Menotropins are a mixture of naturally-occurring hormones that include follicle stimulating hormone (FSH) and luteinizing hormone (LH). Menotropins are used to help women with certain infertility problems to become pregnant. Menotropins work by stimulating the ovaries to produce eggs.

Menotropins are usually given with human chorionic gonadotropin (hCG). This hormone is also present in this medication. It works similarly to LH and helps to ensure that ovulation occurs at the expected time.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop using this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to use this medication if their doctor has not prescribed it.

The dose of menotropins will depend on your circumstances and needs. The recommended starting dose of menotropins is 225 IU injected under the skin daily for a maximum of 20 days. The dose may be adjusted according to your response, but should not exceed 450 IU.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are using the medication without consulting your doctor.

This medication is best injected under the skin of the lower abdomen a few inches below your navel. Each day, use the alternate side of your lower abdomen (e.g., left or right) to prevent soreness.

Your doctor or another health care professional will show you exactly how to mix and draw up the medication into the needles and how to inject it. Once the dose of medication has been prepared, it should be used immediately. Discard any unused material after use. Do not use your injectable solution if it appears cloudy, lumpy, or discoloured.

It is important that you follow the dosing schedule closely and keep all doctor's appointments. Your doctor will monitor how the ovaries are responding to the medication and frequent appointments will be necessary.

It is important to use this medication exactly as prescribed by your doctor. If you miss a dose, use it as soon as possible and continue with your regular schedule. Do not use a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store this medication (unmixed) at room temperature, protect it from light, and keep it out of the reach of children.

Each sterile vial of lyophilized, white-to-off-white powder or pellet contains 75 IU FSH activity and 75 IU LH activity. Nonmedicinal ingredients: lactose monohydrate, polysorbate 20, sodium phosphate buffer (sodium phosphate dibasic, heptahydrate and phosphoric acid), and sodium chloride injection USP.

Do not use this medication if you:

• are allergic to menotropins or any ingredients of the medication
• are pregnant
• have high levels of FSH (indicating primary ovarian failure - another reason for infertility)
• have any lesion inside the head such as a pituitary tumour
• have ovarian cysts or enlargement not due to polycystic ovarian syndrome
• have a tumour of the ovaries, fallopian tubes, uterus, vagina, breast, or cervix that is dependent on hormones for growth
• have uncontrolled thyroid or adrenal gland dysfunction
• have undiagnosed abnormal vaginal bleeding

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who uses this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people using this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

• abdominal pain
• breast tenderness
• constipation
• cramps
• dizziness
• feeling of fullness in the abdomen
• flushing
• general feeling of being unwell
• generalized pain (body, back, joint)
• headache
• nausea, vomiting, or diarrhea (not continuing or severe)
• pain, rash, swelling, or irritation at place of injection
• sweating

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

• abnormal vaginal bleeding
• flu-like symptoms (e.g., cough, fever, sore throat)
• migraine
• mood changes
• pain when urinating
• unusual pain with menstrual bleeding

Stop taking the medication and seek immediate medical attention if any of the following occur:

• difficulty breathing
• signs of a blood clot in blood vessels (e.g., difficulty breathing, chest pain, pain and swelling in one leg muscle)
• signs of stroke (e.g., sudden trouble with vision, dizziness, sudden severe and unusual headache, weakness, difficulty speaking)
• symptoms of a severe allergic reaction (e.g., shortness of breath, swelling of the face or throat, or hives)
• symptoms of ovarian hyperstimulation syndrome or OHSS, e.g.:
• abdominal or pelvic pain or discomfort
• bloating
• diarrhea
• difficulty breathing
• decreased amount of urine
• nausea
• rapid weight gain
• vomiting

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Blood clots: This medication may increase the chance of blood clot formation, causing a reduction of blood flow to organs or the extremities. If you have a history of clotting, you may be at increased risk of experiencing blood clot-related problems such as heart attack, stroke, or clots in the deep veins of your leg. Discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

If you experience symptoms such as sharp pain and swelling in the leg, difficulty breathing, chest pain, blurred vision or difficulty speaking, contact your doctor immediately.

Lung problems: In rare cases, serious lung problems have been reported with the use of menotropins. Get immediate medical attention if you experience difficulty breathing or wheezing.

Multiple births: Multiple births may occur with fertility medications. Talk to your doctor about the risks of multiple births before beginning treatment.

Ovarian enlargement: Some women using this medication may experience ovarian enlargement associated with abdominal bloating or pain. In most cases the bloating and pain stop without treatment within 2 or 3 weeks. If you experience these symptoms, contact your doctor.

Ovarian hyperstimulation syndrome (OHSS): Treatment with this medication can cause a condition called ovarian hyperstimulation syndrome (OHSS). It most often develops after treatment has stopped. With OHSS, too many follicles grow and cause abdominal or pelvic discomfort or pain, nausea, vomiting, and weight gain. Some women may experience difficulty breathing, diarrhea, and decreased urination. OHSS can progress rapidly and may become serious. If you experience any of these symptoms while using this medication, contact your doctor immediately.

Pregnancy: The effect of menotropins on an unborn baby is not known. To avoid the possibility of harm to the baby, menotropins should not be used during pregnancy.

Breast-feeding: It is not known if menotropins pass into breast milk. If you are breast-feeding and are taking this medication, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: This medication is intended for use by women of child-bearing age. Its safety and effectiveness have not been established for children.

Seniors: This medication is intended for use by women of child-bearing age. Its safety and effectiveness have not been established for seniors.

Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications that you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.