Universal reference book for medicines
Product name: CHORAGON ® (CHORAGON)

Active substance: chorionic gonadotrophin

Type: Recombinant human chorionic gonadotropin

Manufacturer: FERRING (Germany)

Composition, form of production and packaging
Powder for injection
1 amp.

human chorionic gonadotropin 1500 IU

Excipients: mannitol.

Solvent: r-r sodium chloride isotonic, diluted hydrochloric acid to create the necessary pH.

Ampoules (3) complete with a solvent (1 ml - amp 3 pcs.) - packs cardboard.

Powder for injection 1 amp.

human chorionic gonadotropin 5000 IU

Excipients: mannitol.

Solvent: r-r sodium chloride isotonic, diluted hydrochloric acid to create the necessary pH.

Ampoules (3) complete with a solvent (1 ml - amp 3 pcs.) - packs cardboard.

INSTRUCTION FOR THE SPECIALIST.

Description of the drug approved by the manufacturer for the printed edition of 2005.

PHARMACHOLOGIC EFFECT

The active substance is human chorionic gonadotropin (hCG or hCG), produced by the placenta and obtained from the urine of pregnant women.
This hormone has the properties of the luteinizing hormone (LH) of the anterior lobe of the pituitary gland, but has a more pronounced effect due to a prolonged half-life. In women, the drug causes ovulation and stimulates the synthesis of estrogens and progesterone. In men - stimulates spermatogenesis and production of sex steroids (testosterone, dihydrotestosterone, 17OH-progesterone, estradiol).
Use strictly according to the doctor's prescription!

PHARMACOKINETICS

Chorionic gonadotropin is given in / m.
Depending on the dose, C max in the blood is reached 4-12 hours after the intravenous injection, which then gradually decreases. T 1/2 is 29-30 hours, so in the case of daily intravenous injections, cumulation of the drug may occur.
Chorionic gonadotropin is excreted by the kidneys.
Up to 10-20% of the administered dose can be detected unchanged in the urine, while the bulk is excreted as fragments of the α chain.
INDICATIONS

Among women:

- induction of ovulation, if necessary, after stimulation of follicle growth;

- maintenance of the function of the ovarian yellow body in patients with luteal phase insufficiency.

In boys and men:

- cryptorchidism, delay in puberty, hypogonadotropic hypogonadism (in combination with preparations of human menopausal gonadotropins - CHMG);

- with a diagnostic purpose: a differential diagnostic test of anarchism and cryptorchidism in boys.
To assess testicular function in hypogonadotropic hypogonadism before initiating long-term stimulating treatment (Leydig functional test).
DOSING MODE

After dissolution in the attached solvent, the Horagon drug should be administered intramuscularly immediately!

In women, 5,000 IU or 10,000 IU of the Horagon drug are administered to induce ovulation .
To maintain the function of the ovary's yellow body at 3, 6 and 9 days after ovulation, 1500-5 000M of the Horagon drug is administered.
In boys and men:

The general scheme for the treatment of cryptorchidism in boys under the age of 2 years and after 6 years - weekly injected 500 - 2 000 IU of the drug Horagon for 5 weeks Boys 3-6 years can be injected 1 time per week 1 500 IU of the drug Horagon for 3 weeks (if necessary - in combination with GnRH).

To accelerate puberty in boys injected 1,500 IU of the drug Horagon 2-3 times a week for 3 months.

When hypogonadotropic hypogonadism, 1,500-6,000 IU of the Horagon drug are administered once a week in combination with HMG preparations (human menopausal gonadotropins, for example, Menogon).

For differential diagnosis of cryptorchidism and anarchism in boys and for the evaluation of testicular function in hypogonadotropic hypogonadism, 5 000 IU of the Horagon drug are administered once.

SIDE EFFECT

In women: after combination treatment of infertility with the use of drugs CHMG or clomiphene and hCG, the development of the syndrome of ovarian hyperstimulation is possible.
This condition is accompanied by the development of ovarian cysts with the danger of their rupture, ascites, accumulation of fluid in the chest cavity and the risk of thromboembolism. In the case of pregnancy, manifestations of hyperstimulation may be intensified.
In boys and men: during the treatment with Horagon, temporary reversible or prolonged enlargement of the mammary glands, proliferative changes in the prostate gland, retention of water and electrolytes, common acne can be observed.
As a result of the increase in testosterone level induced by the drug of chorionic gonadotropin, there may be an increase in the size of the penis and erection.
In some cases, behavioral changes similar to those observed during the first phase of puberty, which occur after the end of treatment, are possible.

Long-term use of the drug Horagon is not recommended because of the possible formation of antibodies that reduce the effectiveness of treatment.

CONTRAINDICATIONS

General information

- tumors that are dependent on sex hormones;

- Allergic reactions to the components of the drug in the history.

Among women

- Ovarian hyperstimulation syndrome

In boys and men

- organically conditioned cryptorchidism (supraphascial position of the testicles, inguinal hernia, consequences of surgical interventions in the inguinal region).

PREGNANCY AND LACTATION

The administration of chorionic gonadotropin in the absence of luteal phase leads to an increase in the production of progesterone, which improves endometrial parameters during the perimplantation phase.

Indications for the appointment of chorionic gonadotropin during normal pregnancy and during breastfeeding currently does not exist.

SPECIAL INSTRUCTIONS

In the treatment of female infertility, before the appointment of chorionic gonadotropin, the growth of follicles (ultrasound) and the cervical index (within 2 days before the onset of the stimulation effect) should be evaluated.
In the process of stimulation, ultrasound and level control of estradiol in the blood plasma should be performed daily. The ovarian response can also be assessed using the cervical index. Careful observation of the patient's condition is necessary!
In case of unintended ovarian hyperstimulation treatment should be stopped.

Influence on the ability to drive a car and other machines - not noted.

OVERDOSE

Ovarian hyperstimulation

- hyperstimulation of 1 degree - mild - does not require treatment, accompanied by a slight increase in the size of the ovaries (up to 5-7 cm), an increased level of sex steroids and abdominal pain.
The patient should be informed about her condition and carefully monitored.
- Grade 2 hyperstimulation - requires hospitalization and symptomatic treatment, including in / vinfusion solutions to maintain bcc (in case of increased hemoglobin concentration).
Ovarian cysts up to 8-10 cm in size are accompanied by abdominal symptoms, nausea and vomiting.
- For 3-degree hyperstimulation, ovarian cysts measuring 10 cm or more, ascites, hydrothorax, an increase in abdominal pain, dyspnea, salt retention, an increase in the concentration of hemoglobin in the blood and an increase in its viscosity, accompanied by increased adhesion of thrombocytes with thromboembolism.
Requires mandatory hospitalization.
DRUG INTERACTION

Reactions caused by concomitant use with other drugs are not known.
An exception is the aggravation, in case of the use of the Horagon drug, of the symptoms of hyperstimulation resulting from the use of drugs CHMG or clomiphene.
TERMS OF RELEASE FROM PHARMACY

The drug Horagon 1500/5000 is released only by prescription.

TERMS AND CONDITIONS OF STORAGE

The preparation Horagon 1500/5000 should be stored at a temperature of up to 20 ° C in a place inaccessible to children.
Do not use the product after the expiration date.
If the storage conditions are met, the shelf life of the drug Horagon is 3 years.
The drug should not be used after the date indicated on the package.
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