Chorionic Gonadotropin and Drug Interaction

Type of Drug:

HCG (human chorionic gonadotropin); hormone that stimulates the ovaries and testes.

How the Drug Works:

This hormone is produced by the human placenta. Its action is identical to the aluminizing hormone (LH) secreted from the pituitary gland. It also has a small degree of follicle stimulating hormone (FSH) activity. HCG has different uses in men and women. In men, HCG stimulates sex glands, specifically the cells in the testicles, to stimulate their growth and development and produce androgens (eg, testosterone). HCG also causes the development of secondary sex characteristics and may cause the testicles to drop. In women, HCG stimulates the ovaries to pro­duce progesterone.

Uses:

Men: To stimulate testicular descent in prepubescent males whose testicles have not dropped or descended. Usually given to males between 4 and 9 years of age.

For selected cases of hypochondrias caused by pituitary deficiency.

To assist in the development of secondary sex characteristics in cases of hormone deficiency.

Women: To promote ovulation. HCG is used in combination with other medications.

Precautions:

Early puberty: In young males using HCG to cause the testes to drop, early puberty can Occur. Discontinue use if signs of early puberty (eg, enlargement of penis or testes, development of pubic hair, aggressive behavior) occur.

Multiple births: Pregnancies following therapy with HCG and menotropins resulted in 80% single births and 15% twin births; 5% of pregnancies resulted in 3 or more fetuses.

Fluid retention: Since androgens may cause fluid retention, use HCG with caution in patients with epilepsy, migraine, asthma, heart, or kidney disease.

Pregnancy: Do not use during pregnancy. The risk of use in a pregnant women clearly outweighs any Possible benefit.

Breastfeeding: It is not known if chorionic gonadotropin appears in breast milk. Consult your doctor before you begin breastfeeding.

Children: Safety and effectiveness in children younger than 4 years of age have not been established.

Lab Tests: Lab tests may be required to monitor treatment.

Drug Interactions:

Tell your doctor or pharmacist if you are taking or planning to take any over­ the-counter or prescription medications or dietary supplements with chorionic gonadotropin. Doses of one or both drugs may be modified or a different drug may need to be prescribed.

Side Effects:

Every drug is capable of producing side effects. Many chorionic gonadotropin users experience no, or minor, side effects. The frequency and severity of side effects depend on many factors including dose, duration of therapy, and individual susceptibility. Possible side effects include:

Men only: Acne; enlargement or redness of penis or testes; early growth of pubic hair; rapid increase in height; breast tenderness or swelling.

Women only: Stomach pain; pelvic pain; multiple births.

Nervous System: Headache; irritability; restlessness; depression; fatigue; aggressive behavior.

Other: Fluid retention (edema); pain at injection site; redness; rash; hives; stroke; difficulty breathing; shortness of breath.

Guidelines for Use:

• Dosage is individualized. Take exactly as prescribed.

• Do not change the dose or stop taking, unless directed by your doctor.

• HCG has not been demonstrated to be effective in the treatment of obesity. HCG has no known effect on fat mobilization, appetite, sense of hunger, or body fat distribution.

• Inject intramuscularly (IM; into a muscle) only.

• If a dose is missed, inject it as soon as possible. If several hours have passed or it is nearing time for the next dose, do not double the dose to catch up, unless advised to do so by your doctor. If more than one dose is missed or it is necessary to establish a new dosage schedule, contact your doctor or pharmacist.

• Visually inspect solution for particles or discoloration before use.

• Lab tests may be required to monitor therapy. Be sure to keep appointments.

• Store dry powder at room temperature (59° to 86°F). After reconstitution (mixing), refrigerate at 36° to 46°F and use within 60 days.

• Women- HCG must be given following menotropins when tests indicate mature follicles are present (changes in vaginal smear or in cervical mucus, urinary estrogen test). Ovulation is confirmed by testing for progesterone production (rise in basal temperature, change in cervical mucus, etc). The couple should have intercourse daily, beginning on the day prior to HCG administration, until ovulation occurs. Take care to ensure insemination. During treatment with menotropins and HCG and for 2 weeks after treatment, patients must be examined by a doctor at least every other day. Monitor for signs of pregnancy. If pregnancy is suspected, contact your doctor. Multiple pregnancy is possible and poses potential hazards.

• Men- HCG is first used alone. Then menotropins and HCG are used together to stimulate sperm production.