Hog

Humog is a follicle-stimulating drug.

Indications Hog

It is used in the following cases:

• infertility (women) caused by a disorder of follicular formation processes, accompanied by normo-and hypogonadotropic ovarian failure;
• stimulation of the superovulation process (growth of a large number of follicles, which helps to carry out additional reproductive procedures that contribute to the subsequent conception) in combination with the hCG component;
• infertility (men) caused by a disorder of spermatogenesis and accompanied by normal and hypogonadotropic hypogonadism (together with the hCG element).

Release form

The release of the medication is realized in the form of a powder, from which liquid is prepared for i / m injections (volumes - 75 IU LH + 75 IU FSH or 150 IU LH + 150 IU FSH). The powder is placed in glass bottles with a capacity of 2 ml, and the solvent is placed in glass ampoules with a capacity of 1 ml. Inside the box contains 1 bottle of powder and 1 ampoule with solvent.

Pharmacodynamics

Humog is an element of hMG, which is based on the urine of women who are in the postmenopausal period. The composition of the drug in the ratio of 1k1 contains the components of LH and FSH.

It has gonadotropic and follicle-stimulating effects. Increases plasma values of sex hormones.

When used by women, it leads to an increase in blood levels of estrogens and induces ovarian growth activity, the process of formation of follicles inside them, together with ovulation, and also contributes to endometrial proliferation.

When used by men, spermatogenesis is stimulated (by activating protein binding processes that synthesize androgens inside the seminiferous tubules and sustentocytes) and activation of testosterone production. This effect is mainly due to the influence of FSH.

[1], [2], [3], [4], [5], [6], [7]

Pharmacokinetics

Plasma values of the Cmax component of FSH are noted after 6-24 hours from the moment of injection; further, the blood level of FSH gradually decreases. Half-life period - within 4-12 hours. After absorption into the blood, the distribution of the hMG element occurs mostly within the kidneys and ovarian tissues, and the excretion mainly occurs through the kidneys.

Reduced excretion may occur in people with renal insufficiency.

[8], [9]

Dosing and administration

Humog must be introduced in the / m method after pre-dilution of the substance in a solvent, which is implemented complete with powder.

Use in women.

To stimulate the growth of the 1st dominant follicle, 2 different methods of administration can be applied.

First method: daily administration of drugs in portions 75 IU (during the 1st week of the menstruation cycle). It is necessary to continue injections until the moment when an adequate response is obtained - that it has come, can be learned through everyday analyzes of estrogen blood counts and identification of follicle sizes through an ultrasound procedure. Follicles often mature during a therapeutic course that lasts 7-12 days. If the reaction of the ovaries to the use of drugs is absent, the daily portion can be gradually increased to 150 ME.

The second method: the use of drugs through the day for 7 days. The size of the initial dosage is within 225-375 IU per day. In the absence of adequate stimulation, the portion is allowed to gradually increase.

After termination of therapy using any of the methods described above, as well as subject to the presence of an adequate (not excessive) ovarian response, controlled through folliculometry and plasma estradiol level monitoring, it is necessary 24-48 hours after the last use of Humoga 1-time input 5000-10000 ME of hCG element (it increases the LH values and stimulates the release of a mature egg).

If the patient has at least 3 follicles having a diameter of 16-20 mm (information is obtained through ultrasound), as well as an adequate ovarian response (plasma estradiol values are 300-400 pg / ml (or 1000-1300 pmol / l) for each follicle, whose diameter is greater than 18 mm), then hCG cannot be entered. In addition, measures should be taken to prevent a possible conception in order to avoid the multiple form of pregnancy. Because each follicle, having a diameter of more than 14 mm, is considered preovulatory, the presence of several such follicles creates the possibility of a multiple fetus.

If ovulation is present, but pregnancy did not occur, therapy can be repeated using one of these methods for 2 cycles. On the day when hCG is administered, and in the next 2-3 days, the woman is recommended to have sexual contact. If the stimulation of the superovulation process is performed (in the case of additional reproductive procedures), the duration of drug use may be increased.

Use in men.

The drug is used in secondary hypogonadism to stimulate spermatogenesis, in cases where prior treatment with the introduction of hCG only led to the appearance of an androgenic response without symptoms of spermatogenesis potentiation. At the same time, therapy is continued with the introduction of 2000 IU hCG 2 times per week, together with Humoga injections in the amount of 75 ME, 3 times per week. Therapy according to a similar scheme should be continued for at least 4 months, and if there is no effect, it continues with the introduction of 2,000 IU hCG 2 times a week and 150 IU Humoga 3 times a week.

The state of spermatogenesis processes should be assessed every month. If a positive effect is absent for 3 months, therapy should be canceled.

In the case of the normogonadotropic form of oligospermia, which is idiopathic in nature, the drug is administered every week at a dosage of 5,000 IU hCG (intramuscularly or s / c method), and at the same time Humog is used - 3-fold administration per week of 75-150 IU LS for 3 months.

[17], [18], [19], [20], [21]

Use Hog during pregnancy

You can not prescribe medication during lactation or pregnancy of a woman.

Contraindications

General contraindications:

• the presence of intolerance against the drug;
• tumors in the hypothalamic-pituitary zone;
• hyperprolactinemia;
• diseases affecting the thyroid or adrenal glands.

Contraindications for women:

• enlarged ovaries in size, having a persistent character;
• a cyst in the ovarian region (provided that there is no Stein-Leventhal syndrome);
• Stein-Leventhal syndrome;
• abnormal development of the genitals (which makes normal gestation of the fetus impossible);
• leiomyoma;
• an unknown genesis metrorrhagia;
• estrogen-dependent neoplasms (carcinoma of the uterus, ovaries or breast);
• primary ovarian failure.

It is forbidden to appoint men in such cases:

• prostate carcinoma;
• tumors in the testicles;
• androgen-dependent tumors.

Caution is required if there are factors that can lead to the development of thromboembolism (for example, familial or individual predisposition, thrombophilia or severe obesity (weight index is> 30 kg / m ² )) because in this case the probability of occurrence thromboembolism of arterial or venous nature (during or after the end of therapy with the use of gonadotropins).

In such conditions, gonadotropins should be used only in situations where their benefit is more likely than the risk of complications.

[10], [11], [12], [13]

Side effects Hog

The use of medication may cause the following side effects:

• disorders affecting digestive activity: vomiting, gastralgia, bloating and nausea;
• endocrine dysfunction: EHH, mastalgia, an increase in the size of the ovaries, the appearance of large ovarian cysts, and a significant increase in the level of estrogen excretion along with urine; men may develop gynecomastia;
• problems with the exchange processes: violation of VEB indicators;
• signs of allergy: fever, rash, arthralgia, urticaria (antibody formation after prolonged use); in addition, allergy symptoms that have a generalized nature, urticaria or erythema, develop;
• local manifestations: pain, swelling or itching at the injection site;
• others: hypovolemia, hydrothorax, oliguria, weight gain, blood clots, as well as ascites, a decrease in blood pressure, pain in the lower abdomen, hemoperitoneum, multiple pregnancy, and TEB.

[14], [15], [16]

Overdose

Intoxication causes ovarian hyperstimulation.

With the 1st degree of pathology (mild form) therapy is not needed. In this case, there is a small increase in the ovaries in size (no more than 5-7 cm), abdominal pain and an increase in sex steroids. A woman should be informed about this and then carefully monitored her condition.

At the 2nd degree of the disease, hospitalization with symptomatic measures is needed, including intravenous infusion of fluids that support the general blood circulation (if the hemoglobin level increases). When ovarian cysts with a size of about 8-10 cm, vomiting, abdominal signs and nausea are noted.

At the 3rd degree of the disease, cysts larger than 10 cm appear, and in addition, hydrothorax, dyspnea, abdominal pain with ascites, salt retention, increase in blood viscosity develop (against the background of this, platelet adhesion increases, which threatens the development of thromboembolism) and blood hemoglobin values increase. In this case, hospitalization is necessary.

[22]

Interactions with other drugs

It is forbidden to mix the drug in one syringe with other drugs.

The combination with clomiphene enhances the ovarian response to Humog.

[23], [24], [25]

Storage conditions

Humog required to keep in a closed from children and penetration of sunlight. The powder is forbidden to freeze; must be stored at temperature values in the range of 2-8 ° C. The solvent may be contained at rates not exceeding 25 ° C.

[26], [27], [28],

Shelf life

Humog in powder form can be used within 36 months from the date of manufacture of the pharmaceutical product. The shelf life of the solvent is 5 years.

Application for children

The drug is not used in pediatrics.

Analogs

Analogues of drugs are the drugs Menogon, Pergonal with Gonadotropin, menopausal, and in addition Pergogrin and CHMG Massone with Menopur and Humegon.

[29], [30], [31]