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What is follicle stimulating hormone?
Follicle stimulating hormone (FSH) is a naturally occurring hormone. FSH is important in the development of follicles (eggs) produced by the ovaries. FSH is also important in the development of sperm. Follicle stimulating hormone is used to stimulate a follicle (egg) to develop and mature. It is used when a woman desires pregnancy and her ovaries can produce a follicle but hormonal stimulation is not sufficient to make the follicle mature. Follicle stimulating hormone is also used to stimulate the development of multiple eggs for in vitro fertilization. Follicle stimulating hormone can be used by men to increase the production of sperm.

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What are the possible side effects of follicle stimulating hormone?

Stop using follicle stimulating hormone and seek emergency medical attention or notify your doctor immediately if you experience any of the following serious side effects:

• an allergic reaction (difficulty breathing; closing of the throat; swelling of the lips, tongue, or face; or hives);

• pain, warmth, redness, numbness, or tingling in an arm or leg (which may indicate a blood clot);

• confusion, severe dizziness, severe headache; or

• difficulty breathing.

Approximately 5% of patients treated with follicle stimulating hormone develop ovarian hyperstimulation syndrome (OHSS), especially after the first cycle of therapy. Symptoms of OHSS include severe pelvic pain, swelling of the hands or legs, abdominal pain and swelling, shortness of breath, weight gain, low urine output, diarrhea, and nausea or vomiting. OHSS can be fatal. Notify your doctor immediately or seek emergency medical attention if you develop any of these symptoms.

Other side effects may also occur. Notify your doctor if you experience

• ovarian enlargement presenting as abdominal or pelvic pain, tenderness, pressure, or swelling;

• nausea, vomiting, diarrhea, or flatulence (gas);

• fever or chills;

• headache;

• dizziness;

• rapid pulse or heart rate;

• muscle or joint weakness or aching;

• breast tenderness;

• spotting or menstrual changes;

• pain, swelling, or irritation at the injection site; or

• dry skin, a rash, or hair loss.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

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How should I use follicle stimulating hormone?
Use follicle stimulating hormone exactly as directed by your doctor. If you do not understand these directions, ask your doctor, nurse, or pharmacist to explain them to you. Gonal-F and Follistim AQ should only be administered subcutaneously. Follistim may be administered as a subcutaneous injection (injection under the skin) or intramuscular injection (injection into the muscle). If you are administering this medication at home, your doctor will give you detailed instructions on how to mix the solution and give the injection. Do not inject this medication if you are not sure how.

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What is the most important information I should know about follicle stimulating hormone?
Treatment with follicle stimulating hormone increases the likelihood of multiple births. Multiple births carry additional risk both for the mother and for fetuses. Discuss the risk of multiple births with your healthcare provider.

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What happens if I miss a dose?
Contact your doctor if you miss a dose of follicle stimulating hormone.

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What other drugs will affect follicle stimulating hormone?
It is not known whether other medications will interact with follicle stimulating hormone. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines, including vitamins, minerals, and herbal products.

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Can I take this if I am pregnant or trying to get pregnant or if I am breastfeeding?

Follicle stimulating hormone has been assigned to pregnancy category X by the FDA. Animal studies have not been reported. There are no controlled data in human pregnancy. Follicle stimulating hormone is considered contraindicated during pregnancy.

There are no data on the excretion of follicle stimulating hormone into human milk. The manufacturer recommends that due to the potential for serious adverse reactions in nursing infants, a decision should be made to discontinue nursing or discontinue the drug, taking into account the importance of the drug to the mother.

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What does my medication look like?
Follicle stimulating hormone is available with a prescription under the brand names Follistim, Follistim AQ Cartridge and Gonal-F. Other brand or generic formulations may also be available. Ask your pharmacist any questions you have about this medication, especially if it is new to you. Follistim 75 IU powder for injection Gonal-F 75 IU powder for injection Gonal-F 150 IU powder for injection Follistim AQ Cartridge 437.5IU/0.525 ml Follistim AQ Cartridge 737.5IU/0.885 ml

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What happens if I overdose?
An overdose of follicle stimulating hormone is unlikely to threaten life. Notify your doctor immediately or call an emergency room or poison control center for advice if an overdose is suspected. Symptoms of a follicle stimulating hormone overdose are not known.

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What should I discuss with my healthcare provider before using follicle stimulating hormone?
Follicle stimulating hormone will not induce ovulation if the ovaries are not capable of producing an egg. Also, follicle stimulating hormone will not induce the production of sperm if the testes are not capable of producing sperm. Before using this medication, tell your doctor if you might be pregnant; have a thyroid problem; have adrenal dysfunction; have cancer or a tumor of the breast, ovary, uterus, hypothalamus, or pituitary gland; have undiagnosed abnormal vaginal bleeding; or have ovarian cysts or enlargement not due to polycystic ovary disease (PCOD).

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Can I stop taking the medication if I feel better?
As a general rule, you should always take your medications exactly as prescribed and do not change the dosage or stop taking the medication without first discussing it with your healthcare provider.

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I am on so many medications; do I have to take them all?
This is called polypharmacy—many different medications being used at the same time by one person. Sometimes, being on multiple medications is acceptable and appropriate but at other times it may be problematic. If you are receiving your medications from multiple physicians you need to ensure that they all know what medications you are taking. The best way to do this is to make a list of all the medications you are currently using, including all nutritional supplements, homeopathic remedies, vitamins and over-the-counter drugs (if possible, also include all the diseases you have been diagnosed with). Give a copy to every doctor who takes care of you so they have it on file, this way they can avoid duplicating medications and perhaps even try to consolidate some. After every doctor's visit remember to update the list accordingly. Also, as much as you possibly can, try to use the same pharmacy to fill all your prescriptions, this way any potential drug interactions can be caught and averted.

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