The gonadotrophin is menopauzny

General characteristics. Structure:

Active ingredient: гонадотроин menopauzny 75 ME follicle-stimulating hormone + 75 ME luteinizing hormone.

Excipients: lactoses monohydrate of 10,0 mg; sodium of hydroxide of 1 M solution or Acidum hydrochloricum of 1 M solution to рН 6,0-7,0.

Pharmacological properties:

Pharmacodynamics. The gonadotrophin is menopauzny, contains follicle-stimulating hormone and luteinizing hormone. Has follicle-stimulating and gonadotropic effect. Increases concentration of sex hormones in plasma.

Causes increase in concentration of estrogen in blood in women and stimulates growth of ovaries, maturing in them of follicles and an ovulation, causes proliferation of an endometria.

At men stimulates a spermatogenesis (due to activation of protein synthesis, connecting androgens in seed tubules and Sertoli's cells).

Strengthens production of steroid hormones gonads. Efficiency is generally caused by action of FSG.

Pharmacokinetics: Time of achievement of the maximum concentration of FSG - 6-24 h (after intramuscular introduction), after that concentration of FSG in blood gradually decreases. An elimination half-life - 4-12 h.

Indications to use:

At women:

- infertility - hypo-ovaria, amenorrhea (primary or secondary central genesis, hypomenstrual molimina); Shikhen's syndrome, Kiari-Frommel's syndrome;

- delay of growth of one dominating follicle, stimulation of a superovulation (growth of a set of follicles for carrying out the auxiliary reproductive techniques promoting conception approach).

At men:

- infertility - oppression of a spermatogenesis (the azoospermism, an oligospermatism caused by primary or secondary hypogonadotropic hypogonadism), stimulation of a spermatogenesis in combination with a human chorionic gonadotrophin.

Route of administration and doses:

Intramusculary. Solution prepares just before an injection with use of the enclosed solvent. In 1 ml of solvent it is possible to dissolve contents of 5 ampoules. For stimulation of growth of one dominating follicle at women use 2 various schemes of introduction.

First scheme: daily introduction in a dose 75 ME in the first 7 days of a cycle at the menstruating women. Injections proceed before achievement of the adequate answer who can be judged approach according to daily analyses of concentration of estrogen and size discriminations of follicles by means of ultrasonography. Maturing of follicles occurs usually during a medical cycle lasting 7-12 days. In the absence of reaction of ovaries to introduction the daily dose of drug can be gradually increased to 150 ME.

Second scheme: introduction every other day during 1 week. The initial dose makes 225-375 ME/days. If adequate stimulation is not reached, the dose can be gradually increased.

After performing treatment on any of schemes and in the presence of adequate, but not the overreaction of ovaries determined by data of clinical and biochemical trials in 24-48 h after the last introduction of a menotropin, for the purpose of induction of an ovulation 5-10 thousand ME of the human chorionic gonadotrophin increasing the maintenance of LG and stimulating emission of a mature ovum are once entered.

In the presence of an ovulation and lack of approach of pregnancy treatment can be repeated on one of the provided schemes during 2 cycles. In day of introduction of HG and the next 2-3 days the patient is recommended to have the sexual intercourses. At stimulation of "superovulation" (when carrying out auxiliary reproductive techniques) duration of administration of drug can be bigger.

Use for men: at a hypogonadotropic hypogonadism at men for stimulation of a spermatogenesis drug is appointed if the previous therapy by a human chorionic gonadotrophin caused only androgenic reaction without signs of strengthening of a spermatogenesis.

In this case treatment continues by introduction of 2 thousand ME of a human chorionic gonadotrophin 2 times a week together with injections of a menotropin on 75 ME 3 time a week. Treatment according to this scheme it is necessary to continue a minimum within 4 months, at inefficiency treatment is continued, entering human HG on 2 thousand ME 2 times a week, and 150 ME menotropin 3 times a week.

The condition of a spermatogenesis should be estimated monthly, and in the absence of positive takes within the next 3 months treatment should be stopped. At an idiopathic normogonadotropny oligospermatism 5 thousand ME of a human chorionic gonadotrophin intramusculary, with parallel introduction 75-150 ME menotropin 3 times a week, within 3 months are entered weekly.

For the purpose of stimulation of a spermatogenesis - on 1-3 thousand ME of a chorionic gonadotrophin 3 times a week before normalization of concentration of testosterone in blood. After that within several months 3 times a week - on 75-150 ME menotropin.

Features of use:

Before an initiation of treatment it is necessary to exclude a syndrome of exhaustion or resistance of ovaries, extragenital endocrinopathies.

Approach of polycarpous pregnancy can be result of treatment. In case of signs of hyper stimulation of ovaries (an abdominal pain and palpated by the doctor or the increased educations determined by ultrasonography in a stomach bottom) treatment is stopped (develops at women with a syndrome of polycystic ovaries more often).

During therapy daily hormonal control and ultrasonography of the developing follicles is obligatory (reaction of ovaries can be estimated on a cervical index).

In case of a syndrome of hyper stimulation of ovaries to enter an ovulatory dose of a chorionic gonadotrophin. contraindicated!

In case of pregnancy approach symptoms of excessive hyper stimulation can amplify and be observed for a long time, being threat for the patient's life.

Before purpose of drug it is necessary to carry out the corresponding treatment at dysfunctions of a thyroid gland or bark of adrenal glands, giperprolaktinemiya of various etiology, a tumor of gipotalamo-pituitary area.

During treatment at men with high concentration in FSG blood of a menotropina are inefficient.

Side effects:

From the alimentary system: nausea, vomiting, meteorism, gastralgia.

From endocrine system: a mastalgiya, a syndrome of hyper stimulation of ovaries, increase in ovaries in a size, development of big cysts of ovaries, significant increase in removal of estrogen with urine, pains in a stomach bottom; men have a gynecomastia.

From a metabolism: hypovolemia, pachemia, water and electrolytic disturbances, ascites, hydrothorax.

Allergic reactions: skin rash, a small tortoiseshell (antibody formation at prolonged use), fever, an arthralgia.

Local reactions: hypostasis, pain or an itch in the field of an injection.

Others: oliguria, lowering of arterial pressure, increase in body weight, hemoperitoneum, clotting disease, polycarpous pregnancy.

Interaction with other medicines:

It is not necessary to mix with other medicines in one syringe.

At a combination to clomifene reaction of a follicle increases.

At combined use with agonists of GRF increase in a dose of a menotropin can be required.

Contraindications:

- hypersensitivity, tumors of gipotalamo-pituitary area, giperprolaktinemiya, diseases of adrenal glands and thyroid gland;

- for women - the persistent increase in ovaries, a cyst of ovaries (which are not caused by existence of a syndrome of polycystic ovaries), a syndrome of polycystic ovaries, anomalies of development of generative organs (pregnancy, incompatible with normal course), a hysteromyoma, a metrorrhagia (the obscure etiology), estrogenzavisimy tumors (ovarian cancer, uterus cancer, a breast cancer), primary insufficiency of ovaries, pregnancy, the lactation period;

- for men - a prostate cancer, a tumor of testicles, androgenzavisimy tumors.

Overdose:

In case of overdose SGYa and tromboembolic episodes is possible. SGYa symptoms - increase in ovaries, pain in the bottom of a stomach, nausea, vomiting, diarrhea, increase in body weight, an oliguria, ascites, a hydrothorax, гемиперитонеум, haemo concentration, an asthma - usually do not demand additional treatment and pass independently within 2-3 weeks.

Storage conditions:

In the place protected from light, at a temperature from 2 to 8 °C.

To store in the places unavailable to children.

Issue conditions:

According to the recipe

Packaging:

Lyophilisate for preparation of solution for intramuscular introduction complete with solvent (chloride sodium solution for injections of 0,9%) or without it.

Drug in ampoules of neutral glass on 1 ml. On 5 or 10 ampoules with drug in a pack cardboard in a corrugated insert together with the application instruction and the scarificator ampoule.

On 5 ampoules with drug in a blister strip packaging from a film polyvinyl chloride. 1 or 2 blister strip packagings with drug in a pack cardboard with the application instruction and the scarificator ampoule.

When packaging ampoules with a point or a ring of a break the scarificator ampoule is not put.