"The woman who received the nation's first transplanted uterus on February 24 at the Cleveland Clinic in Ohio had to have the organ removed because of a "sudden complication," the clinic announced today.
The transplant recipient, a 26-"...
(follitropin alfa for injection)
This leaflet contains information about Gonal-f® Multi-Dose. This drug has been prescribed to you by your doctor for treating infertility. To help you prepare and use this medicine, you should read these instructions carefully and ask your doctor, nurse, or pharmacist to explain anything you do not understand. Keep this leaflet. You may want to read it again.
What is Gonal-f® Multi-Dose?
Gonal-f® Multi-Dose is an injectable hormone contained in a stoppered glass vial. The hormone in the vial is in the form of a white powder. The carton containing the vial of drug also contains a syringe labeled 'Bacteriostatic Water for Injection, USP'. This water must be mixed with the white powder in the vial to form a clear liquid solution for injection. Injection syringes for use with Gonal-f® Multi-Dose are also included in the carton. These injection syringes can only be used to administer Gonal-f® Multi- Dose. Gonal-f® Multi-Dose is only available with a prescription.
Gonal-f® Multi-Dose contains follitropin alfa, which is similar to the human hormone 'follicle stimulating hormone'; the abbreviation is 'FSH'. FSH belongs to the group of hormones associated with human reproduction. In women, FSH causes the ovaries to produce eggs. In men, FSH causes sperm production.
The hormone in Gonal-f® Multi-Dose is manufactured to meet standards for quality and purity. It cannot be taken by mouth since the acids in your stomach would destroy the hormone before it was absorbed into the body. Gonal-f® Multi-Dose is given as an injection usually every day in women and three times per week in men. It is prescribed to patients needing hormone replacement or supplementation to produce either eggs or sperm.
The Gonal-f® Multi-Dose 450 IU (33 mcg) vial is filled with 600 IU of drug in order to deliver 450 IU in several smaller daily doses. This provides between 2 and 6 commonly prescribed daily doses.
The Gonal-f® Multi-Dose 1050 IU (77 mcg) vial is filled with 1200 IU of drug in order to deliver 1050 IU in several smaller daily doses. This provides between 3 and 14 commonly prescribed daily doses.
Your doctor or nurse will tell you the number of units (IU FSH) of Gonal-f® to use each day and the number of days to use the same vial. It is common for a small amount of drug to be leftover in each vial that can not be retrieved with a syringe. This is normal. Any drug remaining in the vial after your treatment is complete should be discarded.
Your doctor, nurse, or pharmacist will show you how to inject the prescribed dose. Usual injection sites include the skin on the stomach, upper leg, or upper arm.
The Gonal-f® liquid solution may be stored refrigerated or at room temperature for a maximum of 28 days from the day the powder is mixed with the water. Do Not Freeze. Discard unused liquid solution after 28 days.
Use only the prescribed dose. Call your doctor immediately should you accidentally inject more than the prescribed dose.
What are the uses of Gonal-f® Multi-Dose?
Doctors specializing in infertility or reproductive health prescribe Gonal-f® Multi-Dose to those patients trying to have a child but for a variety of reasons need medical assistance. After a thorough medical exam to determine your specific medical condition, your doctor may prescribe Gonal-f® Multi- Dose because you require hormone replacement or supplementation as part of your treatment program. Gonal-f® Multi-Dose can be used in women seeking pregnancy or in men with a rare condition that affects sperm production. Gonal-f® Multi-Dose may be one of several drugs prescribed to a patient as part of a treatment program.
Do NOT take Gonal-f® Multi-Dose if you have allergies to any of these materials:
- sodium phosphate
- benzyl alcohol
Do NOT take Gonal-f® Multi-Dose if you are pregnant or breast feeding.
Medical conditions you should tell your doctor about.
If you have any of the following conditions, make sure to tell your doctor before starting or continuing use of Gonal-f®:
- Abnormal bleeding from the uterus or vagina in women
- Swollen, enlarged or painful ovaries in women
- Cancer of the sex organs (uterus, ovaries, testes)
- Permanent damage to the male sex organs (testes)
- Uncontrolled thyroid or adrenal problems
- Cancer of the brain
How to Prepare Gonal-f® Multi-Dose for Use
See your doctor, nurse, or pharmacist to obtain training in the preparation and use of Gonal-f® Multi- Dose.
REVIEW THESE STEPS BEFORE YOU PREPARE OR ADMINISTER GONAL-F MULTIDOSE.
Make sure you have all the necessary items listed below before you begin.
- vial containing Gonal-f® Multi-Dose (white powder)
- single pre-filled syringe labeled 'Bacteriostatic Water for Injection, USP'
- 27-gauge injection syringe with unit dose markings from 37.5 IU to 600 IU FSH for use with the Gonalf Multi-Dose.
- alcohol wipes
- hard plastic or metal container (like an empty coffee can) suitable for safe disposal of used syringes and needles.
Step 1: Mixing (reconstituting) the vial containing Gonal-f®® Multi-Dose
- Wash your hands with soap and water.
- Using your thumb, flip off the plastic cap of the Gonal-f® Multi-Dose vial.
- Wipe the top of the vial stopper with an alcohol wipe.
- Carefully twist the needle cap off the syringe labeled 'Bacteriostatic Water for Injection, USP'. Do not touch the needle or allow the needle to touch any surface.
- Do not shake the vial. If bubbles appear, wait a few moments for the bubbles to settle. The liquid drug should be clear.
Position the needle of the syringe of water in a straight, upright position over the marked center circle of the rubber stopper on the vial of Gonal-f® Multi-Dose powder. Keep the needle in a straight, upright position as you insert it through the center circle, or it may be difficult to depress the plunger. Slowly inject the water into the vial by depressing the syringe plunger. The water and white powder will mix to form a clear liquid. When all the water has been injected into the vial, withdraw the needle and safely dispose of it immediately in your needle container. Do not use this needle to inject your dose.
Do not use the Gonal-f® Multi-Dose liquid solution if it contains any particles. Report this to your doctor, nurse, or pharmacist immediately.
Step 2: Determining your dose on the injection syringe
Your doctor will instruct you to take a specific dose of Gonal-f® Multi-Dose. Your doctor, nurse, or pharmacist should show you how to locate the syringe marking that corresponds to your prescribed dose (see illustration below).
If your doctor or nurse instructs you to increase or decrease your dose for 1 or more days, find the correct dose marking on the injection syringe and make the change as directed. Contact your doctor or nurse if you have questions.
Step 3: Preparing your dose
- Wipe the rubber stopper of the vial of Gonal-f® Multi-Dose liquid with an alcohol wipe.
- Carefully pull the cap from the needle. Do not touch the needle or allow the needle to touch any surface. Firmly hold the vial of Gonal-f® Multi-Dose liquid on a flat surface, insert the needle through the marked center circle of the rubber stopper.
- Keeping the needle in the vial, lift the vial and turn it upside down with the needle pointing toward the ceiling. With the needle tip in the liquid, slowly pull back the plunger until the syringe fills to slightly more than the mark for your prescribed dose. Next, keeping the needle in the vial, slowly adjust the plunger to your prescribed dose – this will clear away any air bubbles.
- Check that you have the plunger set at your prescribed dose.
- Remove the syringe needle from the vial. Do not touch the needle or allow the needle to touch any surface.
You should now be ready to prepare to receive the injection.
Step 4: Injecting your dose
Your doctor, nurse, or pharmacist should provide you with injection training. Inject the prescribed dose as directed. Usual injection sites include the skin on the stomach, upper arm, or upper leg. Change the injection location each day to minimize discomfort. Dispose of all used syringes and needles safely in a container.
The injection syringes provided with Gonal-f® Multi-Dose are designed for use only with this product. Do NOT use the injection syringes to administer other drugs or hormones. All unused syringes should be discarded.
Step 5: Storing Your Vial of Gonal-f® Multi-Dose Between Uses
- After each use, the vial containing the Gonal-f® Multi-Dose liquid must be stored away from light and may be stored refrigerated or at room temperature between 36°- 77° F (2°- 25° C) for up to 28 days. Otherwise, the drug's potency can be reduced. Do not store the drug in the syringe.
- If you are traveling, keep the vial stored away from light and extreme temperatures. Do not freeze.
- Allow the liquid solution to adjust to room temperature prior to administering your injection.
- Check that the Gonal-f® liquid solution is clear. Do not use if it contains any particles. Report this to your doctor, nurse or pharmacist immediately.
Are there any side effects associated with the use of Gonal-f® Multi-Dose?
Your doctor or staff member should review with you the risks and benefits of using Gonal-f® Multi- Dose. As with any medication, report any and all side effects, symptoms, or physical changes to your doctor.
The most common side effects are headache, ovarian cysts, upset stomach, and sinus infections in women and skin pimples, breast pain and growth, and tiredness in men. Needle injections may cause some discomfort.
Use of fertility drugs can be associated with fertilization of more than 1 egg. This can lead to complications for the mother and the birth of 2 or more babies. Pregnancy loss (miscarriage) is higher in women receiving fertility drugs than in women not taking fertility drugs.
Gonal-f® is a potent drug which should be used at the lowest dose expected to achieve the desired results. When used in women, your doctor should monitor your response often to avoid overdose which can lead to serious side effects including blood clots.
Contact your doctor if you take more than the prescribed amount of Gonal-f® or experience severe pain or bloating in the stomach or pelvic area, severe upset stomach, vomiting, and weight gain.
In rare cases, ovarian cancer has been reported in women receiving many courses of fertility drugs.
What should you do if you forget to take Gonal-f® Multi-Dose?
Do NOT take a double dose of Gonal-f® . Contact your doctor if you forget to take a dose of Gonal-f® .
Can you take Gonal-f® Multi-Dose with other medicines?
Inform your doctor and pharmacist if you are taking or have taken any other medicines, even those not requiring a prescription.
Where can more information about Gonal-f® Multi-Dose be obtained?
This leaflet is a summary of the important patient information about Gonal-f® Multi-Dose. If you have any questions or problems, talk to your doctor or other health care provider.
Gonal-f® Multi-Dose is manufactured and distributed by EMD Serono, Inc. You can also visit the Web site www.fertilitylifelines.com or contact EMD Serono at 1-866-538-7879.
Last reviewed on RxList: 10/7/2016
This monograph has been modified to include the generic and brand name in many instances.
Additional Gonal-F Information
Report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.
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