Menotrophin


Generic Medicine Info
Indications and Dosage
Intramuscular, Subcutaneous
Male infertility due to hypogonadotropic hypogonadism
Adult: Pretreatment with hCG stimulates spermatogenesis. Thereafter, initiate menotrophin at 75 or 150 IU 2 or 3 times weekly via SC or IM inj in combination with hCG. Continue treatment for at least 3 or 4 months.

Intramuscular, Subcutaneous
Female infertility of anovulatory origin
Adult: For cases in women (including polycystic ovarian disease) who are unresponsive to clomifene citrate: Begin therapy within the 1st 7 days of the menstrual cycle. Initially, 75-150 IU daily via SC or IM inj; maintained for at least 7 days. Adjust subsequent doses according to individual response (based on clinical monitoring including ovarian ultrasound alone or combined with serum estradiol level measurement); dose must be adjusted in increments of 37.5 IU (up to Max of 75 IU) at least every 7 days. Max: 225 IU daily. If patient fails to adequately respond after 3 or 4 weeks, abandon that cycle and recommence treatment at a higher initial dose than the abandoned cycle. If optimal response is obtained, hCG may be given 1 day after the last menotrophin dose. If an excessive response is attained, discontinue treatment and withhold hCG administration. Further patient instructions and monitoring may be required based on individual ovarian response. Dosage and treatment duration recommendations may vary among individual products and between countries. Refer to local detailed product guidelines.

Intramuscular, Subcutaneous
Controlled ovarian hyperstimulation for assisted reproduction in infertility
Adult: In protocol using down-regulation with gonadotrophin-releasing hormone (GnRH) antagonist, begin menotrophin therapy on day 2 or 3 of the menstrual cycle. In protocol using down-regulation with GnRH agonist, initiate menotrophin therapy approx 2 weeks after the start of the agonist treatment. Initially, 150-225 IU daily via SC or IM inj for at least the 1st 5 days of therapy. Adjust subsequent doses according to individual response (based on clinical monitoring including ovarian ultrasound alone or combined with serum estradiol level measurement); dose must be adjusted in increments of up to 150 IU. Max: 450 IU daily. Max treatment duration: 20 days. When a suitable number of follicles reached an appropriate size, hCG may be given to induce final follicular maturation in preparation for oocyte retrieval. If an excessive response is attained, discontinue treatment and withhold hCG administration. Further patient instructions and monitoring may be required based on individual ovarian response. Dosage and treatment duration recommendations may vary among individual products and between countries. Refer to local detailed product guidelines.
Reconstitution
Reconstitute the contents of the vial with the provided diluent (0.9% NaCl inj). Gently swirl to dissolve; do not shake.
Contraindications
Tumours of pituitary gland or hypothalamus; uncontrolled non-gonadal endocrinopathies (e.g. adrenal, thyroid, pituitary); ovarian, uterine or mammary carcinoma, gynaecological haemorrhage of undetermined origin, ovarian cysts or enlarged ovaries (not caused by polycystic ovarian disease); primary ovarian failure, malformation of sexual organs or fibroid tumours of the uterus that are incompatible with pregnancy; structural abnormalities in which satisfactory outcome cannot be expected such as tubal occlusion (unless superovulation is to be induced for in vitro fertilisation), ovarian dysgenesis, absent uterus or premature menopause; tumour in the testes, prostate carcinoma. Pregnancy and lactation.
Special Precautions
Patient with risk factors for thromboembolic events (e.g. personal or family history, severe obesity [BMI >30 kg/m2], thrombophilia). Woman with history of tubal disease; polycystic ovarian disease.
Adverse Reactions
Significant: Multiple pregnancy, pregnancy loss (by miscarriage), ectopic pregnancy, abnormal ovarian enlargement, ovarian torsion, congenital malformations, ovarian and other reproductive organ neoplasms (benign and malignant); hypersensitivity and anaphylactic reactions.
Gastrointestinal disorders: Abdominal pain, distension, or discomfort; nausea, vomiting, diarrhoea.
General disorders and administration site conditions: Inj site reactions (e.g. pain, inflammation), fatigue, malaise.
Nervous system disorders: Headache, dizziness.
Reproductive system and breast disorders: Pelvic pain, ovarian cyst, breast complaints (e.g. pain, tenderness, discomfort, swelling, nipple pain).
Vascular disorders: Hot flush.
Potentially Fatal: Ovarian hyperstimulation syndrome (OHSS), serious pulmonary effects (e.g. atelectasis, acute respiratory distress syndrome, exacerbation of asthma), thromboembolic events.
IM/Parenteral/SC: X
Monitoring Parameters
In women: Verify pregnancy status and fertility status of the male partner prior to ovulation induction. Perform a thorough gynaecologic and endocrinologic examination, and evaluate for hypothyroidism, adrenocortical deficiency, hyperprolactinaemia, pituitary or hypothalamic tumours before treatment initiation. Obtain transvaginal ultrasound and/or estradiol levels to monitor follicular growth and development. Monitor for signs and symptoms of OHSS for at least 2 weeks after hCG administration. In men: Evaluate the fertility status of the female partner before therapy initiation.
Drug Interactions
May enhance the follicular response when used with clomifene citrate. When using GnRH agonists for pituitary desensitisation, higher doses of menotrophin may be needed to obtain adequate follicular response.
Action
Description: Menotrophin, a purified extract of human post-menopausal urine, contains both LH and FSH activity in a 1:1 ratio. It has gametropic and steroidogenic effect which directly affects the ovaries and testes. In the ovaries, the FSH component increases the number of growing follicles and stimulates their development. In the testes, its FSH component induces the transformation of premature to mature Sertoli cells which results in the maturation of seminal canals and the development of the spermatozoa.
Synonyms: menotropins.
Pharmacokinetics:
Excretion: Mainly via urine. Elimination half-life: Following repeated administration: FSH: 30 ± 11 hours (SC); 27 ± 9 hours (IM).
Storage
Store between 3-25°C. Do not freeze. Protect from light. Storage recommendations may vary among countries or individual products. Refer to specific product guidelines.
MIMS Class
Trophic Hormones & Related Synthetic Drugs
References
Anon. Menotrophins (Menotropins). Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 24/09/2021.

Buckingham R (ed). Human Menopausal Gonadotrophins. British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 24/09/2021.

Joint Formulary Committee. Menotrophin. British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 01/03/2021.

Menopur (Ferring Pharmaceuticals Inc.). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed. Accessed 12/10/2021.

Menopur 150 IU Powder and Solvent for Solution for Injection (Ferring Pharmaceuticals Ltd). MHRA. https://products.mhra.gov.uk. Accessed 01/03/2021.

Menopur Multidose 600 IU and 1200 IU Powder and Solvent for Solution for Injection (Ferring Sdn, Bhd.). National Pharmaceutical Regulatory Agency - Ministry of Health Malaysia. https://www.npra.gov.my. Accessed 01/03/2021.

Pharmaco (NZ) Ltd. Menopur 600 IU and 1200 IU Powder and Solvent for Solution for Injection data sheet September 2020. Medsafe. http://www.medsafe.govt.nz. Accessed 01/03/2021.

Pharmaco (NZ) Ltd. Menopur 75 IU Powder and Solvent for Solution for Injection data sheet 01 October 2018. Medsafe. http://www.medsafe.govt.nz. Accessed 01/03/2021.

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 © 2021 MIMS. All rights reserved. Powered by MIMS.com
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