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In 0,5 ml of solution — a ganireliks of 250 mkg. Mannitolum, sodium hydroxide, acetic acid ice, water as excipients.
Solution of 0,5 ml for hypodermic introduction in syringes.
Decrease in level of gonadotrophins.
Pharmacodynamics and pharmacokinetics
The antagonist the hormone gonadotrophin-rileasing which is slowing down secretion of gonadotrophins a hypophysis. The mechanism of action is connected with blocking of receptors of GNRG of a hypophysis. It strongly contacts these receptors and works immediately — the level of gonadotrophins, and more LG considerably decreases. Extent of suppression of gonadotrophins depends on a dose.
It is applied in programs of treatment of infertility for the purpose of prevention of premature increase of luteinizing hormone at women at a controlled ovulation. Purpose of drug during stimulation of a superovulation is necessary for short time when follicles are in the completing growth phase and there is a risk of premature emission of this hormone (usually it is the 6th day of stimulation). Action is reversible and function of a hypophysis is recovered in 2 days.
Cmax in blood is defined by 1-2 h administration of drug. Bioavailability makes 91%. After repeated introduction of Css it is reached in 2-3 days. There is inverse relation between the weight of the patient and concentration in serum.
It is metabolized with formation of peptide fragments. T1/2 is about 13 hours old. It is removed through intestines (75%) and kidneys (22%). Fast removal from an organism explains that, the level of gonadotrophins is quickly recovered. This property of drug allows to control activity of a hypophysis: in time to suppress it and to recover.
Indications to use
Programs of treatment of infertility at women with use of VRT for the purpose of prevention of a premature ovulation.
System reactions arise seldom:
Sometimes there is a syndrome of hyper stimulation of ovaries which is shown pain in the bottom of a stomach, the increase in ovaries, diarrhea complicated by breath, an oliguria, increase in body weight.
- swelling in an injection site;
Orgalutran, application instruction (Way and dosage)
The drug is administered daily, subcutaneously to the area of a hip. Injections carry out at the same time, and change the place of an injection. Drug possesses fast reversibility of effect therefore time between injections should not exceed 30 h. At introduction in the mornings, it is entered also in day of introduction of chHG, at evening injections the last administration of drug is carried out in the evening, before that day when introduction of chHG is appointed. Introduction of a double dose is inadmissible if the injection was passed.
Controlled stimulation of an ovulation is begun with drug FSG (for example, puregon) for 2-3 day of a cycle, and the given drug in a dose of 0,25 mg is recommended to be administered for the 6th day of use of FSG of drug. At the increased reaction to stimulation its introduction is appointed earlier, and in case of the slow growth of follicles — after the 6th day.
How to prick Orgalutran?
It is impossible to use opaque solution or solution with impurity. Before manipulation of a hand it is necessary to wash up and process the place of an injection the tampon moistened with alcohol.
To remove a cap from a needle, to take skin pleated and at an angle 45% to enter a needle. For check of correctness of introduction of a needle it is necessary to pull a little the syringe piston on itself. If in the syringe blood appeared, the drug cannot be administered. Take the syringe and administer the drug with the new syringe. If the needle is entered correctly, slowly administer the drug subcutaneously. Take the syringe and apply a tampon with alcohol.
Overdose leads to increase in time of its action. Administration of drug temporarily stops, and further tactics of treatment is defined by the doctor.
Simultaneous use with other drugs is rather not investigated. It is impossible to exclude probability of interaction.
Terms of sale
It is released according to the recipe.
Temperature of storage is up to 30 °C.
Period of validity
Coincidence on the ATH code of the 4th level:
Specialists aim to improve the VRT technologies, to improve indicators and to make them more effective. Thanks to emergence of a new class — antagonists of GNRG, the possibility of review of standards of stimulation in the VRT programs was created. Introduction them allows to carry out process of stimulation to practice at the safe level in the short and simple mode.
For what appoint Orgalutran? That hypophysis hormones (gonadotrophins) did not influence process of stimulation of a superovulation not to allow premature increase of luteinizing hormone and a premature ovulation, development of gonadotrophins has to be temporarily blocked. The antagonist of GNRG Orgalutran allowing to block quickly a hypophysis is for this purpose appointed, and in the subsequent also quickly to recover its function.
Such reversible nature of action allowed to improve protocols of a controlled superovulation considerably. The optimum dose of drug (0,25 mg) is defined in a number of researches. At it the high frequency of implantation and frequency of pregnancy is received. At most of the patients applying programs with this drug a large number of embryos (to 70%) good and excellent quality was observed.
At its use, cases of premature emission of luteinizing hormone were noted very seldom. In researches it is shown that Orgalutran at EKO has considerable advantages before GNRG agonists. These advantages are: smaller quantity of injections, shortening of duration of the protocol and decrease in frequency of side reactions. Use simplifies it the EKO program. Follows from responses that patients are quickly trained in independent administration of drug.
- "… Orgalutran I give an injection itself, learned and on this procedure it is not necessary to go".
- "… Appointed this prick to the 6th day of stimulation the Puregony ambassador of ultrasonography. Transferred well".
- "… Pricked only 5 days before introduction of a chorionic gonadotrophin. Very quickly and not tiresomely".
Drug was well transferred with any duration of treatment. Much less often the syndrome of hyper stimulation of ovaries met. Sometimes local reaction to administration of drug about which patients reported met and it was shown by short-term erubescence and an itch.
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