Menotrophin


Concise Prescribing Info
Indications/Uses
Listed in Dosage.
Dosage/Direction for Use
Adult : IM/SC Female Infertility Daily dose providing 75-150 u FSH. Adjust dose gradually till adequate response. Once reached, stop menotrophin and induce ovulation w/ chorionic gonadotrophin 1-2 days later. In menstruating patients, start treatment w/in the 1st 7 days of the menstrual cycle; may repeat cycle at least twice more if needed. In vitro fertilisation procedures or other assisted conception techniques As monotherapy or w/ clomiphene citrate or gonadorelin agonist: Daily dose providing 75-300 u FSH, usually started on the 2nd or 3rd of the menstrual cycle and continued till adequate response is obtained, followed by chorionic gonadotrophin 1-2 days after the last menotrophin inj only if there are ≥3 follicles >17 mm in diameter w/ 17-β-oestradiol levels ≥3,500 pmol/L. Male infertility W/ chorionic gonadotrophin: Dose providing 75 or 150 u FSH 2-3 times wkly, continue treatment for ≥3-4 mth.
Dosage Details
Parenteral
In vitro fertilisation procedures or other assisted conception techniques
Adult: As monotherapy or in conjunction with clomiphene citrate or gonadorelin agonist: Dose providing 75-300 units of FSH is admin daily via IM/SC inj to stimulate follicular growth, usually started on the 2nd or 3rd of the menstrual cycle and continued until adequate response is obtained. After the final inj of menotrophin, this is followed by chorionic gonadotrophin 1-2 days later to stimulate egg maturation. Admin human chorionic gonadotrophin only if there are at least 3 follicles >17 mm in diameter with 17-β-oestradiol levels ≥3500 pmol/L (920 picograms/ml). Egg retrieval may be carried out 32-36 hr after the human chorionic gonadotrophin inj.

Parenteral
Female infertility
Adult: Dosage and schedule depends on patient's needs. Dose is given via IM/SC admin to provide 75-150 units of FSH daily. Adjust dose gradually until adequate response is achieved. Once reached, stop menotrophin admin and induce ovulation by administering chorionic gonadotrophin 1-2 days later at doses of 5,000-10,000 units. In menstruating patients, start treatment within the 1st 7 days of the menstrual cycle; may repeat cycle at least twice more if needed. Alternatively, admin 3 equal doses of menotrophin (each providing 225-375 units of FSH) on alternate days, followed by chorionic gonadotrophin 1 wk after the 1st dose.

Parenteral
Male infertility
Adult: In conjunction with chorionic gonadotrophin (1000 - 2000 IU 2-3 times wkly): Menotrophin is admin at a dose providing 75 or 150 units of FSH via IM/SC inj 2-3 times wkly, continue treatment for at least 3-4 mth.
Reconstitution
Reconstitute with the provided diluent before use.
Contraindications
Pregnancy & lactation. Ovarian cysts or enlarged ovaries (not due to polycystic ovarian syndrome), uncontrolled thyroid and adrenal dysfunction, organic intracranial lesions (e.g. pituitary tumours), abnormal genital bleeding of unknown cause, presence of other causes of infertility other than anovulation (unless they are candidates of in vitro-fertilisation), hormone sensitive tumours e.g. breast, uterus, prostate, ovaries or testes. Primary ovarian failure, malformation of sexual organs or fibroid tumours of the uterus incompatible with pregnancy, structural abnormalities such as tubal occlusion (unless superovulation is to be induced), ovarian dysgenesis, absent uterus or premature menopause.
Special Precautions
In females: Monitor ovarian activity and measure urinary oestrogen at regular intervals, until stimulation occurs. Discontinue menotrophin treatment and withhold human chorionic gonadotrophin if urinary oestrogen levels >540 nmol/24 hr, or if plasma 17 β-oestradiol levels >3000 pmol/l, or if there is any sharp rise in values. Refrain from sexual intercourse or use barrier contraception methods for at least 4 days and pelvic examinations to be avoided or carried out with care.
Adverse Reactions
Ovarian enlargement, ovarian cysts, enlarged abdomen, GI disturbances (e.g. nausea, vomiting, diarrhoea, abdominal pain or cramps, bloating), inj site reactions, headache, dizziness, tachycardia, dyspnoea, tachypnoea, hypersensitivity reactions. Multiple births and miscarriages.
Potentially Fatal: Ovarian Hyperstimulation Syndrome, severe pulmonary conditions (e.g atelectasis, acute respiratory distress syndrome) and thromboembolic events.
IM/Parenteral/SC: X
Overdosage
Symptoms: Ovarian hyperstimulation, ranging from mild to severe. Management: In mild to moderate hyperstimulation: Bed rest, close observation and symptomatic relief. In severe hyperstimulation: Treatment is conservative and aims at restoring blood volume and preventing shock. If conception does not occur, acute symptoms will go away after several days and ovaries return to normal in 20 - 40 days. If conception occurs, symptoms may be prolonged.
Drug Interactions
Increased follicular response with clomiphene citrate. Higher dose of menotrophin needed when gonadotropin-releasing hormone agonist is used for pituitary desensitisation.
Action
Description: Menotrophins, a purified extract of human post-menopausal urine, contain follicle-stimulating hormone (FSH) and luteinising hormone (LH) in a ratio of 1:1. The biological effectiveness of menotrophins is mainly due to its FSH content. In the ovaries, the FSH-component increases the quantity of growing follicles and stimulates their development. Under the influence of LH, FSH increases oestradiol production in the granulosa cells. In the testes, FSH induces the maturation of Sertoli cells and the seminal canals and the development of the spermatozoa.
Pharmacokinetics:
Absorption: Max FSH serum levels reached: 18 hr (IM inj) and 12 hr (SC inj).
Excretion: Half-life: 55 hr (IM inj) and 50 hr (SC inj). Mainly excreted by kidneys.
Storage
Store ≤25°C. Protect from light.
Disclaimer: This information is independently developed by MIMS based on Menotrophin from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to MIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, MIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2020 MIMS. All rights reserved. Powered by MIMS.com
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