Gonal-f Patient Counseling Information

HOW TO USE GONAL-f: Always use GONAL-f exactly as your doctor has told you.
You should check with your doctor or pharmacist if you are not sure.
Using this medicine: GONAL-f is intended to be given by injection just under the skin (subcutaneously). The pre-filled pen can be used for several injections.
The first injection of GONAL-f should be given under supervision of your doctor.
Your doctor or nurse will show you how to use the GONAL-f pre-filled pen to inject the medicine.
If you administer GONAL-f to yourself, carefully read and follow the "Instructions for Use".
How much to use: Your doctor will decide how much medicine you will take and how often. The doses described as follows are stated in International Units (IU).
Women: If you are not ovulating and have irregular or no periods.
GONAL-f is usually given every day.
If you have irregular periods, start using GONAL-f within the first 7 days of your menstrual cycle. If you do not have periods you can start using the medicine on any convenient day.
The usual starting dose of GONAL-f is 75 to 150 IU each day.
Your dose of GONAL-f may be increased every 7 or every 14 days by 37.5 to 75 IU, until you get the desired response.
The maximum daily dose of GONAL-f is usually not higher than 225 IU.
When you get the desired response, you will be given a single injection of 250 micrograms of "recombinant hCG" (r-hCG, an hCG made in a laboratory by a special DNA technique), or 5,000 to 10,000 IU of hCG, 24 to 48 hours after your last GONAL-f injection. The best time to have sex is on the day of the hCG injection and the day after.
If your doctor cannot see a desired response after 4 weeks, that treatment cycle with GONAL-f should be stopped. For the following treatment cycle, your doctor will give you a higher starting dose of GONAL-f than before.
If your body responds too strongly, your treatment will be stopped and you will not be given any hCG (see Description, OHSS). For the following cycle, your doctor will give you a lower dose of GONAL-f than before.
If you need to develop several eggs for collection prior to any assisted reproductive technology: The usual starting dose of GONAL-f is 150 to 225 IU each day, from day 2 or 3 of your treatment cycle.
GONAL-f dose may be increased, depending on your response. The maximum daily dose is 450 IU.
Treatment is continued until your eggs have developed to a desired point. This usually takes about 10 days but can take any time between 5 and 20 days. Your doctor will use blood tests and/or an ultrasound machine to check when this is.
When your eggs are ready, you will be given a single injection of 250 micrograms "recombinant hCG" (r-hCG, an hCG made in a laboratory by a special recombinant DNA technique), or 5,000 IU to 10,000 IU of hCG, 24 to 48 hours after the last GONAL-f injection. This gets your eggs ready for collection.
In other cases, your doctor may first stop you from ovulating by using a gonadotropin-releasing hormone (GnRH) agonist or antagonist. Then GONAL-f is started approximately two weeks after start of agonist treatment. The GONAL-f and GnRH agonist are then both given until your follicles develop as desired. For example, after two weeks of GnRH agonist treatment, 150 to 225 IU GONAL-f is administered for 7 days. The dose is then adjusted according to your ovarian response. When GnRH antagonist is used, it is administered from the 5th or 6th day of GONAL-f treatment and continued until ovulation induction.