Choriogonadotropin alfa

Subcutaneous
Controlled ovarian hyperstimulation for assisted reproduction in infertility, Female infertility of anovulatory origin

Primary ovarian failure; hypothalamus or pituitary gland tumours; ovarian cyst or enlargement unrelated to polycystic ovarian syndrome (PCOS), gynaecological haemorrhages of unknown origin; mammary, ovarian, or uterine carcinoma or sex hormone dependent tumours of the reproductive tract and accessory organs; ectopic pregnancy in the past 3 months, active thromboembolic disorders, fibroid tumours of the uterus or malformation of sexual organs incompatible with pregnancy, uncontrolled thyroid or adrenal dysfunction. Postmenopausal women. Pregnancy.

Patient with PCOS; history of tubal disease; recent thromboembolic disease or risk factors for thromboembolic events (e.g. personal or family history). Not indicated for other conditions such as corpus luteum insufficiency or male conditions. In women being treated for anovulatory infertility, it is recommended to have coitus on the day of and the day after receiving choriogonadotropin alfa inj. Lactation.

Significant: Ovarian hyperstimulation syndrome (OHSS), ovarian enlargement; thromboembolic events; multiple births, pregnancy loss by miscarriage or abortion, ectopic pregnancy, premature labour, postpartum fever, congenital malformations, neoplasms of the ovary and other reproductive system (benign and malignant).
Gastrointestinal disorders: Nausea, vomiting, abdominal pain, distension, or discomfort, diarrhoea.
General disorders and administration site conditions: Inj site reactions.
Nervous system disorders: Headache.

Parenteral/SC: X

Perform thorough gynaecologic and endocrinologic evaluations, and evaluate for hypothyroidism, adrenocortical deficiency, hyperprolactinaemia, pituitary or hypothalamic tumours before therapy. Assess the fertility potential of the male sexual partner (e.g. semen analysis) during initial evaluation. Confirm pregnancy status before initiating therapy. Obtain ultrasound and/or estradiol levels to evaluate follicle development. Assess ovulation (e.g. basal body temperature, menstruation, serum progestin level). Monitor for signs and symptoms of OHSS (e.g. gastrointestinal symptoms, severe ovarian enlargement, weight gain, dyspnoea, oliguria).

May interfere with the immunological determination of serum or urinary hCG which may lead to false positive pregnancy test; interference may last for up to 10 days. May cross-react in the radioimmunoassay of LH and other gonadotrophins.

Description:
Mechanism of Action: Choriogonadotropin alfa is a recombinant form of chorionic gonadotrophin that binds to LH/hCG receptor of the ovarian granulosa and theca cells in the absence of an endogenous LH surge. It stimulates late follicular maturation of the ovarian follicle and resumption of oocyte meiosis, and initiates the rupture of the pre-ovulatory ovarian follicle.
Pharmacokinetics:
Absorption: Bioavailability: Approx 40%. Time to peak plasma concentration: 12-24 hours.
Distribution: Volume of distribution: 21.4 L.
Excretion: Via urine (10%). Terminal elimination half-life: Approx 30 hours.

Pre-filled pen/syringe: Store between 2-8°C. Do not freeze. Pre-filled syringe may also be stored at ≤25°C for up to 30 days. Protect from light.

Trophic Hormones & Related Synthetic Drugs

G03GA08 - choriogonadotropin alfa ; Belongs to the class of gonadotropins. Used as ovulation stimulants.

Anon. Choriogonadotropin Alfa. AHFS Clinical Drug Information [online]. Bethesda, MD. American Society of Health-System Pharmacists, Inc. https://www.ahfscdi.com. Accessed 02/11/2021.

Anon. Chorionic Gonadotrophin [Chorionic Gonadotropin] (Recombinant). Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 02/11/2021.

Buckingham R (ed). Chorionic Gonadotrophin. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 02/11/2021.

Joint Formulary Committee. Choriogonadotropin Alfa. British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 02/11/2021.

Ovidrel 250 mcg/0.5 mL Solution for Injection in Pre-Filled Syringe or Pre-Filled Pen (Merck Sdn. Bhd.). National Pharmaceutical Regulatory Agency - Ministry of Health Malaysia. https://www.npra.gov.my. Accessed 02/11/2021.

Ovidrel Injection, Solution (EMD Serono, Inc.). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed. Accessed 02/11/2021.

Ovitrelle 250 mcg Solution for Injection in Pre-Filled Pen (Merck Serono Ltd). MHRA. https://products.mhra.gov.uk. Accessed 02/11/2021.