Menotropins
Menotropins (Pergonal)
Menotropins
(men-oh- TROH-pinz)
Pregnancy Category: X Humegon Pergonal Repronex (Rx)

Classification: Ovarian stimulant

Action/Kinetics: Menotropins are a mixture of FSH and LH extracted from the urine of postmenopausal women. Causes growth and maturation of ovarian follicles. For ovulation to occur, HCG is administered the day following menotropins. Time to peak effect, females: 18 hr. In men, menotropins with HCG given for a minimum of 3 months induce spermatogenesis. Eliminated through the kidneys.

Uses: Females: In combination with HCG to induce ovulation in clients with anovulatory cycles not due to primary ovarian failure. Use Repronex in conjunction with HCG for multiple follicular development and induction of ovulation in clients who have previously received pituitary suppression. Males: In combination with HCG to induce spermatogenesis in clients with primary or secondary hypogonadotrophic hypogonadism.

Contraindications: Women: Pregnancy. Primary ovarian failure as indicated by high levels of urinary gonadotropins, ovarian cysts, intracranial lesions, including pituitary tumors. Overt thyroid and adrenal dysfunction. Any cause of infertility other than anovulation. Abnormal bleeding of undetermined origin. Ovarian cysts or enlargement of the ovaries not due to polycystic ovarian syndrome. Men: Normal gonadotropin levels, primary testicular failure, disorders of fertility other than hypogonadotrophic hypogonadism. Thyroid or adrenal dysfunction. Absence of neoplastic disease should be established before treatment is initiated.

Side Effects: Women. GU: Ovarian overstimulation, hyperstimulation syndrome (maximal 7-10 days after discontinuation of drug), ovarian enlargement (20% of clients), adnexal torsion, ruptured ovarian cysts, ectopic pregnancy multiple births (20%). CV: Hemoperitoneum, thromboembolism tachycardia, pulmonary and vascular complications. Hypersentivity: Generalized urticaria, angioneurotic edema, facial edema, dysnpea indicating laryngeal edema. CNS: Headaches, malaise, dizziness. GI:N&V;, abdominal pain, diarrhea, abdominal cramps, bloating. At injection site: Pain, rash, swelling, irritation. Miscellaneous: Fever, chills, musculoskeletal aches, joint pains, body rashes, dyspnea, tachypnea.
Men. Gynecomastia, breast pain, mastitis, nausea, abnormal lipoprotein fraction, abnormal AST and ALT.

How Supplied: Powder for injection: 75 IU, 150 IU

Dosage
?IM Induction of ovulation.
Individualized, initial: 75 IU of FSH and 75 IU of LH for 7-12 days (maximum), followed by 10,000 USP units of HCG 1 day after last dose of menotropins. Subsequent courses: Same dosage schedule for two more courses, if ovulation has occurred. Then, dose may be increased to 150 IU of FSH and 150 IU of LH for 7-12 days, followed by HCG as in the preceding for two or more courses. Note: Repronex can also be given or self-administered SC.
Induction of spermatogenesis.
It may be necessary to give HCG alone, 5,000 IU 3 times/week, for 4-6 months prior to menotropins; then, 75 IU FSH and 75 IU LH IM 3 times/week and HCG 2,000 IU 2 times/week for at least 4 months. If no response after 4 months, double each dose of menotropins with the HCG dose unchanged.