Uses

This medication is used to treat certain fertility problems in women. It provides the hormone (FSH) that helps cause the ovaries to produce eggs. This medication is usually used in combination with another hormone (hCG) for the growth and release of a mature egg (ovulation).

This medication is not recommended for women whose ovaries no longer make eggs properly (primary ovarian failure).

How To Use

This medicine comes with a Patient Information Leaflet. Read it carefully. Ask your doctor, nurse, or pharmacist any questions that you may have about this medicine.

Learn all preparation and usage instructions in the product package. If any of the information is unclear, consult your doctor or pharmacist.

Wash your hands with soap and water before using this medication. Before injecting each dose, clean the injection site with rubbing alcohol. It is important to change the location of the injection site daily to avoid discomfort or problem areas under the skin. Before using, check this product visually for particles or discoloration. If either is present, do not use the liquid.

Inject this medication under the skin or into a muscle, usually once a day or as directed by your doctor.

The dosage and length of treatment are based on your medical condition, response to treatment, laboratory tests, and other medications you may be taking. Be sure to tell your doctor and pharmacist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products). Your doctor will do blood/medical tests (such as estradiol blood levels, ultrasound) to find the right dose for you and to decide when to inject the next medication (hCG).

Learn how to store and discard needles and medical supplies safely. Consult your pharmacist.

Side Effects

Headache, nausea, vomiting, mild stomach/abdominal pain, bloating, redness/pain at the injection site, or breast tenderness/pain may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.

Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Tell your doctor right away if any of these unlikely but serious side effects occur:

• unusual bleeding from the vagina/uterus
• pain/redness/swelling of the calf muscles
• cold/numb/pale skin of the arms/legs/hands/feet
• swelling of ankles/hands/feet

Seek immediate medical attention if any of these rare but very serious side effects occur:

• weakness on one side of the body
• trouble speaking
• vision changes
• sudden severe headache
• chest pain
• shortness of breath

This medication may cause a condition known as ovarian hyperstimulation syndrome (OHSS). This condition may occur during treatment and after treatment has been stopped. Rarely, serious OHSS causes fluid to suddenly build up in the stomach, chest, and heart area. Seek immediate medical attention if you develop the following side effects:

• severe pain or swelling in the lower abdominal (pelvic) area
• severe nausea/vomiting
• sudden/rapid weight gain
• difficult/painful breathing
• decreased urination

A very serious allergic reaction to this drug is rare. However, seek immediate medical attention if you notice any symptoms of a serious allergic reaction, including:

• rash
• itching/swelling (especially of the face/tongue/throat)
• severe dizziness
• trouble breathing

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

In the US -

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.

In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

Precautions

Before using this medication, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of:

• other fertility problems (such as primary ovarian failure)
• abnormal bleeding from the vagina/uterus
• thyroid problems
• adrenal gland problems
• cancer of the reproductive organs (such as the breast, uterus, ovary)
• tumor in the brain (such as a pituitary tumor)
• ovarian cysts or enlarged ovaries (not due to polycystic ovary syndrome)
• twisting of the ovary (ovarian torsion)
• personal/family history of blood clots
• blood clotting disorders (such as thrombophilia)
• obesity
• polycystic ovarian syndrome
• stroke
• certain heart diseases (such as angina, heart attack)
• lung problems (such as asthma)

Multiple births may occur as a result of this treatment. Discuss the risks and benefits of having such a pregnancy with your doctor.

Stop using this medication when you become pregnant. This medication must not be used during pregnancy. If you think you may be pregnant, tell your doctor right away.

It is unknown if this drug passes into breast milk. Consult your doctor before breast-feeding.

Drug Interactions

Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.

Some products that may interact with this drug include:

• clomiphene
• gonadorelin

Overdose

If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 9-1-1. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center.

Notes

Do not share this medication with others.

Laboratory and/or medical tests (such as blood hormone tests such as estradiol level, liver tests, ultrasound) should be performed regularly to monitor your progress or check for side effects. Consult your doctor for more details.

It is important to keep all regular medical and laboratory appointments so your doctor can closely monitor your response to help reduce the risk of serious side effects and determine the timing of your hCG dose.

Missed Dose

If you miss a dose, ask your doctor or pharmacist right away for a new dosing schedule. Do not double the dose to catch up.

Storage

Store the unmixed medication in the refrigerator or at room temperature between 37-77 degrees F (3-25 degrees C). Protect from light and moisture. Do not freeze. Do not store in the bathroom. Use immediately after mixing. Discard any unused liquid. Keep all medicines away from children and pets.

Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product.