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Elonva 100 micrograms solution for injection Corifollitropin
2014-09-21 22:07:19 来源: 作者: 【 】 浏览:427次 评论:0

For doctors

 

What is it and how is it used?

Elonva is a medicine belonging to the group of gonadotropic hormones. Gonadotropic hormones play an important role in human fertility and reproduction. One of these gonadotropic hormones is follicle-stimulating hormone (FSH), which is needed in women for the growth and development of eggs in the ovaries.
Elonva is used to help achieve pregnancy in women having infertility treatment, such as in vitro fertilisation (IVF). IVF involves collecting the eggs from the ovary, fertilising them in the laboratory, and transferring the embryos back into the womb a few days later. Elonva causes the growth of several eggs at the same time by a controlled stimulation of the ovaries.

What do you have to consider before using it?

Do not use Elonva if you

Take special care with Elonva

Ovarian hyperstimulation syndrome (OHSS)
Treatment with gonadotropic hormones like Elonva may cause ovarian hyperstimulation syndrome (OHSS). This is a condition where the eggs growing in the ovaries become larger than normal. This may be noticed as severe abdominal swelling and pain in the stomach (abdomen), feeling sick or diarrhoea. Therefore, close supervision by your doctor is very important. To check the effects of treatment, ultrasound scans of the ovaries are usually made, and blood or urine samples may be regularly taken (see also Section 4).

You may use Elonva only once during the same treatment cycle, as otherwise the chance of having OHSS may increase.

Before starting to use this medicine, it is important to inform your doctor if you:

Thrombosis
Treatment with gonadotropic hormones like Elonva may (just as pregnancy) increase the chance of having a thrombosis. Thrombosis is the formation of a blood clot in a blood vessel, which occurs most often in the legs or the lungs.
Please discuss this with your doctor, before starting treatment, especially if:

Multiple births or birth defects
There is an increased chance of having twins or even more than two babies if more than one embryo is transferred back into the womb. Multiple pregnancies carry an increased health risk for both the mother and her babies. Multiple pregnancies and specific characteristics of couples with fertility problems (e.g. age) may also be associated with an increased chance of birth defects.

Pregnancy complications
If treatment with Elonva results in pregnancy, there is a higher chance of pregnancy outside the womb (an ectopic pregnancy) in women with damaged fallopian tubes (the tubes which carry the egg from the ovary to the womb). Therefore, your doctor should perform an early ultrasound examination to exclude the possibility of pregnancy outside the womb.

Using other medicines
Please tell your doctor or pharmacist if you are taking or have recently taken any other medicines, including medicines obtained without a prescription.

Pregnancy and breast-feeding
You should not use Elonva if you are already pregnant, or suspect that you might be pregnant, or if you are breast-feeding.

Ask your doctor or pharmacist for advice before taking any medicine.

Driving and using machines
Elonva may cause dizziness. If you feel dizzy, you should not drive or use machines.

Important information about some of the ingredients of Elonva
This medicinal product contains less than 1 mmol sodium (23 mg) per injection, i.e. essentially ‘sodium-free’.

How is it used?

Always use Elonva exactly as your doctor has told you. You should check with your doctor or pharmacist if you are not sure.

Elonva is used in women having infertility treatment like in vitro fertilisation (IVF). During this treatment Elonva is used in combination with a medicine to prevent too early ovulation (so called GnRH-antagonist). Treatment with the GnRH-antagonist usually starts 4 to 5 days after the injection of Elonva.

The use of Elonva in combination with a GnRH agonist (another medicine to prevent too early ovulation) is not recommended. It may lead to a higher stimulation of your ovaries.

Dose

During the first seven days after the injection with Elonva, you should not use (recombinant) Follicle Stimulating Hormone ((rec)FSH). Seven days after the injection of Elonva, your doctor may decide to continue treatment with another gonadotropic hormone, like (rec)FSH. This may be continued for a few days until enough eggs of adequate size are present. This can be checked by ultrasound examination. Treatment with (rec)FSH is then stopped and the eggs are matured by giving hCG (human Chorionic Gonadotropin). The eggs are collected from the ovary 34-36 hours later.

How Elonva is given
Treatment with Elonva should be supervised by a physician experienced in the treatment of fertility problems. Elonva must be injected under the skin (subcutaneously) into a skin fold, just below the navel. The injection may be given by a healthcare professional (for example a nurse), your partner or yourself, if carefully instructed by your doctor . Always use Elonva exactly as your doctor has told you. You should check with your doctor or pharmacist if you are unsure. A step-by-step “instructions for use” is given at the end of this leaflet .When the instructions are followed carefully, Elonva will be given properly and with minimal discomfort.
Do not inject Elonva into a muscle.

If you use more Elonva or (rec)FSH than you should
If you use one pre-filled syringe of Elonva, it is not possible to inject more than you should. Using too much Elonva or (rec)FSH may occur if Elonva is used more than once during a treatment cycle, or if (rec)FSH is used during the first seven days after the injection with Elonva (see also “How to use Elonva”). This may increase the risk of ovarian hyperstimulation syndrome (OHSS).

If you think you have used more Elonva or (rec)FSH than you should, contact your doctor immediately.

If you forget to use Elonva
If you forgot to inject Elonva on the day you should have, contact your doctor immediately.

If you have any further questions on the use of this product, ask your doctor.

What are possible side effects?

Like all medicines, Elonva can cause side effects, although not everybody gets them. The chance of having a side effect is described by the following categories:

Common (affects 1 to 10 users in 100)

Uncommon (affects 1 to 10 users in 1,000)

A possible complication of treatment with gonadotropic hormones like Elonva is unwanted overstimulation of the ovaries. The chance of having this complication can be reduced by carefully monitoring the number of maturing eggs as well as your hormones during treatment. Your doctor will take care of that. The first symptoms of ovarian overstimulation may be noticed as pain in the stomach (abdomen), feeling sick or diarrhoea. Ovarian overstimulation may develop into a medical condition called ovarian hyperstimulation syndrome (OHSS), which can be a serious medical problem. In more severe cases this may lead to enlargement of the ovaries, collection of fluid in the abdomen and/or chest (which may cause weight gain) or clots in the blood vessels.
Contact your doctor without delay if you have pain in the stomach (abdomen) or any of the other symptoms of ovarian hyperstimulation, even if they occur some days after the injection has been given.

Pregnancy outside the womb, miscarriage and multiple pregnancies have also been reported. These side effects are not considered to be related to the use of Elonva, but to the Assisted Reproductive Technology (ART) program or subsequent pregnancy.

If any of the side effects gets serious, or if you notice any side effects not listed in this leaflet, tell your doctor or pharmacist.

How should it be stored?

Keep out of the reach and sight of children.

Do not use Elonva after the expiry date which is stated on the label and outer carton after “EXP” (expiry date). The expiry date refers to the last day of the indicated month.

Storage by the pharmacistStore in a refrigerator (2ºC-8°C). Do not freeze.

Storage by the patient
There are two options:

1. Store in a refrigerator (2ºC-8°C). Do not freeze.

2. Store at or below 25ºC for a period of not more than one month. Make a note of when you start storing the product out of the refrigerator, and use it within one month of that date.

Keep the syringe in the outer carton in order to protect from light.

Do not use Elonva

An empty or unused syringe should not be disposed of via household waste. Ask your pharmacist or doctor how to dispose of medicines no longer required. These measures will help to protect the environment.

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For doctors

What is it?

Elonva is a solution for injection that contains the active substance corifollitropin alfa. It is available as a pre-filled syringe (100 and 150 micrograms).

What is it used for?

Elonva is used in women who are undergoing fertility treatment to stimulate the development of more than one mature egg at the time in the ovaries. It is used together with a gonadotrophin-releasing hormone (GnRH) antagonist (a type of medicine also used in fertility treatments).
Elonva can only be obtained with a prescription.

How is it used?

Treatment with Elonva should be started under the supervision of a doctor experienced in treating fertility problems.
Elonva is given once as a single injection under the skin. Women weighing 60 kg or less should receive a 100-microgram dose, while women weighing above 60 kg should receive a 150-microgram dose. The patient or their partner may carry out the injection if they have been properly instructed. Four or five days after the Elonva injection, depending on how the ovaries have responded, treatment is started with a GnRH antagonist, which prevents the ovaries from releasing their eggs too early. Seven days after the Elonva injection, if further ovarian stimulation is needed, injections of another medicine similar to Elonva, but suitable for daily injection, may be given. Finally, as soon as three eggs are close to maturation, a single injection of a hormone called human chorionic gonadotropin (hCG) is given to release the mature eggs.
The eggs are collected using a surgical procedure. They will then be fertilised in a laboratory and the resulting embryo is implanted in the womb.

How does it work?

The active substance in Elonva, corifollitropin alfa, is a modified follicle stimulating hormone (FSH), a natural hormone in the body. FSH stimulates the production of eggs in the ovaries. In corifollitropin alfa, a peptide (a short chain of amino acids) is attached to the FSH to prolong its activity in the body. As a result a single dose of the medicine can be given to stimulate egg production, thereby replacing daily injections that would be required with other FSH medicines.

Corifollitropin alfa is produced by a method known as ‘recombinant DNA technology’. This means that it is made by a cell that has received a gene (DNA) and is then able to produce a protein, in this case corifollitropin alfa.

How has it been studied?

The effects of Elonva were first tested in experimental models before being studied in humans. In two main studies involving 1,905 women who needed to have ovarian stimulation, Elonva treatment was compared with treatment with follitropin beta (an FSH medicine also used to stimulate the ovaries). One of the studies involved women weighing 60 kg or less who received a 100-microgram dose of Elonva, while the other study involved women weighing above 60 kg who received a 150-microgram dose. The main measure of effectiveness for both studies was the average number of eggs collected from each woman after treatment. One of the studies had an additional main effectiveness measure which was the number of women who became pregnant. The other study was not large enough to draw strong conclusions about the resulting pregnancies.

What benefits has it shown during the studies?

Treatment with Elonva was as effective as treatment with follitropin beta. In the study in women weighing above 60 kg, the average number of eggs collected from each woman was 13.7 in those treated with Elonva compared with 12.5 in those treated with follitropin beta. Around 39% of those who received Elonva became pregnant compared with 38% of those treated with follitropin beta. In the study in women weighing 60 kg or less, the number of eggs collected from each woman was 13.3 for those treated with Elonva and 10.6 for those treated with follitropin beta.

What is the risk associated?

The most common side effects with Elonva (seen in between 1 and 10 patients in 100) are headache, nausea (feeling sick), tiredness, pelvic pain and discomfort, breast complaints and ovarian hyperstimulation syndrome (OHSS). OHSS occurs when the ovaries over-respond to treatment, causing abdominal swelling and pain, nausea and diarrhoea. For the full list of all side effects reported with Elonva, see the Package Leaflet.
Elonva should not be used in people who may be hypersensitive (allergic) to corifollitropin alfa or any of the other ingredients. It must not be used in patients with tumours of the ovary, breast, womb, pituitary (a gland located at the base of the brain that produces FSH) or hypothalamus (a region of the brain). It must also not be used in women with primary ovarian failure, enlarged ovaries or ovaries with cysts or in women with a history of OHSS. For the full list of restrictions, see the Package Leaflet.

Why has it been approved?

The Committee for Medicinal Products for Human Use (CHMP) decided that Elonva’s benefits are greater than its risks and recommended that it be given marketing authorisation.

Further information

The European Commission granted a marketing authorisation valid throughout the European Union for Elonva to N.V. Organon on 25 January 2010. The marketing authorisation is valid for five years, after which it can be renewed.

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Name

 

Elonva 100 micrograms solution for injection

 

Composition

 

Each pre-filled syringe contains 100 micrograms of corifollitropin alfa in 0.5 ml solution for injection.

Corifollitropin alfa is a glycoprotein produced in Chinese Hamster Ovary (CHO) cells by recombinant DNA technology.

For a full list of excipients, see section 6.1.

 

Pharmaceutical Form

 

Solution for injection (injection).

Clear and colourless aqueous solution.

 

Are you an Healthcare Professional? Access professional drug leaflets on Diagnosia.com!

 

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