Menopur

Menopur contains a purified hMG element obtained from the urine of postmenopausal women. The proportions of indicators of LH and FSH are 1 to 1.

Use in a woman causes the stimulation of estrogen production, as well as follicular maturation and proliferation within the endometrium. The use in a man increases the values of testosterone and stimulates the processes of spermatogenesis by influencing the cells of the seminiferous tubules. [1]

Indications Menopur

It is used in women in case of infertility associated with disorders of the hypothalamus-pituitary gland system, and in addition to stimulate multiple follicular growth when using reproductive methods.

Men are prescribed in case of azoospermia or oligoasthenospermia caused by hypogonadism of a hypogonadtropic nature.

Release form

The release of the medication is realized in the form of a soluble powder for the formation of an injection liquid - inside 2 ml vials. The vials contain ampoules with a solvent (volume 1 ml). There are 5 such sets inside the pack.

Pharmacodynamics

Menotropin, which has the activity of LH and FSH at the same time, stimulates follicular growth and development, and at the same time the production of steroidal gonadosteroids in those women who do not have a primary decrease in ovarian activity.

FSH is the main factor responsible for the replenishment of the follicular population, as well as for growth at the initial stage of folliculogenesis; LH is also important in the processes of ovarian steroidogenesis and preovulatory follicular maturation. FSH is able to stimulate follicular growth in the absence of LH (for example, in the case of a hypogonadotropic type of hypogonadism), but in such situations the follicles develop abnormally - their maturation is insufficient or a low estradiol level is observed. [2]

In accordance with the influence exerted by LH on the increase in the production of steroidal gonadosteroids, the estradiol values with the use of Menopur are higher than the values observed with the introduction of recombinant FSH substances during IVF / ICSI cycles with down-regulation. This phenomenon must be taken into account when monitoring the patient's response to therapy, taking into account the indicators of estradiol. 

Differences in the values of estradiol when using low dosages of induction protocols for ovulation in women with its absence were not found.

Pharmacokinetics

After 1 week of repeated applications of 150 IU of the drug to perform down-regulation in women tested by volunteers, the plasma Cmax of FSH (the correction relative to the initial level was taken into account) was 8.9 ± 3.5 IU / L (with p / to injections) and 8.5 ± 3.2 IU / l (with intramuscular injection). Cmax values for FSH are noted after 7 hours (for both methods of administration).

With repeated use, FSH is excreted with an elimination half-life in the range of 30 ± 11 (with subcutaneous administration) and 27 ± 9 (with intramuscular injections) hours. Excretion of the drug is mainly carried out by the kidneys.

Dosing and administration

Dissolved powder can be applied through i / m or s / c injection. The preparation of the liquid is carried out before the injection; the solvent in this case is the contents of the ampoule from the packaging set.

In case of infertility in a woman, therapy begins with the use of 75 IU of the drug (1-2 bottles) per day. In the absence of a response from the ovaries, the portion is increased until it appears: follicles will begin to grow and the estrogen rate will increase. This dosage is maintained until the estrogen level reaches preovulatory values. With a sharp jump in the estrogenic indicator, the portion of Menopur is reduced.

To induce ovulation, injections are performed according to the standard scheme, and then, upon completion of the standard treatment regimen (after a few days), a single injection of 5-10 thousand IU of the drug is used.

To stimulate spermatogenesis in a man, you need to use 1-3 thousand IU of the medication, 3 times a week. This course lasts until the testosterone levels stabilize. Further, the drug is administered with the above frequency, but at a dosage of 75-150 IU.

• Application for children

The medication is not used in pediatrics.

Use Menopur during pregnancy

Menopur should not be used if pregnant or suspected of having this condition.

Contraindications

The main contraindications:

• diseases associated with the thyroid gland;
• hyperprolactemia;
• adrenal pathology;
• neoplasms that affect the hypothalamus or pituitary gland;
• carcinoma of the prostate;
• an increase in the size of the ovaries, which has a persistent form;
• period of breastfeeding;
• severe intolerance associated with the elements of FSH and LH, as well as with excipients of drugs;
• the presence of cysts that are not associated with polycystic disease;
• malformations in the development of the genitals or uterine fibroids, in connection with which pregnancy is impossible;
• having an unknown nature of vaginal bleeding;
• ovarian functional insufficiency, which has a primary form;
• neoplasms whose development is associated with androgens;
• carcinoma of the ovaries, uterus or breast.

Side effects Menopur

Among the side effects:

• an increase in the size of the ovaries, mastalgia, the appearance of ovarian cysts, ovarian hyperstimulation, gynecomastia;
• vomiting, weight gain, nausea, colic;
• arthralgia;
• an increase in temperature;
• oliguria;
• epidermal rash, itching;
• decrease in blood pressure values;
• swelling or redness in the area of the injection;
• multiple pregnancy;
• the formation of antibodies against the active elements of drugs.

Interactions with other drugs

The medication can be combined with Horagon - to stimulate the processes of spermatogenesis, as well as to induce ovulation.

It is forbidden to mix medicinal liquid with other medications inside the same syringe.

The combination of Menopur with clomiphene citrate leads to increased follicular response.

When using GRF agonists, an increase in the dosage of drugs is required.

Storage conditions

Menopur should be kept at a temperature not exceeding 25oC.

Shelf life

Menopur should be administered within a 24-month term from the date of sale of the therapeutic substance.

Analogs

Analogues of drugs are Menogon, Humegon and Pergogrin with Menopausal Gonadotropin, and in addition Pergonal, Humog with Merional and Menotropins.

Reviews

Menopur receives mostly good reviews from patients - it acts effectively in accordance with its indications. Of the minuses, the high cost of the medication is noted.