Chorionic gonadotropin
Chorionic gonadotropin: instructions for use and reviews
- 1. Release form and composition
- 2. Pharmacological properties
- 3. Indications for use
- 4. Contraindications
- 5. Method of application and dosage
- 6. Side effects
- 7. Overdose
- 8. Special instructions
- 9. Application during pregnancy and lactation
- 10. Use in childhood
- 11. Drug interactions
- 12. Analogs
- 13. Terms and conditions of storage
- 14. Terms of dispensing from pharmacies
- 15. Reviews
- 16. Price in pharmacies
Latin name: Gonadotrophin chorionic
ATX code: G03GA01
Active ingredient: chorionic gonadotropin (Chorionic Gonadotropin)
Manufacturer: Moscow Endocrine Plant (Russia)
Description and photo update: 2018-22-10
Prices in pharmacies: from 342 rubles.
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Chorionic gonadotropin is a drug with gonadotropic, follicle-stimulating and luteinizing effects.
Release form and composition
Dosage form of release of Chorionic Gonadotropin - lyophilisate for the preparation of a solution for intramuscular (i / m) administration: lyophilized almost white or white powder (in vials from a glass tube, in blisters of 5 vials complete with 5 ampoules of 1 ml of solvent, in a cardboard pack 1 pack).
Composition of 1 bottle:
- active substance: chorionic gonadotropin - 500, 1000, 1500 or 5000 IU (international units);
- auxiliary component: mannitol (mannitol) - 20 mg.
Solvent: 0.9% sodium chloride injection solution - 1 ml.
Pharmacological properties
Pharmacodynamics
Chorionic gonadotropin has a luteinizing, follicle-stimulating and gonadotropic effect, while the luteinizing activity is higher than the follicle-stimulating one.
The active substance of the drug is human chorionic gonadotropin (hCG), which is a gonadotropic hormone produced by the placenta during pregnancy (excreted by the kidneys unchanged). The method of obtaining a substance for the drug is extraction from urine with subsequent purification.
HCG is necessary for women and men for normal growth and maturation of gametes, as well as for the production of sex hormones.
The drug stimulates the development of genitals and secondary sexual characteristics. In addition, it promotes ovulation and stimulates the synthesis of estrogen (estradiol) and progesterone in women, and also stimulates spermatogenesis, the production of dihydrotestosterone and testosterone in men.
Pharmacokinetics
After i / m administration, it is well absorbed. The half-life is 8 hours.
Achievement of the maximum plasma concentration of hCG in the blood is observed after 4-12 hours. The half-life of chorionic gonadotropin is approximately 29-30 hours, with daily use, accumulation of the drug can be observed.
Chorionic gonadotropin is excreted by the kidneys. Approximately 10–20% of the administered dose is found unchanged in the urine, the main part is excreted as fragments of the β-chain.
Indications for use
Chorionic gonadotropin 1500, 1000 and 500 IU
Women:
- maintaining the phase of the corpus luteum;
- amenorrhea, anovulatory ovarian dysfunction.
Men and boys:
- delayed puberty associated with insufficiency of the gonadotropic function of the pituitary gland;
- hypogonadotropic hypogonadism;
- oligoasthenospermia, spermatogenesis insufficiency, azoospermia;
- cryptorchidism that is not associated with anatomical obstruction;
- conducting a functional Leydig test to assess testicular function in hypogonadotropic hypogonadism before the appointment of prolonged stimulating therapy;
- conducting a differential diagnostic test of cryptorchidism / anorchism in boys.
Chorionic gonadotropin 5000 IU
Women:
- induction of ovulation with infertility, which is caused by anovulation or disorders of follicular maturation;
- preparation of follicles for puncture in programs of controlled ovarian hyperstimulation (for additional reproduction techniques);
- maintaining the phase of the corpus luteum.
Men:
- hypogonadotropic hypogonadism;
- conducting a functional Leydig test to assess testicular function in hypogonadotropic hypogonadism before the appointment of long-term stimulating therapy.
Contraindications
Absolute:
- hormone-dependent genital and breast cancers (diagnosed or suspected), including ovarian cancer, breast cancer, uterine cancer in women, and prostate cancer, breast carcinoma in men;
- organic lesions of the central nervous system (tumors of the hypothalamus, pituitary gland);
- deep vein thrombophlebitis;
- hypothyroidism;
- adrenal insufficiency;
- hyperprolactinemia;
- premature puberty in boys (for 500, 1000 and 1500 IU);
- infertility, which is not associated with hypogonadotropic hypogonadism in men;
- children under 3 years of age (for 500, 1000 and 1500 IU);
- individual intolerance to the components of the drug.
Additional absolute contraindications for the use of the drug in women:
- bleeding or spotting from the vagina of unknown origin;
- malformation of the genitals, which is incompatible with pregnancy;
- primary ovarian failure;
- fibroid tumor of the uterus, which is incompatible with pregnancy;
- a history of ovarian hyperstimulation syndrome (OHSS) (for 5000 IU);
- infertility that is not associated with anovulation (for example, tubal or cervical genesis, for 500, 1000 and 1500 IU);
- polycystic ovary syndrome (PCOS) (for 5000 IU);
- pregnancy and the period of breastfeeding.
Relative (diseases / conditions in the presence of which the appointment of Chorionic Gonadotropin requires caution):
- risk factors for thrombosis (burdened personal / family history, severe obesity with a body mass index> 30 kg / m 2, thrombophilia, etc.);
- prepubertal age in boys - for doses of 500, 1000 and 15000 IU;
- latent or overt heart failure, impaired renal function, arterial hypertension, epilepsy, migraine, including indications of these diseases / conditions in history - for men;
- bronchial asthma.
Instructions for the use of Chorionic Gonadotropin: method and dosage
The drug is administered intramuscularly slowly, after the preliminary addition of the solvent to the lyophilisate.
The dosage regimen can be adjusted individually by the doctor.
Chorionic gonadotropin 1000, 500 or 1500 IU
Women:
- anovulatory cycles: 2-3 times with an interval of 2-3 days, 3000 ME, from 10-12 days of the menstrual cycle, or 6-7 injections - every other day, 1500 ME;
- maintaining the phase of the corpus luteum: 2-3 injections of 1500-5000 IU for 9 days after ovulation or embryo transfer (for example, once every three days).
Men and boys:
- hypogonadotropic hypogonadism: 2–3 times a week, 1000–2000 ME. In cases of infertility, a drug containing follitropin (follicle-stimulating hormone) can be additionally prescribed. The duration of the course, in which any improvement in spermatogenesis can be expected, is at least 3 months. During the period of use of the drug, testosterone replacement therapy should be suspended. After improvement, in order to maintain the result, a sufficiently isolated use of Chorionic Gonadotropin;
- delayed puberty due to insufficiency of the gonadotropic function of the pituitary gland: 2-3 times a week, 1500 ME for a course of at least 6 months;
- cryptorchidism, not due to anatomical obstruction: 2 times a week, 500–1000 ME for children 3–6 years old or 1500 ME for children over 6 years old; if necessary, repeat therapy;
- insufficiency of spermatogenesis, oligoasthenospermia, azoospermia: daily 500 IU in combination with menotropin (75 IU of follicle-stimulating and luteinizing hormone) or every 5 days 2000 IU in combination with menotropin (150 IU of follicle-stimulating and luteinizing hormone) 3 times a week months. In cases of insufficient effect or its absence, the drug is prescribed 2-3 times a week, 2000 IU in combination with menotropin (150 IU of follicle-stimulating and luteinizing hormone) 3 times a week for a course of 3-12 months. After improvement of spermatogenesis, in some cases, maintenance doses of Chorionic Gonadotropin can be administered;
- Differential diagnosis of anorchism / cryptorchidism in boys: a single dose of 100 IU / kg, the serum testosterone concentration in the blood is determined before the test and 72–96 hours after the injection. With anorchism, the test will be negative, which is evidence of the absence of testicular tissue; with cryptorchidism, even if only one testicle is present, positive (5–10-fold increase in testosterone concentration). If the test is weakly positive, a search for the gonad (laparoscopy or abdominal ultrasound) is required, as there is a high risk of malignancy.
Chorionic gonadotropin 5000 IU
Women:
- induction of ovulation in infertility, which is caused by anovulation or disorders of follicle maturation, preparation of follicles for puncture in programs of controlled ovarian hyperstimulation: 5000-10,000 IU once to complete therapy with follicle-stimulating hormone preparations;
- maintaining the phase of the corpus luteum: 2-3 injections of 1500-5000 IU for 9 days after ovulation or embryo transfer (for example, once every three days).
Men:
- hypogonadotropic hypogonadism: 1 time per week, 1500-6000 ME. In cases of infertility, hCG can be administered with a drug containing follitropin 2-3 times a week. The duration of the course, in which any improvement in spermatogenesis can be expected, is at least 3 months. During this period, testosterone replacement therapy should be suspended. After improvement in order to maintain the result, in some cases, Chorionic Gonadotropin is used in isolation;
- functional test Leydig: daily 5000 IU for 3 days (at the same time). After the last injection, the next day, blood is drawn and the testosterone level is tested. The sample is assessed as positive if there is an increase of 30-50% or more from the initial values. It is preferable to combine this test with another spermogram on the same day.
Side effects
- immune system: in rare cases - fever, generalized rash;
- local reactions at the injection site and general disorders: pain, bruising, redness, itching, swelling; in some cases - allergic reactions (rash / pain at the injection site), increased fatigue.
Chorionic gonadotropin 500, 1000 and 1500 IU
Women:
- nervous system: dizziness, headache;
- psyche: anxiety, irritability, depression;
- metabolism and nutrition: edema.
Men and boys:
- subcutaneous tissue and skin: acne;
- endocrine system: premature puberty;
- genitals and mammary gland: gynecomastia, enlargement of the penis, prostatic hyperplasia, increased sensitivity of the nipples of the mammary glands in men, with cryptorchidism - an increase in the testicles in the inguinal canal.
Chorionic gonadotropin 5000 IU
Women:
- nervous system: headache;
- respiratory system: hydrothorax in severe OHSS;
- vessels: in rare cases - thromboembolic complications associated with combined therapy of anovulatory infertility (in combination with follicle-stimulating hormone), complicated by OHSS in severe form;
- genitals and mammary gland: breast tenderness, moderate to severe OHSS (ovarian diameter> 5 cm or large ovarian cysts> 12 cm in diameter, prone to rupture). Clinical manifestations of OHSS - bursting pain in the abdomen, hemoperitoneum, diarrhea, a feeling of heaviness in the lower abdomen, tachycardia, decreased hemostasis, blood pressure, increased activity of hepatic transaminases, acute renal failure, oliguria, respiratory failure, shortness of breath;
- digestive system: ascites in severe OHSS, abdominal pain and dyspeptic symptoms, including nausea and diarrhea associated with moderate OHSS;
- psyche: anxiety, irritability, depression;
- metabolism and nutrition: weight gain (a sign of severe OHSS), edema.
Men:
- subcutaneous tissue and skin: acne;
- genitals and breast: gynecomastia, enlargement of the penis, prostatic hyperplasia, hypersensitivity of the nipples of the mammary glands.
Long-term therapy can cause increased side effects.
Overdose
The drug is characterized by very low toxicity.
Against the background of an overdose, women may experience OHSS. Depending on the severity, there are several types of this complication:
- light: the size of the ovaries usually does not exceed 8 cm; symptoms - abdominal discomfort, minor abdominal pain;
- medium: the average size of the ovaries is 8–12 cm; symptoms - moderate / small increase in ovarian cysts, breast tenderness, abdominal pain of moderate intensity, diarrhea, vomiting and / or nausea, ultrasound signs of ascites;
- severe: the size of the ovaries usually exceeds 12 cm; symptoms - weight gain, clinical signs of ascites (sometimes hydrothorax), in rare cases - thromboembolism; oliguria, hemoconcentration, hematocrit> 45%, hypoproteinemia, large ovarian cysts prone to rupture.
Basic principles of OHSS therapy in case of overdose (depending on the severity):
- light: bed rest, monitoring the patient's condition, drinking plenty of mineral water;
- medium and severe (only in stationary conditions): control of the hematocrit level, the function of the respiratory and cardiovascular system, kidneys, liver, water / electrolyte balance (diuresis, changes in abdominal circumference, weight dynamics); intravenous drip crystalloid solutions (in order to maintain / restore the volume of circulating blood); intravenous drip colloidal solutions of 1.5-3 liters per day (with persistent oliguria and preservation of hemoconcentration); hemodialysis (in cases of development of renal failure); antihistamines, antiprostaglandin and corticosteroid drugs (to decrease capillary permeability); low molecular weight heparins, including clexane, fraxiparin (for thromboembolism); 1-4 sessions of plasmapheresis with an interval of 1-2 days (to improve the rheological properties of blood, reduce the size of the ovaries,normalization of the acid-base state and blood gas composition); transvaginal puncture of the abdominal cavity and paracentesis (with ascites).
Overdose symptoms in men and boys:
- gynecomastia;
- degeneration of the gonads (in cases of unreasonably prolonged therapy for cryptorchidism);
- behavioral changes in boys, similar to those observed during the first phase of puberty;
- a decrease in the number of sperm in the ejaculate in men (in cases of drug abuse);
- seminiferous tubule atrophy (associated with inhibition of the production of follicle-stimulating hormone due to the stimulation of the production of estrogens and androgens).
special instructions
During therapy, the likelihood of arterial / venous thromboembolism increases, and therefore, patients assigned to the risk group should evaluate the benefits of in vitro fertilization therapy before prescribing the drug. It should also be noted that pregnancy itself is accompanied by an increased risk of thrombosis.
The use of Chorionic Gonadotropin increases the risk of multiple pregnancies. During therapy and for 10 days after stopping treatment, the drug is able to affect the values of immunological tests, the concentration of hCG in the plasma of urine and blood, which can cause a false-positive pregnancy test result.
In male patients, Chorionic Gonadotropin can lead to an increase in androgen production, and therefore, patients at risk require strict medical supervision.
Since hCG promotes premature puberty or premature closure of the pineal glands, regular monitoring of skeletal development is required.
With a high content of follicle-stimulating hormone in men, treatment is not effective.
Long-term therapy can lead to the formation of antibodies to the drug.
An unreasonably long course with cryptorchidism, especially in the presence of indications of surgical intervention, can lead to degeneration of the gonads.
Influence on the ability to drive vehicles and complex mechanisms
It is recommended to refuse to drive vehicles during the course of the treatment course.
Application during pregnancy and lactation
According to the instructions, Chorionic Gonadotropin is contraindicated for use during pregnancy and lactation.
Pediatric use
HCG therapy is not prescribed for children under 3 years of age.
Drug interactions
When combined with preparations of human menopausal gonadotropin (MHG) in cases of infertility treatment, it is possible to increase the symptoms of ovarian hyperstimulation, which has occurred due to the use of MHG.
The combination with high doses of glucocorticosteroids is not recommended.
No other interactions noted.
Analogs
Chorionic gonadotropin analogs are: Choral, Ecostimulin, Horagon, Pregnil.
Terms and conditions of storage
Store in a place protected from light at temperatures up to 20 ° C. Keep out of the reach of children.
Shelf life (depending on the dose): 500, 1000 and 1500 IU - 4 years; 5000 IU - 3 years.
Terms of dispensing from pharmacies
Dispensed by prescription.
Reviews of Chorionic Gonadotropin
According to reviews, Chorionic Gonadotropin effectively stimulates ovulation, which helps to conceive and bear a child. There are also positive reviews when using the drug for the treatment of ovarian cysts. Of the shortcomings, they usually indicate its high cost.
Price for Chorionic Gonadotropin in pharmacies
The approximate price for Chorionic Gonadotropin (5 ampoules per pack) is:
- Chorionic gonadotropin 500 IU - 365–385 rubles;
- Chorionic gonadotropin 1000 IU - 600–640 rubles;
- Chorionic gonadotropin 1500 IU - 1115 rubles;
- Chorionic gonadotropin 5000 IU - 2455–2795 rubles.
Chorionic gonadotropin: prices in online pharmacies
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Drug name Price Pharmacy |
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Chorionic gonadotropin 500 IU lyophilisate for preparation of a solution for intramuscular administration complete with a solvent 1 ml 5 pcs. 342 r Buy |
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Chorionic gonadotropin lyoph. for prigot. solution for intramuscular injection. 500ME 5ml 5 pcs. 421 r Buy |
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Chorionic gonadotropin 1000 IU lyophilisate for preparation of a solution for intramuscular administration complete with a solvent 1 ml 5 pcs. 659 r Buy |
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Chorionic gonadotropin lyoph. for prigot. solution for i / m. 1000ME 5ml 5 pcs. 674 r Buy |
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Chorionic gonadotropin 1500 IU lyophilisate for preparation of a solution for intramuscular administration complete with a solvent 5 ml 5 pcs. 1039 RUB Buy |
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Chorionic gonadotropin 5000 IU lyophilisate for preparation of a solution for intramuscular administration 5 ml 5 pcs. 2607 RUB Buy |
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Chorionic gonadotropin lyoph. prigot. solution of intramuscular injection 5000 IU fl. 5ml No. 5 (with sodium solution chl-d 9 mg / ml amp. 1 ml No. 5) RUB 2724 Buy |
Anna Kozlova Medical journalist About the author
Education: Rostov State Medical University, specialty "General Medicine".
Information about the drug is generalized, provided for informational purposes only and does not replace the official instructions. Self-medication is hazardous to health!
