Menopur is a drug of the human menopausal gonadotropin (hMG).
Release form and composition
Menopur is produced in the form of a lyophilisate for the preparation of an injection solution, which is a white or almost white briquette, odorless (in 2 ml bottles, 5 bottles in blister packs, in a cardboard box of 1 or 2 packs complete with 5 ampoules of solvent) .
The active ingredients of the drug in 1 bottle:
- Follicle-stimulating hormone (FSH) - 75 IU;
- Luteinizing hormone (LH) - 75 MEU.
Auxiliary components: polysorbate 20, hydrochloric acid, lactose monohydrate, sodium hydroxide.
The solvent supplied is an isotonic solution of sodium chloride.
Indications for use
Menopur women are prescribed in the following cases:
- Infertility due to hypothalamic-pituitary disorders (to stimulate the growth of one dominant follicle);
- Conducting assisted reproductive techniques (to stimulate the growth of multiple follicles).
Men Menopur is prescribed to stimulate spermatogenesis in oligoastenospermia or azoospermia caused by primary or secondary hypogonadotropic hypogonadism (in combination with human chorionic gonadotropin preparations, for example, Choragon).
- Uterine fibroids or abnormalities of the genital organs that are incompatible with pregnancy;
- Vaginal bleeding of unknown etiology;
- Persistent ovarian enlargement or the formation of cysts not related to polycystic ovary syndrome;
- Primary ovarian failure;
- Breast, uterine or ovarian cancer;
- Tumors of the hypothalamic-pituitary region;
- Thyroid and adrenal gland diseases;
- Prostate cancer and other androgen-dependent tumors in men;
- Hypersensitivity to menotropin (drugs containing FSH and / or LH) or auxiliary components of the drug.
Dosing and Administration
Prepared immediately before the introduction of the lyophilisate Menopur solution is intended for intramuscular or subcutaneous injections.
Women with infertility caused by the hypothalamic-pituitary disorders, the dose of the drug is selected individually depending on the performance of ultrasound of the ovaries, the level of estrogen in the blood and the results of clinical observation.
The initial daily dose is 75-150 IU (1-2 bottles). In the absence of ovarian response, the dose is gradually increased until the follicles grow or the level of estrogen in the blood increases and remain unchanged until the concentration of estrogen reaches the pre-ovulatory level. If there is a rapid rise in the level of estrogen at the very beginning of stimulation, the menopur dose is reduced.
For the induction of ovulation, 1-2 days after the last injection of this drug, human chorionic gonadotropin (hCG) is administered once in a dose of 5000-10000 IU.
Men are prescribed Menopur to stimulate spermatogenesis. First, cXG of 1000-3000 IU is administered 3 times a week to normalize the level of testosterone in the blood, then for several months Menopur is administered three times a week in a dose of 75-150 IU.
- Endocrine system: in women - a sharp increase in the excretion of estrogen in the urine, mastalgia, the formation of ovarian cysts, moderately expressed and uncomplicated enlargement of the ovaries; for men, gynecomastia;
- The digestive system: infrequently - colicky pain, nausea, vomiting;
- Allergic reactions: arthralgia; rarely, hypersensitivity reactions (including fever and skin rash), with long-term use, very rarely - the formation of antibodies, leading to a decrease in the effectiveness of Menopur;
- Local reactions: itching, redness and swelling at the injection site;
- Other: weight gain, lower blood pressure, oliguria; women often have multiple pregnancies;
- Ovarian hyperstimulation syndrome in women: early signs - nausea, vomiting, severe abdominal pain, weight gain, increased red blood cell count in plasma, hypovolemia, hemoperitoneum (presence of blood in the abdominal cavity), ascites, hydrothorax, electrolyte imbalance, thromboembolic syndrome .
Before the appointment of Menopur in connection with infertility, it is necessary to assess the patient's ovarian condition: conduct an ultrasound examination and determine the level of estradiol in the blood plasma. These studies must be carried out every day or every other day during the entire course of treatment.
Before starting treatment with Menopur, it is recommended that appropriate treatment be carried out in the event of the presence of such comorbidities as hypothyroidism, hyperprolactinemia, adrenal cortex insufficiency, tumors of the hypothalamic-pituitary region, hemoconcentration.
It should be borne in mind that hMG preparations can lead to ovarian hyperstimulation, which is clinically expressed after the introduction of Menopur for the purpose of ovulation and is manifested by the formation of large ovarian cysts. It is possible the development of ascites and hydrothorax, accompanied by arterial hypotension, oliguria and thromboembolic syndrome.
In the case of the first signs of ovarian hyperstimulation - abdominal pain and palpable or determined by ultrasound examination of education in the lower abdomen - the drug should be immediately canceled.
Women with ovarian hyperstimulation syndrome should not use hCG for ovulation.
With a high level of FSH in the blood of men (this indicates primary testicular failure) Menopur is usually ineffective.
If necessary, Menopur can be combined with Choragon (human chorionic gonadotropin): in men, to stimulate spermatogenesis, in women, to induce ovulation after follicle growth is stimulated.
Terms and conditions of storage
Store at temperatures up to 25 ºC. Do not expose to light. Keep out of the reach of children.
Shelf life - 2 years.