Fertility Treatments

Gonal-f® Multi-Dose

Gonal-f® Multi-Dose (follitropin alfa for injection)

To help you prepare and use Gonal‑f® Multi-Dose, you should read the patient information leaflet contained in the box and ask your doctor, nurse, or pharmacist to explain anything you do not understand. You should keep the leaflet as you may want to read it again.

Read the patient information each time you get a refill, because there may be new information. The leaflet does not take the place of talking with your healthcare provider about your condition or treatment.

What is Gonal-f® Multi-Dose?

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 cannot 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.

IMPORTANT

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?

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.

IMPORTANT

Do NOT take Gonal-f® Multi-Dose if you have allergies to any of these materials:

  • follitropin
  • sucrose
  • sodium phosphate
  • benzyl alcohol

Do NOT take Gonal‑f® Multi-Dose if you are pregnant or breast feeding.

 
Medical conditions I should tell my doctor about

Medical conditions I should tell my 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
What are the possible side effects of Gonal-f® Multi-Dose?

What are the possible side effects 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.

IMPORTANT

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.

 
How should I use Gonal‑f® Multi-Dose?

How should I use Gonal‑f® Multi-Dose?

You may self-inject Gonal‑f® Multi-Dose after special instruction from your doctor.

Gonal‑f® Multi-Dose is for injection under the skin of the lower abdominal area, preferably around, but staying at least one inch away from the belly button.

Before you inject Gonal‑f® Multi-Dose yourself, please carefully read the instructions included in the packet with the needles and pre-filled syringe.

What should I do if I forget to take Gonal-f® Multi-Dose?

What should I do if I 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 I take Gonal-f® Multi-Dose with other medicine?

Can I take Gonal-f Multi-Dose with other medicine?

Inform your doctor and pharmacist if you are taking or have taken any other medicines, even those not requiring a prescription.

Storing my Vial of Gonal‑f® Multi-Dose

Storing Your Vial of Gonalf® Multi-Dose

  • 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.
Gonal-f® Multi-Dose Use Instructions (Video)

Gonal-f Multi-Dose use instructions

Watch this brief video that demonstrates how to administer Gonal-f® Multi-Dose.

Download Full Prescribing Information for Gonal-f® (follitropin alfa for injection) Multi-Dose

Download Full Prescribing Information for Gonal-f® (follitropin alfa for injection) Multi-Dose

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Where can I find more information about Gonal-f® Multi-Dose?

Where can I find more information about Gonal-f Multi-Dose?

This information on this website 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 contact EMD Serono at 1-866-538-7879.

 

 

IMPORTANT INFORMATION ABOUT THE PROPER USE AND RISKS OF Gonal-f® RFF* Redi-ject™ (follitropin alfa injection) for subcutaneous use

Gonal-f® RFF Redi-ject™ is an injection Pen that delivers a prescription medicine containing follicle-stimulating hormone (FSH) used in infertile women to:

  • help healthy ovaries develop (mature) and release an egg
  • cause your ovaries to make multiple (more than 1) eggs as part of an Assisted Reproductive Technology (ART) program

Do not use the Gonal-f® RFF Redi-ject™ if you:

  • are allergic to recombinant human FSH or any of the ingredients listed here:  follitropin alfa (r-hFSH), sucrose, meta-cresol, di-sodium hydrogen phosphate dihydrate, sodium dihydrogen phosphate monohydrate, methionine, Poloxamer 188, O-phosphoric acid, sodium hydroxide
  • have ovaries that no longer make eggs (primary ovarian failure)
  • are pregnant or think you may be pregnant
  • have uncontrolled thyroid or adrenal problems
  • have a tumor in your female organs, including your ovaries, breast, or uterus
  • have a tumor in your brain, such as a tumor in your pituitary or hypothalamus
  • have abnormal bleeding from your uterus or vagina
  • have ovarian cysts or large ovaries, not due to polycystic ovary syndrome (PCOS)

Before you use Gonal-f® RFF Redi-ject™, tell your healthcare provider if you:

  • have or have had asthma
  • have been told by a healthcare provider that you have an increased risk for blood clots (thrombosis)
  • have ever had a blood clot (thrombosis), or anyone in your family has ever had a blood clot (thrombosis)
  • have had abdominal surgery
  • have had twisting of your ovary (ovarian torsion)
  • had or have a cyst on your ovary
  • have polycystic ovarian disease
  • have any other medical conditions
  • are breastfeeding or plan to breastfeed
  • are taking any other prescription or over-the-counter medicines, vitamins, and herbal supplements

Gonal-f® RFF Redi-ject™ may cause serious side effects, including:

  • severe allergic reactions in women who have used Gonal-f®, Gonal-f® RFF, or Gonal-f® RFF Redi-ject™ in the past.  New allergic reactions can occur immediately after an injection.  Severe allergic reaction may lead to death. If you have any of the following symptoms of a severe allergic reaction, stop using Gonal-f® RFF Redi-ject™ and go to the hospital right away:
    • shortness of breath
    • swelling of your face
    • itchy, red bumps or rash on your skin (hives)
  • ovaries that are too large; symptoms of bloating or pain in your lower stomach (pelvic) area.
  • ovarian hyperstimulation syndrome (OHSS); a serious medical condition that can happen when your ovaries produce too many eggs (overstimulated). OHSS can cause fluid to suddenly build up in the area of your stomach, chest, and heart, and can cause blood clots to form. In rare cases OHSS has caused death. OHSS may also happen after you stop using Gonal-f® RFF Redi-ject™.  Stop using Gonal-f® RFF Redi-ject™ and call your healthcare provider right away if you have symptoms of OHSS, including:
    • trouble breathing                                                           
    • severe lower stomach (pelvic) area pain      
    • decreased urine output
    • nausea
    • vomiting
    • weight gain
    • diarrhea
  • lung problems; that cause trouble breathing (acute respiratory distress syndrome, atelectasia) and worsening of asthma.
  • blood clots can cause:
    • blood vessel problems (thrombophlebitis)
    • stroke
    • loss of your arm or leg
    • blood clot in your lung (pulmonary embolism)
  • twisting (torsion) of your ovary if you already have certain conditions such as ovarian cysts, OHSS, pregnancy and previous abdominal surgery. Twisting of your ovary may lead to blood flow being cut off to your ovary.
  • pregnancy with and birth of multiple babies; Having a pregnancy and giving birth to multiple babies at a time increases the health risk for you and your babies. Your healthcare provider should tell you about your chances of multiple births. 
  • birth defects in a baby born after an ART cycle (IVF or ICSI).  Your chances of having a baby with birth defects may increase depending on:
    • your age
    • certain sperm problems
    • your genetic background and that of your partner
    • a pregnancy with more than 1 baby at a time
  • ectopic pregnancy (pregnancy outside your womb).  Your chance of having a pregnancy outside of your womb is increased if you also have fallopian tube problems.
  • miscarriage. Your chance of loss of an early pregnancy may be increased if you had difficulty becoming pregnant.
  • tumors of the ovary. If you have used fertility medicines like Gonal-f® RFF Redi-ject™ before to get pregnant, you may have an increased chance of having tumors in your ovary(ies) (including cancer).

The most common side effects of Gonal-f® RFF Redi-ject™ include:

  • headache
  • stomach pain
  • stomach bloating
  • bruising at the injection site
  • nausea

These are not all the possible side effects of Gonal-f® RFF Redi-ject™. For more information, call your healthcare provider or pharmacist. Tell your healthcare provider if you have any side effect that bothers you or that does not go away.

Do not share your Gonal-f® RFF Redi-ject™ and needles with another person. You may give another person an infection or get an infection from them.

Call your healthcare provider for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Also read the Gonal-f® RFF Redi-ject™ “Instructions for Use” that comes with Pen for information about the correct use of Gonal-f® RFF Redi-ject™ and follow all training and instruction provided by your healthcare provider.

*revised formulation female


IMPORTANT INFORMATION ABOUT THE PROPER USE AND RISKS OF Gonal-f® (follitropin alfa for injection):

What are the uses of Gonal-f® (follitropin alfa for injection) and Gonal-f® RFF*(follitropin alfa for injection)?

Gonal-f® Multi-Dose and Gonal-f® RFF are 2 products that contain follitropin alfa, which is similar to the human hormone follicle-stimulating hormone, referred to as FSH. FSH belongs to a group of human reproductive hormones.

Gonal-f® Multi-Dose and Gonal-f® RFF are used in certain infertile women to help with ovulation (production and release of a mature egg) and pregnancy. Gonal-f® will not help women whose ovaries no longer work because of a condition called Primary Ovarian Failure. Gonal-f® may also be used in women who are in an Assisted Reproductive Technology (ART) program such as in vitro fertilization to help their ovaries make more eggs.

Gonal-f® Multi-Dose can also be prescribed to increase sperm production in men with a rare condition that affects sperm production.

Both products should be prescribed only by doctors specializing in infertility problems and their treatment.

Who should not use Gonal-f® and Gonal-f® RFF?

Gonal-f® Multi-Dose and Gonal-f® RFF should not be used in patients who are pregnant or think they might be pregnant, in patients with primary ovarian failure (the ovaries no longer produce eggs), or in patients with allergies to recombinant human FSH products or any other ingredients in the medication.

Patients with cancer of the sex organs or brain, or with uncontrolled thyroid or adrenal disease, should not use Gonal-f® Multi-Dose or Gonal-f® RFF. Women with a history of abnormal bleeding from the uterus or vagina or with swollen, enlarged, or painful ovaries should speak to their doctor before starting treatment.

What are the possible side effects of Gonal-f® and Gonal-f® RFF?

The lowest dose expected to achieve the desired results should be used. A doctor should monitor a woman’s response often to avoid overdose, which can lead to serious side effects, including blood clots.

Women should contact their doctor if severe pain or bloating in the stomach or pelvic area, severe upset stomach, vomiting, or weight gain are experienced during treatment. These could be signs of a rare but serious condition known as Ovarian Hyperstimulation Syndrome, or OHSS, which can result in hospitalization.

Use of Gonal-f® Multi-Dose or Gonal-f® RFF by a woman can be associated with fertilization of more than 1 egg. This can lead to complications for the woman and the birth of 2 or more babies.

The most common side effects reported by women were headache, ovarian cysts, upset stomach, and sinus infection. The most common side effects reported by men taking Gonal-f® Multi-Dose were skin pimples, breast pain and growth, and tiredness. Injections may cause some discomfort.

*RFF, Revised Formulation Female


IMPORTANT INFORMATION ABOUT THE PROPER USE AND RISKS OF OVIDREL® PREFILLED SYRINGE (choriogonadotropin alfa injection):

What are the uses of Ovidrel® PreFilled Syringe (choriogonadotropin alfa injection)?
Ovidrel® PreFilled Syringe contains recombinant human choriogonadotropin alfa (hCG), an injectable hormone. This is the hormone that causes your eggs to finish maturing and be released. You may be given Ovidrel® PreFilled Syringe to complete this final stage of your cycle. Doctors specializing in infertility or reproductive health prescribe Ovidrel® PreFilled Syringe to those women 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 Ovidrel® PreFilled Syringe because you require hormone replacement or supplementation as part of your treatment program. Ovidrel® PreFilled Syringe may be one of several drugs prescribed to a patient as part of a treatment program.

Who should not use Ovidrel® PreFilled Syringe?

Ovidrel® PreFilled Syringe should not be used in patients who are pregnant or breastfeeding, in patients with primary ovarian failure (the ovaries no longer produce eggs), or in patients with allergies to hCG or any other ingredients in the medication.

Patients with cancer of the sex organs or brain, or with uncontrolled thyroid or adrenal disease, should not use Ovidrel® PreFilled Syringe. Women with a history of abnormal bleeding from the uterus or vagina or with swollen, enlarged, or painful ovaries should speak to their doctor before starting treatment.

In infertile women undergoing assisted reproductive technologies (ART) and ovulation induction (OI), Ovidrel® PreFilled Syringe should not be administered until adequate follicular development is indicated by serum estradiol and vaginal ultrasonography.

Ovidrel® PreFilled Syringe administration should be withheld in situations where there is an excessive ovarian response, as evidenced by multiple follicular development, clinically significant ovarian enlargement or excessive estradiol production.

What are the possible side effects of Ovidrel® PreFilled Syringe?

Your doctor should review with you the risks and benefits of using Ovidrel® PreFilled Syringe. As with any medication, report any and all side effects, symptoms, or physical changes to your doctor.

Ovidrel® PreFilled Syringe can cause serious side effects including ovarian hyperstimulation syndrome (OHSS) and lung and blood vessel problems. Contact your healthcare provider if you experience severe pain or bloating in the stomach or pelvic area, severe upset stomach, vomiting, or weight gain.

Use of fertility drugs can be associated with fertilization of more than one egg. This can lead to complications for the mother and the birth of two or more babies.

The most common side effects in women using Ovidrel® PreFilled Syringe include abdominal pain, nausea, and vomiting. Needle injections may cause some discomfort.


IMPORTANT INFORMATION ABOUT THE PROPER USE AND RISKS OF CETROTIDE®(cetrorelix acetate for injection):

What are the uses of Cetrotide® (cetrorelix acetate for injection)?

Cetrotide® blocks the effects of a natural hormone, called gonadotropin-releasing hormone (GnRH). GnRH controls the secretion of another hormone, called luteinizing hormone (LH), which induces ovulation during the menstrual cycle.

During hormone treatment for ovarian stimulation, premature ovulation may lead to eggs that are not suitable for fertilization. Cetrotide® blocks such undesirable premature ovulation.

Who should not use Cetrotide®?

Cetrotide® should not be used in patients who are pregnant, think they might be pregnant, or are breastfeeding.

Cetrotide® should not be used in patients with kidney disease.

Patients that are allergic to cetrorelix acetate, mannitol, or exogenous peptide hormones (medicines similar to Cetrotide®) should not use Cetrotide®. Consult your doctor before taking Cetrotide® if you have had severe allergic reactions.

What are the possible side effects of Cetrotide®?

Your doctor should review with you the risks and benefits of using Cetrotide®. As with any medication, report any and all side effects, symptoms, or physical changes to your doctor.

Mild and short-lasting reactions may occur at the injection site like reddening, itching, and swelling. Nausea and headache have also been reported.

Call your doctor if you have any other side effect or if you are unsure about the effect of this medicine.

© 2014 EMD Serono, Inc. and its affiliates.

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1. ASRM Patient fact Sheet: Medications for inducing Ovulation, www.asrm.org/Medications_for_Inducing_Ovulation. Accessed August 22, 2013