can be classified as a gonadotropin that stimulates ovulation, although the main difference from other tablets is that it is based on human gonadotropin.

“Menopur” contains FSH and LH in equal proportions, since it is made from the urine of women during menopause.

Main Impact The drug is aimed at increasing estrogen levels in the blood, stimulating follicle growth and normalizing the endometrium.

As for men, they can be prescribed the drug "Menopur" in cases where they need to increase testosterone levels and stimulate spermatogenesis, increasing the chances of fertilization. Since then the effect is directly on the seminal canals.

Composition and release form

The main active component will be menotropin in the amount of 75 IU.

But effectiveness is achieved due to other substances in the preparation: lactose monohydrate, polysorbate, hydroxide, hydrogen acid.

Since the drug is used together with a solvent, for better absorption it contains sodium chloride, acid and purified water for injection.

The drug "Menopur" is sold in the form of ampoules with solvents in packs of 5 and 10 pieces each.

Indications for use

The use of the drug "Menopur" is allowed only after visiting the hospital, taking tests and developing an individual course from a doctor.

Injections are usually used in several cases:

• Infertility due to anovulation, polycystic ovary syndrome, when taking clomiphene does not produce results;
• To control ovarian hyperstimulation, follicle stimulation during infertility treatment, artificial insemination;
• Stimulation of spermatogenesis in men;
• Treatment of hypoganodism.

In other cases, the drug should be used very carefully, only in some cases under the supervision of a doctor.

This could be seborrhea, cancer prevention, normalization of hormone levels. Then the methodology, duration of the course and dosage of injections of this medicine may differ.

Contraindications

There are also a number of contraindications in which taking the drug "Menopur" is prohibited or the course may differ or be shortened, and you should immediately inform your doctor about this:

• • • Abnormal development of the genital organs;
    • Bleeding and vague vaginal discharge;
    • Oncology of the genital organs;
    • Ovarian failure;
    • Pregnancy;
    • Breastfeeding period;
    • Tumors in the hypothalamus and pituitary gland;
    • Intolerance to some components of the drug "Menopur".

If you have one of the contraindications, then you need to find an alternative treatment. The same applies to situations where problems began after taking the medicine. This may be preceded by a number of side effects.

Side effects

In the first days of taking Menopur, most patients may experience side effects that are associated with the body's reaction and stimulation of the follicles.

Single, rare, common, and very common side effects occur:

• • • Ovarian hyperstimulation;
    • Pain, burning in the lower abdomen;
    • Pain during sexual intercourse;
    • Headache, migraine;
    • Nausea and vomiting;
    • Edema;
    • Hematomas, bruises at the injection site;
    • Gynecomastia.

There are also more dangerous manifestations after Menopur injections, which include torsion of the ovaries, the appearance of other symptoms, and worsening of existing ones.

If side effects occur in a severe form, for more than five days, you also need to go to the hospital.

Drug interactions

It is worth saying that no drug interaction studies have yet been conducted with the drug Menopur.

Although when combined with Clomiphene, you may encounter an increased reaction of the follicles.

You can learn more about the drug Clomiphene here.

If you take the drug "Menopur" with agonists, you will have to increase the dosage of the first drug in order to achieve the desired ovarian reaction and stimulate follicle growth.

Regarding combined use with alcohol, drugs for epilepsy and tuberculosis, no negative reactions were identified.

Menopur and alcohol

There are no clear contraindications when using Menopur together with alcohol, but it is better to avoid it to improve the results of treatment.

Since alcohol reduces the activity of sperm, reduces the activity of follicles, complicates fertilization and the passage of the zygote through the fallopian tube.

It is better to consult your doctor in advance about combining alcohol with this drug.

Instructions for use and dosage

Menopur is taken as an intravenous injection, but before this you need to prepare a solution from a bottle and water for injection in a syringe. Although doctors recommend doing this only before administering the drug Menopur.

Typically, the dosage and duration of the course are developed by the doctor, depending on the problem and special contraindications in patients.

The minimum dose of Menopura for the treatment of infertility in women is 15-100 IU, approximately two bottles per day. 48 hours after the first injection of Menopur, diagnostics are carried out to determine the quality of the follicles and the reaction of the ovaries. If it is absent, then the dosage is increased.

If it is necessary to induce ovulation, then take 5000-10000 IU two days after the start of the Menopur course.

Regarding the treatment of men and stimulation of spermatogenesis, they are administered 1000-3000 IU three times a week. After a few months, an examination is carried out and an additional 75-150 IU of Menopur injections are administered per day.

Cases of overdose with Menopur have not yet been established, but if the dose is increased without a doctor’s permission, the following symptoms may appear:

• Nausea;
• Vomit;
• Ovarian enlargement;
• Change in body weight;
• Diarrhea;
• Dyspnea.

Then you need to go to the hospital or see your doctor, although most symptoms of an overdose with Menopur go away on their own after a couple of weeks.

special instructions

Before starting a course of Menopur injections, it is necessary to undergo a full examination by a doctor, have your partner’s sperm tested, treat kidney or liver failure, and examine ovarian cysts or tumors for malignancy.

You need to understand that taking Menopur can stimulate multiple pregnancies naturally. Although miscarriages may occur in the early stages of pregnancy after fertilization.

Regarding oncology, taking Menopur injections does not affect this fact, although patients often encounter fetal pathologies.

The main danger is that the drug "Menopur" leads to ovarian hyperstimulation, then you need to consult a doctor, treat the symptoms and refuse injections of this drug.

Price for the drug

You need to buy Menopur injections separately from the solvent for injections, so for the first set of 10 pieces you need to pay about 11,000 rubles, and for a package of solvent you will have to pay almost 12,000 rubles. We are talking about injections of 75 IU.

If necessary, you can select substitute analogues with a more affordable cost. Merional, Humog, Bravel and Fostimon, although Luveris are no less effective.

They all have the same active ingredient, pharmacological action and indications for use. The price fluctuates around 5,000 rubles per bottle with a dosage of 75 IU.

The active ingredient in Menopur substitute preparations is gonadotropin or folitropin beta.

But before the appointment, you need to consult a doctor, get tested and start the course without interruption from Menopur injections.

Photos of analogues:

What is better to choose Menopur or its analogues

When compared with other drugs, Menopur is natural and therefore causes less harm to the body's systems. In addition, patients are less likely to develop excess weight or excessive hair growth. You also don’t have to worry about severe ovarian hyperstimulation or genital cysts.

Regarding effectiveness, Menopur injections need to be used longer and more due to the naturalness of the ingredients.

Fetal pathology or miscarriages or bleeding may occur in the early stages of pregnancy after fertilization.

In this matter, everything is individual, depending on the woman’s age, indications, weight and condition of the genital organs.

The main thing to remember is that you can inject with Menopur only in the presence of a doctor or after permission, on your own, at home. It is not recommended to increase the dosage, and if there are contraindications or side effects, consult a doctor immediately.

After the expiration date (24 months), the powder and solvent for injection "Menopur" must be disposed of.