

MENOPUR is a preparation of human menopausal gonadotropin (hMG), a high degree of purification. Belongs to the group of menotoropinov, contains FSH and LH in a 1: 1 ratio. The drug is obtained from the urine of postmenopausal women.
In women, the drug causes an increase in the level of estrogen in the blood and stimulates the growth and maturation of ovarian follicles, proliferation of the endometrium.
In men, the use of Menopur increases the concentration of testosterone in the blood and stimulates spermatogenesis, affecting the Sertoli of the seminiferous tubules.
Pharmacokinetics
Suction. Cmax FSH in plasma is reached within 7 hours after sc or i / m administration.
Distribution. Vd after repeated doses of 150 ME for 7 days, it is 8.9 ± 3.5 IU / l for p / quveti and 8.5 ± 3.2 IU / l for i / m administration.
Metabolism. Not studied.
Derivation. The concentration of FSH in the blood decreases gradually. T1/2 is (30 ± 11) hours at s / c and (27 ± 9) hours with i / m administration. Excreted mainly by the kidneys.
For women
For men
1 bottle contains:
Active substance: menotropins75 ME;
Excipients: lactose monohydrate - 20 mg; polysorbate-20 - 0.1 mg; sodium hydroxide 0,0008–0,003 mg; hydrochloric acid 0–0,0005 mg;
Ampoule of solvent (0.9% sodium chloride solution): sodium chloride - 9 mg, hydrochloric acid 0.007 mg - 0.02 mg; water for injection - up to 1 ml.
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The drug is administered IM or s / c. Solution for injection is prepared immediately before administration, using the attached solvent.
Unless otherwise prescribed, the following treatment regimen is recommended:
For women
In infertility due to hypothalamic-pituitary disorders, in order to stimulate the growth of one dominant follicle
The dosage regimen of the drug is set individually. The optimal dose of the drug and the duration of treatment are selected on the basis of ultrasound of the ovaries, determining the level of estrogen in the blood, as well as clinical observation. About the maturation of the follicle is judged by the increase in the level of estrogen in the blood.
The initial dose of Menopur® is 75-150 IU (1-2 vials / day). In the absence of ovarian response, the dose is gradually increased to increase the level of estrogen in the blood or growth of follicles. The dose is left unchanged until the concentration of estrogen reaches the preovulatory level. With a rapid rise in the level of estrogen at the beginning of stimulation, the dose of the drug should be reduced.
In order to induce ovulation, 1–2 days after the last injection of Menopur, 5,000–10,000 IU hGH are administered once.
Men: In order to stimulate spermatogenesis, 1,000-3,000 IU hCG is administered 3 times a week until blood testosterone levels are normalized. Then within a few months, Menopur® 75-150 IU (1-2 vials) is administered 3 times a week.
From the genitourinary system: ovarian hyperstimulation syndrome (OHSS), lower abdominal pain.
From the nervous system: headache.
From the digestive system: abdominal pain, nausea, flatulence.
General reactions and reactions at the injection site: pain, swelling and irritation at the injection site.
In men, gynecomastia may occur.
The most serious side effect is OHS and its associated complications: thromboembolic syndrome and ovarian looping. If any of the side effects indicated in the instructions are aggravated, or any other side effects that are not indicated in the instructions have developed, you should inform your doctor.
In the presence of one of these diseases, before taking the drug should always consult with your doctor.
Carefully: see “Special Instructions”.
Menopur® can be used in combination with the drug Horagon (human chorionic gonadotropin) in women - to induce ovulation, after stimulating the growth of follicles; in men, in order to stimulate spermatogenesis.
Menopur® is contraindicated for use during pregnancy and lactation.
During pregnancy, the manifestations of ovarian hyperstimulation syndrome are exacerbated, their duration increases, this condition can lead to a threat to the patient's life.
Before starting treatment, it is recommended to analyze the sexual partner sperm; if necessary, treat hypothyroidism, adrenal insufficiency, hyperprolactinemia, pituitary tumors or hypothalamus. Gynecological examination with an increase in the ovaries is carried out very carefully in order to avoid rupture of ovarian cysts.
After stimulation of follicle maturation and ovulation, the likelihood of multiple pregnancy with natural conception increases. In the case of ART, the likelihood of multiple pregnancy depends on the number of injected oocytes.
It should be borne in mind the possibility of ectopic pregnancy, especially with diseases of the fallopian tubes in history. Frequency of early and spontaneous abortions during pregnancy that occurred after treatment with Menopur®, higher than in healthy patients, but comparable to that in infertility of a different etiology.
The relationship between the use of the drug Menopur is not established.® and the occurrence or development of benign or malignant neoplasms of the reproductive organs.
The incidence of congenital developmental abnormalities in newborns during ART is slightly higher than when conceived naturally. However, this is most likely due to the individual characteristics of the parents (age, sperm characteristics, etc.), than with Menopur.®.
It should be remembered that in patients with a body mass index ≥30 kg / m2 increases the risk of thromboembolic complications.
Treatment with menotropins can lead to the development of OHSS, which becomes clinically pronounced after the administration of hCG preparations and is manifested in the formation of large ovarian cysts. This is combined with the accumulation of fluid in the abdominal cavity (ascites), the pleural cavity (hydrothorax), accompanied by a decrease in urine output (oliguria), a decrease in blood pressure (hypotension) and blockage of blood vessels (thromboembolic phenomenon). Most often, OHSS occurs on the 7-10th day after ovulation, stimulated by the administration of hCG, (less often - when conducting ART).
At the first signs of OHSS (abdominal pain, palpated by the doctor or ultrasound-defined volume lesions in the lower abdomen), treatment should be stopped immediately!
In the presence of pregnancy, the above-described phenomena are exacerbated, and their duration increases, which may threaten the patient's life.
In cases of developing OHSS, it is not advisable to inject ChCHG for the purpose of ovulation. When conducting ART, the risk of OHS can be reduced if the contents of all follicles are aspirated before ovulation occurs.
During treatment in men with a high concentration of FSH, menotropins are ineffective.
Menopur® does not adversely affect the ability to drive a car and other mechanisms.
Symptoms: cases of overdose are unknown, but in such situations we should expect the development of OHSS and thromboembolic complications. Symptoms of OHSS - increase in ovaries, abdominal pain, nausea, vomiting, diarrhea, weight gain, oliguria, ascites, hydrothorax, hemoperitoneum, hemoconcentration, shortness of breath
Treatment: usually do not require additional treatment and pass independently within 2–3 weeks. For details, see the section “Special Instructions”.