Adult Dosing
Ovulation Induction
- Cartridge
- Initial dose: 50 IU SC q24 hrs x 7 days
- May increase by 25-50 IU SC qwk, until adequate ovarian response, followed by hCG injection
- Max: 250 IU/day
- Single use vials
- Initial dose: 75 IU IM/SC q24 hrs x 7 days
- May increase by 25-50 IU IM/SC qwk, until adequate ovarian response, followed by hCG injection
- Max: 300 IU/day
Note:
- Asses the women every other day during the treatment and two-weeks post-treatment period, for signs of excessive ovarian stimulation
ART program
- Single use vials
- 150-225 IU IM/SC q24 hrs x 4 days
- May adjust the dose according to the ovarian response, followed by hCG injection
- Max: 600 IU/day
Induction of Spermatogenesis in Men
- Cartridge and Single use vials
- 450 IU SC qwk
- Alt: 225 IU SC x2/wk x 3-4 months
- Alt: 150 IU SC x3/wk x 3-4 months
- Max duration: 12 months
- Administer after normal serum testosterone levels have been reached, concomitantly with hCG
Controlled Ovarian Stimulation
- Cartridge
- Initial dose: 200 IU SC q24 hrs x 7 days
- Max: 500 IU/day
Pediatric Dosing
- Safety and effectiveness in pediatric patients have not been established
[Outline]
- Follitropin should be used only by physicians experienced in infertility treatment with appropriate monitoring facilities
- Follitropin therapy should be started after proper diagnosis of infertility and selection of candidates
- Dose adjustments may be required when switching from other brands, types, and/or methods of administration
- Follitropin therapy can cause abnormal ovarian enlargement. Hence, 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
- 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 proteins with albumin: globulin ratio, coagulation studies, electrocardiogram to monitor for hyperkalemia, and abdominal girth, daily or more often based on 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
- Ovarian torsion associated with OHSS, pregnancy, previous abdominal surgery, past history of ovarian torsion, previous or current ovarian cyst and polycystic ovaries has been reported with follitropin or other gonadotropins therapy. Early diagnosis and immediate detorsion can minimize the damage to the ovary due to reduced blood supply
- Gonadotropin therapy including follitropin can cause multi-fetal gestation and births. Patient should be advised of the potential risk of multi-fetal gestation and births before starting treatment
- There is a slightly higher incidence of congenital malformations after ART then after spontaneous conception
- Incidence of ectopic pregnancies might be increased, as infertile women undergoing ART, and particularly IVF, often have tubal abnormalities. Confirm intrauterine pregnancy by early hCG testing and transvaginal ultrasound
- Gonadotropin products increase the risk of spontaneous abortions
- Ovarian neoplasms, both benign and malignant have been reported in women who have undergone multiple drug regimens for ovulation induction
- 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
- Monitor spermatogenesis in men by measuring serum testosterone level and semen analysis
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.
- Follistim AQ 600 UNT/0.72ML SOLN [Crtrdg-Ndl] (ORGANON)
0.78 0.72ml = $919.99
2.34 0.72ml = $2471.65 - Follistim AQ 300 UNT/0.36ML SOLN [Crtrdg-Ndl] (ORGANON)
0.42 0.36ml = $457.98
1.26 0.36ml = $1270.94
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.
