Menopur

Menopur contains purified hMG, obtained from the urine of postmenopausal women. The ratio of LH and FSH is 1:1.

Use in women causes stimulation of estrogen production, as well as follicular maturation and proliferation within the endometrium. Use in men increases testosterone levels and stimulates spermatogenesis processes by influencing the cells of the seminiferous tubules. [ 1 ]

Indications Menopur

It is used in women in cases of infertility associated with disorders of the hypothalamus-pituitary system, and also to stimulate multiple follicle growth when using reproductive methods.

It is prescribed to men in cases of azoospermia or oligoasthenospermia caused by hypogonadism of a hypogonadtropic nature.

Release form

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

Pharmacodynamics

Menotropin, which has both LH and FSH activity, stimulates follicular growth and development, and at the same time the production of steroid gonadosteroids in women who do not experience a primary decline in ovarian activity.

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

In line with the effect of LH on increasing steroid gonadosteroid production, estradiol levels with Menopur are higher than those observed with recombinant FSH during IVF/ICSI cycles with down regulation. This phenomenon should be taken into account when monitoring the patient's response to therapy, taking into account estradiol levels.

No differences in estradiol values were found when using low-dose ovulation induction protocols in women with ovulation absence.

Pharmacokinetics

After 1 week of repeated administration of 150 IU of the drug to perform down-regulation in women tested by volunteers, the plasma Cmax values of FSH (corrected for the initial level) were 8.9±3.5 IU/L (with subcutaneous injections) and 8.5±3.2 IU/L (with intramuscular administration). The Cmax values for FSH are noted after 7 hours (for both methods of administration).

With repeated use, FSH is excreted with a 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

The dissolved powder can be used via intramuscular or subcutaneous injection. The liquid is prepared before the injection; the solvent is the contents of the ampoule from the packaging kit.

In case of infertility in women, therapy begins with the use of 75 IU of the drug (1-2 vials) per day. If there is no response from the ovaries, the dose is increased until it appears: follicles begin to grow and the estrogen level increases. This dosage is maintained until the estrogen level reaches preovulatory values. If there is a sharp jump in the estrogen level, the dose of Menopur is reduced.

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

To stimulate spermatogenesis in men, it is necessary to use 1-3 thousand IU of the drug, 3 times a week. This course lasts until testosterone levels stabilize. Then the drug is administered with the above frequency, but in a dosage of 75-150 IU.

• Application for children

The drug is not used in pediatrics.

Use Menopur during pregnancy

Menopur should not be used if you are pregnant or suspect you may be pregnant.

Contraindications

Main contraindications:

• thyroid related diseases;
• hyperprolactemia;
• adrenal pathologies;
• neoplasms affecting the hypothalamus or pituitary gland;
• prostate carcinoma;
• an increase in the size of the ovaries that has a persistent form;
• breastfeeding period;
• severe intolerance associated with the elements of FSH and LH, as well as with excipients of the drug;
• the presence of cysts that are not associated with polycystic disease;
• malformations of the genitals or uterine fibroids, due to which pregnancy is impossible;
• vaginal bleeding of unknown origin;
• 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

Side effects include:

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

Interactions with other drugs

The medication can be combined with Choragon to stimulate spermatogenesis processes and also to induce ovulation.

It is prohibited to mix the medicinal liquid with other medicines inside the same syringe.

The combination of Menopur with clomiphene citrate results in an enhanced follicular response.

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

Storage conditions

Menopur should be stored at temperatures no higher than 25°C.

Shelf life

Menopur should be used within 24 months from the date of sale of the therapeutic substance.

Analogues

Analogues of the drug are the drugs Menogon, Humegon and Pergogrin with menopausal gonadotropin, as well as Pergonal, Humog with Merional and Menotropins.

Reviews

Menopur receives mostly good reviews from patients – it works effectively according to its indications. The disadvantages include the high cost of the medication.