Menogon (Menotrophin injection) a prescription drug manufactured by Ferring is purified combination of follicle stimulating hormone (FSH) and luteinizing hormone (LH) extracted from the urine of post menopausal women. Menogon is administered as an intramuscular or a subcutaneous injection to treat infertility, to induce ovulation and enable pregnancy in women. It may also be used to stimulate the production of sperm in certain forms of male infertility.
Unless prescribed otherwise, doses are as follows: Sterility in Females: The dosage of HMG for the induction of follicle growth in normo- or hypogonadotrophic women varies according to the individual.
The amount depends on ovarian reaction and should be checked by ultrasound examinations of the ovaries and measuring estradiol levels. If the HMG dosage is too high for the treated individual, multiple uni- and bilateral follicle growth can occur.
HMG is administered IM or SC and in general, the therapy is begun with a daily dosage corresponding to 75-150 iu FSH. If the ovaries do not respond, the dosage can slowly be increased until a rise in estradiol secretion and follicle growth is evident. Treatment with the same dosage of HMG continues until the preovulatory estradiol serum level is attained. If the level rises too quickly, the dosage should be reduced. To induce ovulation, hCG 5000 or 10,000 iu are injected IM 1-2 days after the last HMG administration.
Note: After administering a HMG dosage which is too high for the corresponding individual, a subsequent hCG administration can cause an unintentional hyperstimulation of the ovaries. Sterility in Males: Initially, 3 x 1000 and 3000 iu hCG a week are administered until a normal testosterone serum level is reached. Then, an additional dose of HMG 3 x (75-150 iu FSH + 75-150 iu LH)/week is administered IM for a few months.
Interactions with other medications are unknown. HMG can be injected together with hCG when treating infertile males.
Store and protect from light. Menogon should not be stored at temperatures exceeding +25°C.
Occasionally, nausea and vomiting can occur.
In single cases, hypersensitivity reactions and fever can occur during treatment with HMG. The administration of Menogon may lead to reactions at the injection site: Reddening, pain, swelling and itching. In very rare cases, long-term usage can lead to the formation of antibodies, making the therapy ineffective.
Treatment with HMG can often lead to ovarian hyperstimulation that first becomes clinically relevant after the administration of hCG (pregnancy hormone) to induce ovulation. This can lead to the formation of large ovarian cysts that tend to rupture and to intra-abdominal bleeding.
In addition, the accumulation of fluids in the abdominal cavity (ascites), the accumulation of fluids in the chest cavity (hydrothorax), a decrease in the excretion of urine (oliguria), lowering of the blood pressure (hypotension), and occlusion of blood vessels by blood clots (thromboembolic phenomena) can occur. Treatment should be immediately discontinued when the first signs of hyperstimulation appear: Abdominal pain and a palpable (by the physician) enlargement in the lower abdomen, which can be detected sonographically.
If abdominal pain occurs, see the doctor.
With pregnancy, these side effects can intensify, continue over a long period of time, and be life threatening.
Unintentional multiple pregnancies occur more often during treatment with HMG.
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