Anovulation including polycystic ovarian syndrome (PCOS) in women unresponsive to treatment w/ clomiphene citrate. Stimulation of multifollicular development in women undergoing superovulation for assisted reproductive technologies (ART).
Anovulation including PCOS Initially 75-150 IU daily, may be increased by 37.5 IU or 75 IU at 7- or 14-day intervals, if necessary. Max daily dose: 225 IU. Ovarian stimulation for multiple follicular development prior to IVF or other ART 150-225 IU daily commencing on day 2 or 3 of the cycle. Dose adjustment should not exceed 450 IU daily.
Hypersensitivity. Hypothalamic & pituitary tumours; ovarian enlargement or cyst not due to polycystic ovarian disease; gynaecological haemorrhages of unknown aetiology; ovarian, uterine or mammary carcinoma; primary ovarian failure; malformations of sexual organs or fibroid uterine tumours incompatible w/ pregnancy.
Existing or history of porphyria. Evaluate for hypothyroidism, adrenocortical deficiency & hyperprolactinemia before starting therapy. Ovarian hyperstimulation syndrome (OHSS); monitor stimulation cycles by ultrasound scans & oestradiol measurements; discontinue if severe OHSS occurs. Incidence of multiple pregnancy & pregnancy loss by miscarriage/abortion is increased in patients undergoing induction of ovulation. Careful monitoring of ovarian response is recommended. Patients w/ history of tubal disease are at risk for ectopic pregnancy. Congenital malformation. Thromboembolism. Pregnancy & lactation.
Headache, ovarian cysts, local inj site reactions (eg pain, erythema, haematoma, swelling &/or irritation at the site of inj); abdominal pain, distension & discomfort, nausea, vomiting, diarrhoea; mild/moderate OHSS.