Менопур является препаратом человеческого менопаузного гонад... Инструкция
Показания к применению
Для женщин- Бесплодие, обусловленное гипоталамо-гипофизарными нарушениями (с целью стимуляции роста одного доминирующего фолликула); - При проведении вспомогательных репродуктивных методик для наступления зачатия (стимуляция роста множественных фолликулов). Для мужчин- Стимуляция сперматогенеза при азооспермии или олигоастеноспермии, обусловленными ...
Заболевания щитовидной железы и надпочечников; - Опухоли гипоталамо-гипофизарной области; - Гиперпролактинемия; - Персистирующее увеличение яичников или возникновение кист, не связанные с синдромом поликистозных яичников; - Аномалии развития половых органов или миома матки, несовместимая с беременностью; - Вагинальные кровотечения неясной этиологии; - Рак матки, яичников или молочных желез; - Первичная недостаточность яичников; - Рак предстательной железы или другие андрогенозависимые опухоли у мужчин; - Беременность; - Период лактации; - Повышенная чувствительность к менотропинам (препаратам, содержащим ЛГ и/или ФСГ) и другим компонентам препарата.
Менопур является препаратом человеческого менопаузного гонадотропина (чМГ), высокой степени очистки. Относится к группе меноторопинов, содержит ФСГ и ЛГ в соотношении 1: 1. Препарат получают из мочи женщин в постменопаузе. У женщин препарат вызывает повышение уровня эстрогенов в крови и стимулирует рост и созревание фолликулов яичника, пролиферацию эндометрия. У мужчин применение Менопура приводит к повышению концентрации тестостерона в крови и стимулирует сперматогенез, воздействуя на клетки Сертоли семенных канальцев.
Показания к применению
Для женщин- Бесплодие, обусловленное гипоталамо-гипофизарными нарушениями (с целью стимуляции роста одного доминирующего фолликула); - При проведении вспомогательных репродуктивных методик для наступления зачатия (стимуляция роста множественных фолликулов). Для мужчин- Стимуляция сперматогенеза при азооспермии или олигоастеноспермии, обусловленными первичным или вторичным гипогонадотропным гипогонадизмом (в сочетании с терапией препаратами человеческого хорионического гонадотропина, например, препаратом Хорагон).
Противопоказания
Заболевания щитовидной железы и надпочечников; - Опухоли гипоталамо-гипофизарной области; - Гиперпролактинемия; - Персистирующее увеличение яичников или возникновение кист, не связанные с синдромом поликистозных яичников; - Аномалии развития половых органов или миома матки, несовместимая с беременностью; - Вагинальные кровотечения неясной этиологии; - Рак матки, яичников или молочных желез; - Первичная недостаточность яичников; - Рак предстательной железы или другие андрогенозависимые опухоли у мужчин; - Беременность; - Период лактации; - Повышенная чувствительность к менотропинам (препаратам, содержащим ЛГ и/или ФСГ) и другим компонентам препарата.
Применение при беременности и в период грудного вскармливания
Менопур противопоказан к применению при беременности и в период лактации. При беременности проявления синдрома гиперстимуляции яичников обостряются, увеличивается их продолжительность, такое состояние может приводить к угрозе для жизни пациентки.
Способ применения и дозы
Препарат вводят в/м или п/к. Раствор для инъекций готовят непосредственно перед введением, используя прилагаемый растворитель. Если не предписано иное, рекомендуется следующая схема терапии: ЖенщинамПри бесплодии, обусловленном гипоталамо-гипофизарными нарушениями, с целью стимуляции роста одного доминирующего фолликулаРежим дозирования препарата устанавливают индивидуально. Оптимальную дозу препарата и длительность лечения подбирают на основании УЗИ яичников, определения уровня эстрогенов в крови, а также клинического наблюдения. О созревании фолликула судят по увеличению уровня эстрогенов в крови. Начальная доза препарата Менопур составляет 75-150 МЕ (1-2 флакона/сут). При отсутствии реакции яичников дозу постепенно увеличивают до повышения уровня эстрогенов в крови или роста фолликулов. Дозу оставляют без изменения до того момента, когда концентрация эстрогенов достигнет преовуляторного уровня. При быстром подъеме уровня эстрогенов в начале стимуляции дозу препарата следует снизить. С целью индукции овуляции через 1-2 дня после последней инъекции Менопура однократно вводят 5 000-10 000 МЕ чХГ. МужчинамС целью стимуляции сперматогенеза вводят по 1 000-3 000 МЕ чХГ 3 раза в неделю до нормализации уровня тестостерона в крови. Затем в течение нескольких месяцев 3 раза в неделю вводят препарат Менопур по 75-150 МЕ (1-2 флакона).
Побочное действие
Со стороны эндокринной системы: масталгия, резкое увеличение экскреции эстрогенов с мочой, умеренно выраженное (неосложненное) увеличение яичников, образование кист яичников; у мужчин - гинекомастия. Синдром гиперстимуляции яичников: ранние признаки - выраженные боли в низу живота, тошнота, рвота, увеличение массы тела; гиповолемия, увеличение количества эритроцитов в плазме (связанное с уменьшением объема плазмы), нарушение электролитного баланса, асцит, гемоперитонеум (наличие крови в брюшной полости), гидроторакс, тромбоэмболический синдром. Со стороны пищеварительной системы: иногда - тошнота, рвота, коликообразные боли. Местные реакции: покраснение, отек, зуд в месте инъекции. Аллергические реакции: артралгия; редко – реакции повышенной чувствительности (в т.ч. кожная сыпь, повышение температуры тела); очень редко при длительном применении препарата - образование антител (что приводит к снижению эффективности проводимой терапии). Прочие: олигурия, снижение АД, повышение массы тела, многоплодная беременность.
Передозировка
В настоящее время о случаях передозировки препарата Менопур не сообщалось.
Особые указания
Перед назначением препарата Менопур рекомендуется проведение соответствующего лечения при наличии сопутствующего гипотиреоза, недостаточности коры надпочечников, гиперпролактинемии, опухолей гипоталамо-гипофизарной области, коррекции гемоконцентрации. Перед началом лечения бесплодия следует оценить состояние яичников (УЗИ и уровень эстрадиола в плазме крови). В течение курса лечения эти исследования должны проводиться ежедневно или через день. Следует учитывать, что на фоне применения препаратов чМГ возможно развитие гиперстимуляции яичников, которая становится клинически выраженной после введения с целью овуляции препаратов чХГ и проявляется в формировании кист яичников большого размера. При этом может возникать асцит, гидроторакс, сопровождающиеся олигурией, артериальной гипотензией и тромбоэмболическим синдромом. При появлении первых признаков гиперстимуляции яичников (боль в животе, пальпируемые или определяемые при УЗИ образования внизу живота) лечение следует немедленно прекратить! В случае развития гиперстимуляции яичников не следует вводить препарат чХГ с целью овуляции. При лечении препаратами чМГ часто развивается многоплодная беременность. У мужчин с высоким уровнем ФСГ в крови (что свидетельствует о первичной тестикулярной недостаточности) Менопур обычно неэффективен.
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