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What are menotropins?
Menotropins are an equal mixture of the naturally occurring follicle-stimulating hormone (FSH) and luteinizing hormone (LH). FSH and LH are important for the development of follicles (eggs) produced by the ovaries and for the development of sperm. Menotropins are used to stimulate ovulation (the release of an egg) when a woman's ovaries can produce a follicle but hormonal stimulation is deficient. Menotropins are also used to stimulate the development of multiple eggs for in vitro fertilization. Likewise, menotropins are used to stimulate the production of sperm in men who have functioning testes but in whom hormonal stimulation is deficient.

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What are the possible side effects of menotropins?

Stop using menotropins and seek emergency medical attention if you experience an allergic reaction (difficulty breathing; closing of your throat; swelling of your lips, tongue, or face; or hives).

Less than 2% of female patients treated with menotropins develop ovarian hyperstimulation syndrome (OHSS), especially after the first cycle of therapy. Symptoms of OHSS include swelling of the hands or legs, abdominal pain and swelling, shortness of breath, weight gain, and nausea or vomiting. OHSS can be fatal. Notify your doctor immediately or seek emergency medical attention if you develop any of these side effects.

Serious pulmonary (lung and breathing) conditions have been reported in patients using menotropins. Seek medical attention if you experience any sudden changes in your breathing.

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, or diarrhea;

• shortness of breath;

• pain, warmth, or tenderness centralized in an arm or leg;

• fever or chills;

• headache or drowsiness;

• weakness or aching of muscles or joints;

• breast enlargement or tenderness;

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

• rash.

Menotropins may increase the likelihood of multiple births. Multiple births may carry additional risk both for the mother and for the fetuses.

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 menotropins?
Use menotropins exactly as directed by your doctor. If you do not understand these directions, ask your doctor, nurse, or pharmacist to explain them to you. Formulations of menotropins intended for intramuscular injection (an injection into muscle) must not be administered subcutaneously (under the skin), and vice versa. If you are administering this medication at home, your doctor will give you detailed instructions on how to mix the solution and give yourself the injection. Do not inject menotropins if you are not sure how.

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What is the most important information I should know about menotropins?
Menotropins may increase the likelihood of multiple births. Multiple births may carry additional risk both for the mother and for the fetuses.

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What happens if I miss a dose?
Contact your doctor if you miss a dose of menotropins. Do not use a double dose of this medication without first talking to your doctor.

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What other drugs will affect menotropins?
It is not known whether other medications will interact with menotropins. 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?

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

There are no data on the excretion of menotropins into human milk. The manufacturer recommends that caution be used when administering menotropins to nursing women.

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What does my medication look like?
Menotropins is available with a prescription under the brand names Pergonal and Humegon. 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. Pergonal 75 IU powder for injection Pergonal 150 IU powder for injection Humegon 75 IU powder for injection Humegon 150 IU powder for injection

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What happens if I overdose?
An overdose of menotropins is unlikely to threaten life. Notify your doctor immediately or call an emergency room or poison control center for advice. Symptoms of a menotropins overdose are not known. Ovarian hyperstimulation syndrome (OHSS) may result with an overdose of menotropins. Symptoms of OHSS include swelling of the hands or legs, abdominal pain and swelling, shortness of breath, weight gain, and nausea or vomiting. OHSS can be fatal.

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What should I discuss with my healthcare provider before using menotropins?
Menotropins will not induce ovulation or sperm production if your ovaries or testes are not functioning properly. Do not use menotropins without first taking to your doctor if you might be pregnant; have a thyroid problem; have cancer or a tumor of the breast, ovary, uterus, hypothalamus, or pituitary gland; have undiagnosed vaginal bleeding; have ovarian cysts or enlargement; or have any other serious or chronic medical illness. You may not be able to use menotropins, or you may require a dosage adjustment or special monitoring if you have any of the conditions listed above.

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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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