Urophrolthyropin (Urofollitropinum)

Pharmacodynamics Pharmacokinetics Indications Carefully Contraindications Dosing and Administration Side effects
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Clinical and pharmacological group: & nbsp

Hormones and their antagonists

Other hormones, their analogs and antagonists

Included in the formulation
  • Alterpur
    solution w / m PC 
    IBSA Institute Biokimik S.A.     Switzerland
  • Bravelle
    solution w / m PC 
    Ferring Artsynmittel GmbH     Germany
    • АТХ:

    G.03.G.A.04   Urophrolthyropin

    G.03.G.A   Gonadotropins

    G.03.G   Gonadotropins and other stimulants of ovulation

    Pharmacodynamics:

    Stimulates the growth and maturation of ovarian follicles, increases the level of estrogen, stimulates the proliferation of the endometrium. Does not render luteinizing actions.

    Pharmacokinetics:

    After a single sc administration, the absorption of urofol- lotropin is slower than after the im injection. However, with the repeated use of urofallitropine for 7-21 days (in the treatment of female infertility), the values ​​of AUC and Css with both modes of administration.

    Half-life urofollitropina is 30-40 hours.

    Indications:

    Polycystic ovary syndrome (with a high ratio of LTG / FSH and ineffectiveness of clomiphene citrate therapy), infertility of ovarian genesis.

    ICD-10

    IV.E20-E35.E28.2   Polycystic ovary syndrome

    XIV.N80-N98.N97   Female infertility

    Contraindications:

    Hypersensitivity, children under 18 years of age, high FSH levels in primary ovarian failure, decompensated thyroid and adrenal gland pathologies, pituitary tumors, infertility not associated with ovarian failure, metrorrhagia, etc.bleeding not established etiology, ovarian enlargement (except polycystic ovary syndrome), pregnancy, breast-feeding (during the period of treatment it is necessary to refuse breastfeeding).

    Carefully:

    Elderly age, renal and hepatic insufficiency.

    Pregnancy and lactation:

    Category of recommendations FDA H.

    Contraindicated in pregnancy and lactation.

    Dosing and Administration:

    In / m (solution for injection is prepared immediately before use). There are two schemes of the drug: daily administration in a dose of 75 IU in the first 7 days of the cycle in menstruating women, the second scheme - administered every other day at a dose of 225-375 IU for 1 week. After 24-48 hours after the last dose (irrespective of the use of the regimen), a single injection of HC is given at a dose of 10,000 IU. In the presence of ovulation, but the absence of pregnancy, the introduction of the drug can be repeated on one of the circuits for at least 2 more cycles.

    Side effects:

    From the digestive system: possible abdominal pain, nausea, vomiting, diarrhea, abdominal cramps, flatulence.

    From the side of the central nervous system: rarely - a headache.

    On the part of the reproductive system: often - a moderate increase in the ovaries, ovarian cysts, mammary gland tension; possible - ovarian hyperstimulation syndrome.

    Dermatological reactions: dry skin, hair loss.

    Allergic reactions: rarely - fever, chills, pain in the muscles and joints, general malaise, weakness, skin rash, urticaria.

    From the coagulation system: rarely - thromboembolism (usually associated with a severe ovarian hyperstimulation syndrome).

    Local reactions: often - pain, swelling, rash, irritation at the injection site.

    Overdose:

    Symptoms: ovarian hyperstimulation syndrome (ovarian hypertension, abdominal pain, nausea, vomiting, diarrhea, weight gain, oliguria, ascites, hydrothorax, hemoperitoneum, hemoconcentration, dyspnea) and thromboembolic complications.

    The treatment consists of three phases: I - is aimed at reducing the concentration of the hormone in the blood and preventing the development of thromboembolic complications (pneumonia, acute renal failure, it consists in / in the administration of small amounts of albumin, with a constant control of the electrolytes in the blood and the level of hematocrit.II - begins after stabilization of the patient's condition and should lead to a decrease in the fluid content in the body cavities, for which I / v inject small amounts of hypertonic sodium chloride solution and albumin. III - aims to prevent the development of pulmonary edema associated with the massive flow of fluid from the body cavities into the vascular bed, and involves the use of diuretics (with constant monitoring of hematocrit and the content of electrolytes in blood plasma).

    Interaction:

    With the simultaneous use of urofallitropine and clomiphene citrate, potentiation of the reaction from the follicles is possible.

    Simultaneous use with GnRH agonists can induce desensitization of the pituitary gland (an increase in the dose of urofollitropine is required to obtain an adequate response from the ovaries).

    Special instructions:

    Before the start of treatment, it is recommended to perform an analysis of the sperm of the sexual partner; if necessary, to treat hypothyroidism, insufficiency of the adrenal cortex, hyperprolactinaemia, pituitary tumors or hypothalamus. Gynecological examination with ovarian enlargement is carried out very carefully to avoid rupture of ovarian cysts, with the same purpose it is recommended to avoid sexual intercourse.

    After stimulation of maturation of follicles and ovulation, the possibility of multiple pregnancy during natural conception increases. In the case of artificial conception, the probability of multiple pregnancy depends on the number of oocytes administered.

    It should be borne in mind the possibility of an ectopic pregnancy, especially in diseases of the fallopian tubes in the anamnesis. The frequency of early and spontaneous miscarriages in pregnancy after treatment with urofollitropine is higher than in healthy patients, but comparable to that of infertility of another etiology.

    Ovarian hyperstimulation syndrome most often occurs on the 7th-10th day after ovulation, stimulated by the administration of human chorionic gonadotropin (but may occur, albeit much more rarely, in the implementation of assisted reproductive techniques).

    The possibility of developing the ovarian hyperstimulation syndrome in women during the superovulation (created by assisted reproductive techniques) can be reduced if aspirates the contents of all the follicles before ovulation.

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