Menogon

Menogon is a medicine with a pronounced follicle-stimulating therapeutic effect.

The active element of the drug is the hMG substance. The composition of the drug contains the hormones LH and FSH in a proportion of 1k1 - 75 IU of these hormones, which are also produced by the human pituitary gland. In this case, the specified active element is obtained from urine, which is taken from postmenopausal women. [1]

Indications Menogon

It is used for such conditions and disorders:

• infertility in women , provoked by a disorder of the processes of follicular maturation - due to normo- or hypogonadotropic ovarian functional insufficiency;
• induction of the ovulation process (combined with hCG medicine);
• infertility in men due to a disorder of spermatogenesis in connection with normo- or hypogonadotropic hypogonadism (in combination with the substance hCG).

Release form

The release of the drug element is carried out in the form of a powder for an injection liquid (s / c and i / m injections) - 5 or 10 ampoules with powder and 5 or 10 ampoules with a special solvent inside the box.

Pharmacodynamics

The use of Menogon causes an increase in the blood level of estrogen in women, and also leads to the maturation of the egg; when used in men, spermatogenesis and testosterone production are activated. [2]

Pharmacokinetics

Plasma values of Cmax FSH are noted after 6-48 hours with an intramuscular injection, as well as after 6-36 hours with a subcutaneous injection. Further, the blood value of FSH gradually decreases with a half-life term equal to 56 hours (i / m use) and 51 hours (s / c injection). 

Dosing and administration

The medication should be administered by the s / c or i / m method, after dissolving the lyophilisate in the solvent that is included in the kit.

For women, to stimulate follicular growth, the portion is selected personally, taking into account how the ovaries react. Correction is performed in accordance with the data obtained on ultrasound and blood levels of estrogen.

In the case of an overestimated dosage of the hMG substance, multiple 1- or 2-sided follicular growth occurs.

Therapy often begins with a portion of 75-150 ME (corresponds to 1-2 ampoules of drugs) per day. If the ovaries do not respond to this dosage, it is gradually increased until an increase in the blood count of estrogen or follicular growth is recorded. This portion is maintained until the pre-ovulatory estrogen level is reached. If at the beginning of therapy there is a rapid increase in the value of estrogen, it is necessary to reduce the portion of hMG.

To induce ovulation, it is required to inject 5-10 thousand IU of hCG once a day after 1-2 days after the last injection of hMG.

Men, in order to stimulate spermatogenesis, require the use of 1-3 thousand IU of hCG, 3 times a week, until the blood testosterone level stabilizes. Further, for several months, 75-150 IU of the drug is used 3 times a week.

Use Menogon during pregnancy

Menogon should not be used while breastfeeding or pregnancy.

Contraindications

The main contraindications:

• severe intolerance to the elements of the drug and solvent;
• the presence of cysts or an increase in the size of the ovaries (their cause is not PCOS);
• neoplasm in the area of the hypothalamus-pituitary gland;
• hyperprolactinemia;
• diseases affecting the adrenal glands and thyroid gland;
• PCOS;
• any defects in the development of the genitals (in which the normal course of pregnancy is impossible);
• uterine myoma;
• metrorrhagia of an indefinite nature;
• carcinoma of the prostate;
• tumor neoplasms of an estrogen-dependent nature (carcinoma affecting the uterus, breast or ovaries);
• ovarian functional insufficiency of the primary form;
• neoplasms associated with androgens.

Side effects Menogon

Among the side signs:

• lesions associated with the work of the gastrointestinal tract: vomiting or nausea often appears;
• disorders of endocrine function: ovarian hyperstimulation often develops;
• violations of the activity of the mammary glands and genitals: often men have gynecomastia or pain in the area of the mammary glands;
• immune lesions: rarely, there are signs of intolerance (epidermal rash or fever). The formation of antibodies is singly noted;
• local symptoms: very often there are pains, swelling or itching in the area of the injection.

The use of hMG substances can provoke ovarian hyperstimulation, which clinically occurs after the use of hCG (it is prescribed to stimulate the ovulation process). As a result, large ovarian cysts can form, which can rupture and cause bleeding inside the abdomen. Along with this, intense ovarian hyperstimulation can lead to the appearance of oliguria, ascites, hypotension, hydrothorax and signs of thromboembolism.

Long-term use of drugs can occasionally lead to the formation of antibodies, which makes the treatment course ineffective.

Overdose

With intoxication, ovarian hyperstimulation develops:

• in the case of the 1st degree of impairment (mild), specific treatment is not carried out; in this case, there is a slight overgrowth of the ovaries (maximum 5-7 cm), an increase in the values of sex steroids and the appearance of pain in the abdominal area. It is necessary to notify the patient about this condition, and then establish constant control over her;
• 2nd degree of impairment - hospitalization and symptomatic actions are necessary, including intravenous infusions - the introduction of therapeutic fluids that maintain the BCC values (if an increase in hemoglobin levels occurs). With ovarian cysts, whose size is in the range of 8-10 cm, nausea, manifestations in the abdominal area and vomiting are noted;
• 3rd degree of disorder - the ovaries increase to a size of 10+ cm, hydrothorax, dyspnea, ascites develop, pain in the abdomen and its increase appears, the blood hemoglobin count rises, blood viscosity increases, at which platelet adhesion is potentiated (there is a risk of thromboembolism), and electrolyte retention occurs. In this case, the patient must be hospitalized.

Storage conditions

Menogon must be kept out of the reach of small children. The liquid must not be frozen. Temperature readings - maximum 25 ° C.

Shelf life

Menogon is allowed to be used for a period of 3 years from the date of manufacture of the therapeutic substance.

Analogs

The analogues of the medication are Puregon, Ovitrel with Gonal-f, Sustanon with Bravel, Menopur and Formon. In addition, Luveris, Pregnil, Horagon with Merional, Humog with Pergoveris, and Profazi.

Reviews

Menogone is receiving good reviews for its therapeutic efficacy - it is noted that it helps the onset of pregnancy. Of the minuses, its high cost is distinguished.