Instructions for use of the drug Pergoveris

Photo: health.mail.ru

Photo: lekhar.ru

Photo: lekhar.ru

Photo: irecommend.ru

Pergoveris is a combination hormonal drug. Refers to sex hormones and modulators of the reproductive system - gonadotropins (G03GA30). Active ingredients: Follitropin alfa and Lutropin alfa.

You need to know that mixing another drug in one syringe is unacceptable. The bioavailability of Follitropin is 70%, Lutropin is about 60%. The drug Pergoveris is available with a doctor's prescription!

pharmachologic effect

The drug belongs to the combined hormonal drugs. It works due to the presence of recombinant hormones: follicle-stimulating and luteinizing. These substances from the Pergoveris solution were obtained using genetic engineering.

The first provokes the activation of folliculogenesis, and the second is responsible for the maturation of the formed follicle and the ovulation process

Luteinizing hormone normalizes the functioning of the corpus luteum, and this is necessary for the formation of pregnancy and its safe development.

This effect is ensured by the production of androgens, which are then converted into estrogens. Without them, a woman will not be able to get pregnant. The growth of the endometrium will be impaired, as will the maturation of the corpus luteum.

The drug Pergoveris is used to treat female gynadotropic hypogonadism, which occurs due to a lack of LH and FSH. For better effectiveness of the drug, it is often used with alpha lutropin.

After a subcutaneous injection of the Pergoveris solution, it enters all organs. It does not stay in the body longer than 5 hours.

Rules for administering medication

Before administering the solution with a disposable syringe, inspect the contents of the bottle. If you notice any foreign particles or sediment, the solution should not be used. After piercing the rubber stopper with a needle, the solution is immediately introduced into the body; the remainder must be poured out. To avoid pain, the medicine is administered slowly.

Preparation of the solution

First you need to remove the covering of the rubber cap - the protective layer. Then connect the syringe to the needle and draw up the required volume of solution by piercing the rubber cap with the needle. Remove the needle and replace it with a new one - the medicine must be administered with a sterile needle. That is, when preparing the solution, one needle is used, and for injection, another.

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Lift the syringe vertically and click a couple of times with your finger so that the air bubbles rise towards the needle. Then press the plunger and release a drop of solution so that air bubbles are removed along with it

Note! A solution containing air bubbles should not be injected into the body.

Medication injection site

Where should the medicinal solution be injected? It is best to inject in the area around the navel. Pull back the fat fold on the abdomen with your left hand and inject the solution with your right. Injections are not recommended in areas with stretched, elastic skin. In addition to the folds on the abdomen, you can inject the solution into other places on the body - your doctor will tell you about this.

Keep in mind that puncture sites must be alternated so as not to provoke fatty atrophy.

Preparing the skin for injection

When injecting, sterility must be strictly observed, so the skin is prepared before the injection. First, wash your hands with soap and then wipe the skin area with an antiseptic solution - aseptolin or chlorhexidine. These solutions will completely eliminate the bacterial environment from the surface of the skin. After treating the skin, you need to wait until the area dries on its own, only after that Puregon is administered.

How to insert a needle

The needle is directed at an angle of 90 degrees to the retracted skin fold. Next, you need to slowly press on the piston so that the medicine enters the body. After the injection, you need to quickly remove the needle from the body and apply a cotton pad with an antiseptic liquid (chlorhexidine or antiseptin) to the puncture site.

Important! Do not squeeze the skin too hard with your fingers before inserting the needle - this will increase the discomfort from the injection.

Composition and release form

The drug Pergoveris uses alpha follitropin and alpha lutropin as its main active ingredients.

The first substance in one bottle contains 11 mcg, and the second - 3 mcg.

In addition to them, the drug is supplemented with excipients in the form of:

• Sucrose;
• Sodium hydrogen phosphate dihydrate;
• Sodium dihydrophosphate monohydrate;
• Methionine;
• Polysorbate;
• Concentrated phosphoric acid;
• Sodium hydroxide.

Pergoveris is available in the form of powder or porous mass. When dry, they are white or almost white.

Package the dry mixture into plastic bottles with a volume of 3 ml. There can be 1, 3 or 10 bottles in a cardboard package along with solvent

The prepared solution is practically not colored and becomes transparent. There may be a slight yellowish or opalescent tint.

The package contains not only powder, but also water for injection, which is used to prepare the solution.

Description of the drug

The cessation of ovulation leads to the absence of menstruation, which prevents the possibility of conception. Therefore, doctors have developed a special drug that restores the functionality of the reproductive system - Puregon. The drug is made from a bioengineered recombinant hormone (FSH) designed to activate the maturation of several follicles in the ovaries of a woman's reproductive system.

Note! The modern drug Puregon is a product of bioengineering research, and not an extract from the urine of women. Puregon is produced in the form of a lyophilisate for the production of therapeutic serum or in a ready-to-use form

Lyophilisate in the form of powder in bottles is in different concentrations, which makes it possible to choose the best option for the dosage of the drug during treatment. Each bottle of lyophilisate is accompanied by an ampoule with a solvent. Ready-made solutions are produced in the form of cartridges (Puregon Pen) or bottles with liquid

Puregon is produced in the form of a lyophilisate for the production of therapeutic serum or in a ready-to-use form. Lyophilisate in the form of powder in bottles is in different concentrations, which makes it possible to choose the best option for the dosage of the drug during treatment. Each bottle of lyophilisate is accompanied by an ampoule with a solvent. Ready-made solutions are produced in the form of cartridges (Puregon Pen) or bottles with liquid.

Puregon is administered orally subcutaneously or intramuscularly using a disposable medical syringe or pen syringe. Intramuscular injections are made with a regular syringe, and subcutaneous injections are made with a pen-shaped syringe. The syringe pen is intended for use by people without medical education, as it does not require professional training for use. For the pen you need to buy a cartridge with medicine - 300/600 IU. Each cartridge comes with needles in closed caps.

Additional components of Puregon:

• sucrose;
• benzyl alcohol;
• sodium hydroxide;
• other substances.

Ready-to-use solutions contain water.

Note! 300 IU cartridges are designed for 6 injections of 50 IU. Cartridges 600 IU are designed for 6 injections of 100 IU

Indications for use

The drug Pergoveris in the form of a solution is used for:

• ICSI;
• IVF+ICSI;

The drug is used in in vitro fertilization (IVF)

• Low ovarian reserve;
• Deficiency of LH and FSH to activate the growth and maturation of follicles.

Pharmadynamics

The drug Pergoveris is a combined drug containing recombinant human FSH (follitropin alfa, r-FSH) and recombinant human LH (lutropin alfa, r-LH). The drug is obtained by genetic engineering using a culture of Chinese hamster ovary cells.

The main role of FSH is to initiate folliculogenesis by acting on the granulosa cells of the developing follicle, while LH plays an important role in enhancing the production of estradiol by the mature follicle, inducing follicle maturation and ovulation at the peak of its activity. LH supports the functioning of the corpus luteum and, thereby, ensures the onset and development of pregnancy in the early stages.

During follicle development, FSH, together with estradiol, induces LH receptors on the membrane of granulosa cells.

The effect of LH on theca cells ensures the production of androgens for granulosa cells, where the transformation of androgens into estrogens occurs through the aromatase system. Thus, in the absence of LH, FSH can induce follicular growth, but the synthesis of estradiol is reduced. Without a sufficient amount of estradiol, the conditions for pregnancy are disrupted, as well as the secretion of cervical mucus, endometrial growth and the maturation of a full-fledged corpus luteum in response to the administration of human hCG (hCG).

In clinical studies, the effectiveness of the combination of follitropin alfa and lutropin alfa was shown for hypogonadotropic hypogonadism in women.

When stimulating the development of follicles in women with anovulation with LH and FSH deficiency, the main effect of lutropin alfa is to increase the secretion of estradiol by the follicles, the growth of which, in turn, is stimulated by FSH.

It has been shown that in women with hypogonadotropic hypogonadism and serum LH concentrations below 1.2 IU/l, daily use of a combination of lutropin alfa at a dose of 75 IU and follitropin alfa at a dose of 150 IU leads to adequate development of follicles and an increase in estradiol synthesis, while as a combination of lutropin alfa 25 IU and follitropin alfa 150 IU does not provide such an effect.

Thus, when prescribing less than one bottle of Pergoveris per day, LH activity may be insufficient for the full development of follicles.

Although the effectiveness of r-FSH monotherapy when using assisted reproductive technologies (ART) has been proven, published results of clinical studies indicate the benefits of additional administration of r-FSH in patients with insufficient (suboptimal) effectiveness of r-FSH monotherapy.

The addition of r-LGH is intended to increase the sensitivity of the ovaries to r-FSH, to stimulate the secretion of estradiol by the preovulatory follicle, causing endometrial growth, and also to ensure later luteinization of the follicles, leading to normalization of progesterone levels in the luteal phase.

Contraindications

In certain cases, the drug is contraindicated.

Pergoveris solution should not be used for:

• Tumors of the hypothalamus/pituitary gland;
• Large neoplasms or ovarian cystosis;
• Cancer process in the ovary/uterus/breast;
• Primary ovarian insufficiency;
• Anomalies in the development of the genital organs that prevent pregnancy;
• Fibroid formations in the uterus;
• Pregnancy;
• Lactation;
• Hypersensitivity to the components of the drug.

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Side effects

Some women complain that their stomach feels bloated after using Progoveris. This really refers to the symptoms of an adverse reaction to the solution, but the use of this drug can result in other negative responses from the body.

Before starting to use the drug Pergoveris, a woman should be informed about all possible negative consequences.

Drug interactions

There is no information about the compatibility/incompatibility of Peroveris solution with other drugs in the manufacturer's instructions.

It is prohibited to combine Pergoveris solution with drugs other than alpha follitropin in the same syringe.

Is it possible to combine Menopur and Pergoveris?

These drugs are similar in action.
Reviews are positive about both Menopur and Pergoveris. The second remedy is more effective and is more often used for IVF, to a greater extent, without additional drugs.

At the same time, the difference between Menopur and Pergoveris is that when used, fewer eggs are formed, but they are of better quality.

In certain cases, stronger stimulation may be necessary. For this reason, the specialist prescribes another medication.

Officially, the combination of Menopur and Pergoveris solution is not indicated anywhere, but if the doctor considers their interaction necessary, then such a combination is possible.

You can learn more about Menopur in this article.

special instructions

Before starting treatment, a thorough examination of both sexual partners is required to identify the causes of infertility. The woman is also examined for hormone levels in the blood. LH is considered reduced if its concentration is below 1.2 IU/ml. This is a direct indication for the use of Luveris.

A thorough examination of the fallopian tubes is necessary. It is advisable to perform hysterosalpingography. The study evaluates not only the patency, but also the function and structure of the fallopian tubes. Because if there are abnormalities, the risk of ectopic pregnancy increases. In addition, in case of complete bilateral obstruction of the fallopian tubes, the success of treatment using Luveris will be impossible without assisted reproductive technologies.

When using Luveris, you should not mix it with other medications in the same syringe. The exception is FSH preparations. It has been proven that when used together, neither the bioavailability nor the clinical effectiveness of these drugs is reduced. As for other drugs, they can disrupt the structure of the hormone or reduce its absorption. Therefore, they cannot be used simultaneously. In particular, the use of local anesthetics (for example, lidocaine) to reduce pain during injection is not allowed.

Luveris is not used in monotherapy. It is always used in combination with other drugs. At a minimum, FSH and hCG are additionally used. FSH drugs are injected into the LH simultaneously. HCG is prescribed at the very end of stimulation, one day after the last injection of Luveris. Another day later, sexual intercourse or puncture of the follicles is carried out.

Luveris can be used in in vitro fertilization cycles. In this case, higher doses of LH and FSH may be used. Because the purpose of stimulation is the maturation of multiple follicles in the ovaries. Then, after the introduction of an ovulation trigger (usually hCG), oocytes are collected from the ovaries 36 hours later. This procedure is performed by a doctor under short-term general anesthesia. Subsequently, the eggs are fertilized in the laboratory or frozen, depending on the purpose of the procedure.

Instructions for use

It is better to use the drug under the supervision of specialists, since it is injected under the skin.

The prepared Pergoveris solution is used at a time, and the dosage can be either individual or constant.

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Using a syringe pen

How to inject Puregon using a syringe pen? First you need to warm the cartridge to room temperature if it was stored in the refrigerator. Then release the pen from the cap and detach the cartridge holder. Inspect the cartridge and make sure that the solution in it is completely clear.

Then you need to disinfect the open tip of the pen and screw the needle cap onto it. Then you need to set the required dosage of the medicine by turning the wheel with numbers - for example, 250 IU. If you accidentally miss the correct number, do not try to turn the wheel back. Reach the zero mark and turn again to the desired number.

Then lift the pen vertically, click your finger and use the plunger to squeeze out a few drops of the solution - that is, you need to remove air bubbles from the liquid with this action.

After this, disinfect the skin on the abdomen, remove the cap from the needle, pull back the fat fold with two fingers and insert the needle into the skin at a right angle. Now you need to press the injection button with your right hand and wait for a zero to appear in the window and a click - you have injected all the medicine.

What should you do next? Wait a little (count to five) and pull the needle out of the skin. After this, immediately disinfect the puncture site with alcohol or aseptin - a medical wipe with alcohol will also work.

Now put the cap on the needle, unscrew it and dispose of it in the trash. Then disconnect the used cartridge and throw it in the trash. Cover the handle with a lid and put it in the refrigerator. You can immediately insert the cartridge into the pen, or you can do this immediately before the injection.

What to do if there is not enough medicine in the cartridge? You need to replace it with a new one or add the missing amount of medicine using an additional injection. In this case, you must keep strict records of the administered doses of Puregon.

Is it possible to make intramuscular injections with a pen? The device is intended for subcutaneous administration, however, injecting the medicine into the muscle is also acceptable - but not advisable.

Cartridge storage

How to store Puregon in a cartridge? If you have not opened the cartridge, it can be stored in the refrigerator until the expiration date. The cartridge can also be stored in the house if the air temperature does not exceed 25C. In this case, the period for selling the medicine does not exceed three months.

Note! The cartridge should be stored in a place protected from the sun. They cannot be placed in the freezer.

If you open the cartridge, the shelf life does not exceed a month. Remember that you need to store the cartridge in a closed state, that is, in the cap. Do not leave the pen with a used or new needle attached. Injection needles are stored in caps covered with film.

Two women cannot use the same pen and cartridge - this is a device for individual use. The pen can last for a long time - it is designed to perform 300 injections. Then you need to buy a new pen.

If you need to administer 50 IU of medication, purchase a 300 IU cartridge. If your single dose is 100 IU, it is better to buy 600 IU cartridges. If you don't have enough injection needles, you need to contact your doctor.

Analogues substitutes

The medicine in the form of a solution has several similar drugs:

• Puregon;
• Menopur;
• Horagon;
• Ovitrel;
• Chorionic genadotropin;
• Decayed;
• Gonal-F.

Photo gallery of analogues:

Menopur

Puregon

Horagon

Ovitrel

Decayed

Gonal-F

Chorionic genadotropin

Which is better Pergoveris or Gonal?

The drugs are similar in effect.
Reviews from women who have tried them on themselves indicate that the drugs are suitable for each individual.

Some claim that Pergoveris is better, they do not know, while others prefer Gonal.

Some experts believe that the second drug is slightly weaker. Other doctors combine Pergoveris + Gonal for medicinal purposes.

You can learn more about the drug Gonal-F in this article.

Have you used the drug and was it effective?

Dosage

Luveris is most often prescribed in conjunction with follicle-stimulating hormone (FSH) medications. It is prescribed once a day. The course lasts on average 3 weeks. It can last up to 5 weeks if necessary. The standard starting dose is 75 IU. Additionally, 75 or 150 IU of FSH is administered. If necessary, the dose of this hormone can be increased. The need to increase it depends on:

• stimulation goals - how many follicles should mature in the ovaries: one or several;
• response to current stimulation - the doctor monitors the growth of follicles using ultrasound; if their growth is too slow, the dosage of FSH can be increased;
• results of previous stimulation - the doctor looks at what results and at what doses were achieved in the last menstrual cycle.

The step of increasing the FSH dose is 37.5 or 75 IU. The possibility of increasing is considered once a week or every 2 weeks.

USEFUL INFORMATION: How is infertility in women determined?

Treatment with Luveris continues until treatment goals are achieved. These most often involve the maturation of one dominant follicle up to 18 mm. Treatment can be carried out with the aim of maturing several follicles - this increases the chances of pregnancy. But this increases the risk of multiple births. Because 2 or more eggs mature. There is a possibility that they will all be fertilized. If this happens, the woman will have twins.

After the doctor has determined during an ultrasound that the goal of therapy has been achieved, the hCG drug is administered. The injection is given in a dose of 5 to 10 thousand IU. The drug is administered one day after the next dose of Luveris and FSH. Then another day later, fertilizing sexual intercourse is recommended.

If during the treatment the patient forgot to administer Luveris, the next injection of the drug should be done as soon as possible. In this case, you should not compensate for the missed dose by administering 2 or more bottles of the drug at a time. This will not lead to improved treatment results. Despite the missed dose, further treatment must be continued, administering Luveris in the same quantities, in the same regimen. At your next visit to your doctor, you need to inform him that a dose was missed.

Reviews and results

Christina, 35 years old : “I tested the effect of Pergoveris solution on myself for hypogonadism. This medicine is excellent. For the first time in a long time, my progesterone levels are normal, but it is best to use it under the guidance of a doctor."

Alevtina, 38 years old : “I used Pergoveris to conceive a child. I had stimulation with Pergoveris in a short protocol . The result is simply phenomenal - I have twins!”

Karina, 37 years old : “My husband and I really wanted a child, but we still couldn’t get pregnant. Finally, we decided to turn to specialists. The doctor prescribed me the drug Pergoveris. After injections with him, we were able to achieve what we wanted. Now I'm 7 months old."