Adult Dosing
Ovulation Induction
- Initial dose: 75 IU SC q24 hrs x 14 days
- After 14 days, may increase by 37.5 IU q7 days, if necessary
- Max: 300 IU/day
- Max duration: 35 days, unless serum estradiol increase indicates imminent follicular development
Note:
- Initial dose in the subsequent cycles should be individualized for each patient based on her response in the preceding cycle
ART program
Oligoanovulatory infertility
- Initial dose: 150 IU SC q24 hrs, start on day 2 or 3 of cycle, until sufficient follicular development is attained
- Max for 10 days
Endogenous gonadotropin levels suppressed
- Initial dose: 150 IU (<35 yrs age) and 225 IU (>35 yrs age) SC q24 hrs x 5 days
- May adjust the dose by 75-150 IU q3-5 days
- Max: 450 IU/day
Induction of Spermatogenesis in Men [Gonal-F]
- 150 IU SC x3/wk
- Max: 300 IU x3/wk
- Administer after normal serum testosterone levels have been reached, concomitantly with hCG
Note:
- Use lowest effective dose
Pediatric Dosing
- Safety and effectiveness in pediatric patients have not been established
[Outline]
- Follitropin alpha should be used only by physicians experienced in infertility treatment with appropriate monitoring facilities
- Follitropin alpha therapy should be started after proper diagnosis of infertility and selection of candidates
- Follitropin alpha therapy can cause abnormal ovarian enlargement. To minimize the risk, use the lowest effective dose and monitor ovarian response by ultrasound and/or measure serum estradiol levels periodically
- If ovaries are abnormally enlarged, do not administer hCG, to reduce the chances of developing ovarian hyperstimulation syndrome (OHSS) and advise patient to prohibit intercourse after ovulation because of the danger of hemoperitoneum resulting from ruptured ovarian cysts
- Ovarian Hyperstimulation Syndrome (OHSS), a serious medical condition, can occur with follitropin therapy. It is manifested as severe pelvic pain, nausea, vomiting, weight gain, abdominal pain, abdominal distension, severe ovarian enlargement and dyspnea. Hypovolemia, hemoconcentration, electrolyte imbalances, ascites, hemoperitoneum, pleural effusions, hydrothorax, acute pulmonary distress, thromboembolic reactions, and abnormal liver function tests have been reported
- OHSS mostly occurs after treatment has been discontinued, reaches its maximum at about seven to ten days following treatment, and resolves with the onset of menses. Withhold hCG administration if OHSS develops prior to hCG administration
- If serious OHSS occurs, discontinue the treatment immediately and hospitalize the patient. Management includes complete bed rest, fluid and electrolyte balance and analgesic (if needed); avoid diuretics except in the late phase of resolution. Asses fluid intake and output, weight, hematocrit, serum and urinary electrolytes, urine specific gravity, BUN and creatinine, total protein with albumin: globulin ratio, coagulation studies, electrocardiogram to monitor for hyperkalemia, and abdominal girth, daily, or more often based on the clinical need
- Gonadotropin therapy can cause serious pulmonary conditions such as atelectasis and acute respiratory distress syndrome. Thromboembolic reactions resulting in venous thrombophlebitis, pulmonary embolism, pulmonary infarction, cerebral vascular occlusion (stroke), and arterial occlusion (resulting in loss of limb and rarely in myocardial infarction) have been reported. Personal or family history, severe obesity, or thrombophilia are risk factors
- Gonadotropin therapy including follitropin can cause multi-fetal gestation and births. Before starting treatment, patient should be advised of the potential risk of multi-fetal gestation and births
- Use sonographic visualization of the ovaries and endometrial lining in conjunction with measurement of serum estradiol levels to determine the degree of follicular maturation and the timing of hCG administration and also to minimize the risk of OHSS, multi-fetal gestations and ectopic pregnancy
- Serious systemic hypersensitivity reactions, including anaphylaxis have been reported with follitropin alfa. If an anaphylactic or other serious allergic reaction occurs initiate appropriate therapy including supportive measures if cardiovascular instability and/or respiratory compromise occur, discontinue further use
Cautions: Use cautiously in
- Personal or family history of thromboembolic reactions
- Severe obesity
- Thrombophilia
Pregnancy Category:X
Breastfeeding: Safety unknown, it is unknown whether follitropin is excreted in human milk. Because of the potential for possible serious adverse reactions in nursing infants a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother.
Pricing data from www.DrugStore.com in U.S.A.
- Gonal-f RFF 75 UNIT SOLR [Vial] (SERONO)
1 unit = $123.99
3 unit = $358.97 - Gonal-f 450 UNIT SOLR [Vial] (SERONO)
1 unit = $726
3 unit = $2095.98
Warning: This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.
