Name: Phone: Best Time To Call: A PharmaCare representative will call to assist you and answer your questions. We will leave a brief message if you are unavailable at the time of our call.

To speak with a PharmaCare pharmacist or representative, Call 800-238-1548

Selective Estrogen Receptor Modulator

GENERIC NAME: clomiphene citrate
TRADE NAME: Clomid® Serophene®

MANUFACTURER:	Hoeschst Marion Roussel 1-800-633-1610
	Serono 1-800-283-8088

Administration	Side Effects	Actions	Considerations	Common Dosage
Oral Tablets	OHSS, multiple births, enlargement of the ovaries, hot flashes, abdominal discomfort, breast tenderness, nausea, vomiting, nervousness, insomnia, visual disturbances, dry cervical mucus	Stimulates the hypothalamus gland to increase production of GnRH, which increases release of LH and FSH from the pituitary gland; The end result is stimulation of the ovary to release an egg (ovulation).	Typically, the 1st drug of choice; Prolonged use may increase the risk of ovarian tumors. Should not use for longer than 6 cycles. Observe caution while driving or operating machinery if you experience visual disturbances	Initial dose is 50mg (one tablet) daily for 5 days each cycle. May be increased to 100mg daily (2 tablets given as a single daily dose) for 5 days. Maximum dose: 200-250mg per day

  Gonadotropins: Follitropins (Follicle Stimulating Hormone)

GENERIC NAME: urofollitropin
TRADE NAME: Fertinex^TM (purified urine extract)

MANUFACTURER:

Serono 1-800-283-8088

Administration	Side Effects	Actions	Considerations	Common Dosage
Subcutaneously	OHSS, multiple births, enlargement of the ovaries, nausea, headache, ovarian cysts, abdominal pain, gastrointestinal symptoms including nausea, vomiting, diarrhea, bloating, breast tenderness, body rashes	Stimulates follicle growth and maturation by mimicking the actions of the body's natural FSH	Sensitivity reaction can occur with Fertinex including flu-like symptoms of fever, chills, muscle aches, joint pain, nausea, headache, malaise. Powder may be stored in the refrigerator or at room temperature. Protect from light. Use immediately after preparing.	Ovulation induction: Initial dose is 75IU per day; max dose varies. Assisted reproductive technology (follicle stimulation): initial dose of 150 to 225 IU starting on cycle day 2 or 3. Follitropin regimens are typically followed by HCG 5,000 to 10,000 Units, one day after the last dose of FSH

GENERIC NAME: follitropin alpha
TRADE NAME: Gonal-F® (recombinant)

MANUFACTURER:

Serono 1-800-283-8088

Administration	Side Effects	Actions	Considerations	Common Dosage
Subcutaneously	OHSS, multiple births, enlargement of the ovaries, nausea, headache, ovarian cysts, abdominal pain, gastrointestinal symptoms including nausea, vomiting, diarrhea, bloating, breast tenderness, body rashes	Stimulates follicle growth and maturation by mimicking the actions of the body's natural FSH	Sensitivity reaction can occur with Fertinex including flu-like symptoms of fever, chills, muscle aches, joint pain, nausea, headache, malaise. Powder may be stored in the refrigerator or at room temperature. Protect from light. Use immediately after preparing.	Ovulation induction: Initial dose is 75IU per day; max dose varies. Assisted reproductive technology (follicle stimulation): initial dose of 150 to 225 IU starting on cycle day 2 or 3. Follitropin regimens are typically followed by HCG 5,000 to 10,000 Units, one day after the last dose of FSH

GENERIC NAME: follitropin beta
TRADE NAME: Follistim® (recombinant)

MANUFACTURER:

Organon 1-800-631-1253

Administration	Side Effects	Actions	Considerations	Common Dosage
Subcutaneously or Intramuscularly	OHSS, multiple births, enlargement of the ovaries, nausea, headache, ovarian cysts, abdominal pain, gastrointestinal symptoms including nausea, vomiting, diarrhea, bloating, breast tenderness, body rashes	Stimulates follicle growth and maturation by mimicking the actions of the body's natural FSH	Sensitivity reaction can occur with Fertinex including flu-like symptoms of fever, chills, muscle aches, joint pain, nausea, headache, malaise. Powder may be stored in the refrigerator or at room temperature. Protect from light. Use immediately after preparing.	Ovulation induction: Initial dose is 75IU per day; max dose varies. Assisted reproductive technology (follicle stimulation): initial dose of 150 to 225 IU starting on cycle day 2 or 3. Follitropin regimens are typically followed by HCG 5,000 to 10,000 Units, one day after the last dose of FSH

  Gonadotropins: Menotropins [Human Menopausal Gonadotropin (HMG)]

GENERIC NAME: (Product made of equal amounts of FSH and LH; extracted from urine of post-menopausal women)
TRADE NAME: Pergonal®

MANUFACTURER:

Serono 1-800-283-8088

Administration	Side Effects	Actions	Considerations	Common Dosage
Intramuscularly	OHSS, enlargement of the ovaries, multiple births, ovarian cysts, abdominal pain, gastrointestinal symptoms including nausea, vomiting, diarrhea, bloating, body rashes, irritation at injection site, dizziness	Promotes the development and maturation of follicles in the ovaries.	Sensitivity reactions can occur with these products, including flu-like symptoms of fever, chills, muscle aches, joint pain, nausea, headache, malaise. Store in the refrigerator or at room temperature. Protect from light. Use immediately after preparing.	Initial dose of 75-150 IU per day for 7 to 12 days, followed by HCG 5,000 to 10,000 units, one day after the last dose of HMG.

GENERIC NAME: (Product made of equal amounts of FSH and LH; extracted from urine of post-menopausal women)
TRADE NAME: Repronex®

MANUFACTURER:

Ferring 1-888-337-7464

Administration	Side Effects	Actions	Considerations	Common Dosage
Subcutaneously or Intramuscularly	OHSS, enlargement of the ovaries, multiple births, ovarian cysts, abdominal pain, gastrointestinal symptoms including nausea, vomiting, diarrhea, bloating, body rashes, irritation at injection site, dizziness	Promotes the development and maturation of follicles in the ovaries.	Sensitivity reactions can occur with these products, including flu-like symptoms of fever, chills, muscle aches, joint pain, nausea, headache, malaise. Store in the refrigerator or at room temperature. Protect from light. Use immediately after preparing.	Initial dose of 75-150 IU per day for 7 to 12 days, followed by HCG 5,000 to 10,000 units, one day after the last dose of HMG.

GENERIC NAME: (Product made of equal amounts of FSH and LH; extracted from urine of post-menopausal women)
TRADE NAME: Humegon®

MANUFACTURER:

Organon 1-800-631-1253

Administration	Side Effects	Actions	Considerations	Common Dosage
Intramuscularly	OHSS, enlargement of the ovaries, multiple births, ovarian cysts, abdominal pain, gastrointestinal symptoms including nausea, vomiting, diarrhea, bloating, body rashes, irritation at injection site, dizziness	Promotes the development and maturation of follicles in the ovaries.	Sensitivity reactions can occur with these products, including flu-like symptoms of fever, chills, muscle aches, joint pain, nausea, headache, malaise. Store in the refrigerator or at room temperature. Protect from light. Use immediately after preparing.	Initial dose of 75-150 IU per day for 7 to 12 days, followed by HCG 5,000 to 10,000 units, one day after the last dose of HMG.

  Human Chorionic Gonadotropin (HCG)

GENERIC NAME: Not Applicable
TRADE NAME: Pregnyl®

MANUFACTURER:

Organon 1-800-631-1253

Administration	Side Effects	Actions	Considerations	Common Dosage
Intramuscularly	OHSS, injection site pain, headache, restlessness, depression, irritability, fatigue, fluid retention, multiple births	Induces ovulation by stimulating the release of eggs from the follicles	Use completely after reconstitution. Reconstituted solution is stable for 60 days when refrigerated.	5,000 to 10,000 USP units one day following the last dose of menotropins or follitropins.

GENERIC NAME: Not Applicable
TRADE NAME: Profasi®

MANUFACTURER:

Serono 1-800-283-8088

Administration	Side Effects	Actions	Considerations	Common Dosage
Intramuscularly	OHSS, injection site pain, headache, restlessness, depression, irritability, fatigue, fluid retention, multiple births	Induces ovulation by stimulating the release of eggs from the follicles	Store at room temperature. Reconstituted solution, should be refrigerated and used within 30 days.	5,000 to 10,000 USP units one day following the last dose of menotropins or follitropins.

GENERIC NAME: Not Applicable
TRADE NAME: Novarel^TM

MANUFACTURER:

Ferring 1-888-337-7464

Administration	Side Effects	Actions	Considerations	Common Dosage
Intramuscularly	OHSS, injection site pain, headache, restlessness, depression, irritability, fatigue, fluid retention, multiple births	Induces ovulation by stimulating the release of eggs from the follicles	Store at room temperature. Reconstituted solution, should be refrigerated and used within 60 days.	5,000 to 10,000 USP units one day following the last dose of menotropins or follitropins.

GENERIC NAME: Not Applicable
TRADE NAME: A.P.L.®

MANUFACTURER:

Wyeth-Ayerst 1-800-934-5556

Administration	Side Effects	Actions	Considerations	Common Dosage
Intramuscularly	OHSS, injection site pain, headache, restlessness, depression, irritability, fatigue, fluid retention, multiple births	Induces ovulation by stimulating the release of eggs from the follicles	Store in refrigerator prior to preparing. Keep the prepared solution refrigerated and use within 30 days.	5,000 to 10,000 USP units one day following the last dose of menotropins or follitropins.

  Gonadotropin-releasing Hormone Antagonist (GnRH antagonist)

GENERIC NAME: ganirelix acetate
TRADE NAME: Antagon^TM

MANUFACTURER:

Organon 1-800-631-1253

Administration	Side Effects	Actions	Considerations	Common Dosage
Subcutaneously	Abdominal pain (gynecological), headache, vaginal bleeding, OHSS, injection site reaction, nausea, abdominal pain (gastrointestinal)	Prevents premature LH surges in women undergoing controlled ovarian hyperstim. (COH) by inhibiting the release of LH from the pituitary gland	Protect from light. Store at room temperature.	250ug once daily during the early to mid follicular phase, following stimulation with follitropins

  Gonadotropin-releasing Hormone Agonists (GnRH agonist)

GENERIC NAME: naferelin acetate
TRADE NAME: Synarel®

MANUFACTURER:

Searle 1-847-982-7000

Administration	Side Effects	Actions	Considerations	Common Dosage
Nasal spray	Hot flashes, headache, decreased sex drive, depression, bone loss, vaginal dryness; these are reversible upon discontinuation of the medication	Suppresses release of pituitary hormones LH and FSH, with continuous use. These agents may also be used in the treatment of endometriosis.	Treatment of endometriosis: the recommended duration of administration is 6 months.	1 spray (200mcg) in one nostril in the morning & 1 spray (200mcg) in the other nostril in the evening;

GENERIC NAME: goserelin acetate
TRADE NAME: Zoladex®

MANUFACTURER:

Zeneca Pharmaceuticals 1-800-456-3669

Administration	Side Effects	Actions	Considerations	Common Dosage
Monthly implant	Hot flashes, headache, decreased sex drive, depression, bone loss, vaginal dryness; these are reversible upon discontinuation of the medication	Suppresses release of pituitary hormones LH and FSH, with continuous use. These agents may also be used in the treatment of endometriosis.	Treatment of endometriosis: the recommended duration of administration is 6 months.	3.6 mg administered subcutaneously every 28 days.

GENERIC NAME: leuprolide acetate
TRADE NAME: Lupron®

MANUFACTURER:

Tap Pharmaceuticals 1-800-348-2779

Administration	Side Effects	Actions	Considerations	Common Dosage
Controlled ovarian hyper-stimulation (COH): SQ Endometriosis: IM injection monthly or every 3 months	Hot flashes, headache, decreased sex drive, depression, bone loss, vaginal dryness; these are reversible upon discontinuation of the medication	Treatment of endometriosis Used in combination with other fertility medications for controlled ovarian hyperstimulation (COH)	Treatment of endometriosis: the recommended duration of administration is 6 months.	COH: 1mg SQ daily *Microdose regimens of 20-40mcg twice daily are sometimes used. Endometriosis: 3.75mg IM monthly up to 6 months or 11.25mg IM injection every 3 months.

  Naturally Occurring Hormone: Progesterone

GENERIC NAME: Not Applicable
TRADE NAME: Crinone® (2 strengths: 4% and 8% gel)

MANUFACTURER:

Wyeth-Ayerst

Administration	Side Effects	Actions	Considerations	Common Dosage
Intravaginal gel	Nausea, constipation, breast enlargement and tenderness, headache, drowsiness, vaginal discharge, joint discomfort, depression, fluid retention, abdominal pain, excessive urination at night, dizziness, diarrhea, breakthrough bleeding	Used during the luteal phase of the cycle if the body's own supply of natural progesterone is insufficient. Progesterone prepares the uterus to receive a fertilized egg for implantation and then acts to maintain the corpus luteum during pregnancy. May be used as part of in vitro fertilization protocols. The injectable and the intravaginal preparations are typically used for this indication.		90 mg once to twice daily intravaginally.

GENERIC NAME: Not Applicable
TRADE NAME: Injectable (compounded) (50mg/ml vial)

MANUFACTURER:

Contact PharmaCare Pharmacy: 1-800-218-6315

Administration	Side Effects	Actions	Considerations	Common Dosage
Intramuscularly	Nausea, constipation, breast enlargement and tenderness, headache, drowsiness, vaginal discharge, joint discomfort, depression, fluid retention, abdominal pain, excessive urination at night, dizziness, diarrhea, breakthrough bleeding	Used during the luteal phase of the cycle if the body's own supply of natural progesterone is insufficient. Progesterone prepares the uterus to receive a fertilized egg for implantation and then acts to maintain the corpus luteum during pregnancy. May be used as part of in vitro fertilization protocols. The injectable and the intravaginal preparations are typically used for this indication.	Preparation of progesterone, containing benzyl alcohol and sesame oil. Should be stored in tight, light resistant containers; store at room temperature for no longer than 6 months	50mg twice daily

GENERIC NAME: Not Applicable
TRADE NAME: Suppositories (compounded)

MANUFACTURER:

Contact PharmaCare Pharmacy: 1-800-218-6315

Administration	Side Effects	Actions	Considerations	Common Dosage
Intravaginal suppository	Nausea, constipation, breast enlargement and tenderness, headache, drowsiness, vaginal discharge, joint discomfort, depression, fluid retention, abdominal pain, excessive urination at night, dizziness, diarrhea, breakthrough bleeding	Used during the luteal phase of the cycle if the body's own supply of natural progesterone is insufficient. Progesterone prepares the uterus to receive a fertilized egg for implantation and then acts to maintain the corpus luteum during pregnancy. May be used as part of in vitro fertilization protocols. The injectable and the intravaginal preparations are typically used for this indication.		100mg or 200mg three times a day

GENERIC NAME: Not Applicable
TRADE NAME: Prometrium®

MANUFACTURER:

Solvay

Administration	Side Effects	Actions	Considerations	Common Dosage
Oral Capsules	Nausea, constipation, breast enlargement and tenderness, headache, drowsiness, vaginal discharge, joint discomfort, depression, fluid retention, abdominal pain, excessive urination at night, dizziness, diarrhea, breakthrough bleeding	Used during the luteal phase of the cycle if the body's own supply of natural progesterone is insufficient. Progesterone prepares the uterus to receive a fertilized egg for implantation and then acts to maintain the corpus luteum during pregnancy. May be used as part of in vitro fertilization protocols. The injectable and the intravaginal preparations are typically used for this indication.	Contains peanut oil; should not be used by anyone allergic to peanuts. Indicated for post-menopausal hormone replacement with estrogens & for secondary amenorrhea (lack of menstruation for > 3 months in a woman who has previously had menses)	Secondary amenorrhea: 400mg in the evening for 10 days Postmenopausal hormone replacement: 200mg in the evening for 12 days during the cycle

GENERIC NAME: Not Applicable
TRADE NAME: Troches (compounded)

MANUFACTURER:

Contact PharmaCare Pharmacy: 1-800-218-6315

Administration	Side Effects	Actions	Considerations	Common Dosage
Slowly dissolved in mouth	Nausea, constipation, breast enlargement and tenderness, headache, drowsiness, vaginal discharge, joint discomfort, depression, fluid retention, abdominal pain, excessive urination at night, dizziness, diarrhea, breakthrough bleeding	Used during the luteal phase of the cycle if the body's own supply of natural progesterone is insufficient. Progesterone prepares the uterus to receive a fertilized egg for implantation and then acts to maintain the corpus luteum during pregnancy. May be used as part of in vitro fertilization protocols. The injectable and the intravaginal preparations are typically used for this indication.		Varies - call your doctor or pharmacist.

Note: The side effects listed in the above tables are not all inclusive, for more information on the side effects of the above products, consult with your physician or pharmacist.

Subcutaneously -just under the skin
Intramuscularly-deep within the muscle
OHSS - Ovarian Hyperstimulation Syndrome
COH - Controlled Ovarian Hyperstimulation

For more information or to enroll, you may call PharmaCare Pharmacy at 1-800-238-7828.

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