GONASI ® Chorionic gonadotropin
GONASI ® is a drug based on Chorionic Gonadotropin
THERAPEUTIC GROUP: Gonadotropins and other ovulation stimulants
Indications GONASIS ® Chorionic gonadotropin
GONASI ® is a drug used in the treatment of infertility in women with proven hypopitituarism and anovulation, in case of recurrent abortions, threat of abortion and amenorrhea.
Chorionic gonadotropin is also used in the treatment of male infertility associated with azoospermia, oligoastenospermia and asthenospermia.
Recent studies show the efficacy of this drug, also in the medical treatment of cryptorchidism, hypogonadotropic eunucoidism and in the delays of correct male sexual development.
Mechanism of action GONASI ® Chorionic gonadotropin
Chorionic gonadotropin is a hormone produced by the placenta, essential in the correct evolution of pregnancy given the ability to preserve the functionality of the corpus luteum, therefore the secretion of progesterone.
The hormone contained in GONASI ® extracted from the urine of pregnant women, when taken outside of pregnancy is able to exert an action similar to the luteinizing hormone causing:
- Stimulation of Leydig cells with increased testosterone secretion and consequent androgenizing effect, particularly important in patients with cryptorchidism or delayed development of secondary sexual characteristics in improving symptoms;
- Induction of the ovulatory process;
- Incretion of estrogen by the ovary.
Administered by injection, usually intramuscular or subcutaneous, the chorionic gonadotropin reaches the target tissues through the bloodstream, and after a "half-life of about 8 hours it is eliminated through the urine, ideal biological material for the detection of this hormone, useful as pregnancy markers.
Studies carried out and clinical efficacy
1. THE CHEMICAL LIMITS OF EXTRACTION CHORIONIC GONADOTROPIN
Curr Med Res Opin. 2005 Dec; 21: 1969-76.
Comparative characterization of a commercial human chorionic gonadotrophin extracted from human urine with a commercial recombinant human chorionic gonadotrophin.
Bassett R, De Bellis C, Chiacchiarini L, Mendola D, Micangeli E, Minari K, Grimaldi L, Mancinelli M, Mastrangeli R, Bucci R.
The use of chorionic gonadotropin extracted from urine does not allow, however effective the current means of extraction and purification, to obtain a totally pure product. Studies like this show the possibility of tracing other proteins and high concentrations of oxidized gonadotropin.
2. THE EFFECTIVENESS OF CHORIONIC GONADOTROPIN IN THE MALE HYPOGONADOTROP HYPOGONADISM
Chonnam Med J. 2011 Apr; 47: 39-42. Epub 2011 Apr 26.
Penile Growth in Response to Human Chorionic Gonadotropin (hCG) Treatment in Patients with Idiopathic Hypogonadotrophic Hypogonadism.
Kim SO, Ryu KH, Hwang IS, Jung SI, Oh KJ, Park K.
Study showing how the administration of chorionic gonadotropin in patients with hypogonadotropic hypogonadism can be effective both in improving gonadal function and penile growth
3. CHORIONIC GONADOTROPIN AND IVF SUCCESS
Fertil Steril. 2011 Oct; 96: 898-904. Epub 2011 Aug 11.
Low-dose human chorionic gonadotropin may improve in vitro fertilization cycle outcomes in patients with low luteinizing hormone levels after gonadotropin-releasing hormone antagonist administration.
Propst AM, Hill MJ, Bates GW, Palumbo M, Van Horne AK, Retzloff MG.
Prospective work that demonstrates how the administration at low doses of chorionic gonadotropin can determine a more successful implantation of the embryo obtained by IVF, in patients with low levels of LH.
Method of use and dosage
Powder and solvent for solution for injection for intramuscular use of 125, 250, 500, 1000, 2000, 5000, 10000 I.U. of chorionic gonadotropin:
the definition of the dosage and the overall therapeutic scheme is the responsibility of the specialist doctor, who must adapt the dosage to the physio-pathological characteristics of the patient, to his clinical picture and to the therapeutic objectives.
Warnings GONASIS ® Chorionic gonadotropin
The high biological complexity of chorionic gonadotropin therapy requires the supervision of a specialist physician both in the dosage definition phase and throughout the therapeutic process.
When the first side effects appear, especially referring to ovarian function and the related hyperstimulation syndrome, the doctor should evaluate the possibility of suspending the administration of GONASI ®.
Particular attention should be paid to patients suffering from renal, cardiac or nerve pathologies given the ability of this hormone to further compromise the clinical course of the aforementioned diseases.
PREGNANCY AND BREASTFEEDING
The absence of indications regarding the use of chorionic gonadotropin during pregnancy suggests avoiding the administration of GONASIS both during gestation and breastfeeding, although there are no studies in the literature that demonstrate the toxicity of this hormone for the fetus.
Although no particularly significant pharmacokinetic studies are currently known, it is advisable to avoid the simultaneous use of chorionic gonadotropin and corticosteroids.
Contraindications GONASI ® Chorionic gonadotropin
GONASI ® is contraindicated in the case of precocious puberty, pituitary, ovarian, prostatic and testicular neoplastic pathologies, premature menopause, endocrine pathologies, absence of the uterus, thrombophlebitis and hypersensitivity to the active ingredient or to one of its excipients.
Undesirable Effects - Side Effects
Administration of chorionic gonadotropin can lead to headache, asthenia, irritability, depression, edema, gynecomastia and precocious puberty in prepubertal patients.
The use of GONASI ® in the induction of ovulation has been statistically associated with a higher incidence of twin pregnancies and with ovarian hyperstimulation syndrome.
GONASI ® can only be sold under medical prescription.
The use of GONASI ® outside the medical prescription, before and during a sports competition is prohibited as it constitutes a doping practice
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