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What you need to administer Merional. Merional is usually administered under your skin (subcutaneously), after training you will normally be able to inject Merional subcutaneously. Merional can also be injected into a muscle (intramuscularly), this is normally done by a healthcare professional. How to store Merional. Do not inject into a vein. Inject directly under the skin by pushing gently on the plunger. Ensure that you inject all of the solution. If you have any further questions about the use of this medicine, ask your doctor or nurse. Injecting your medicine intramuscularly. For intramuscular injections your healthcare provider will prepare and then inject Merional into the side of your thigh or buttock. Your doctor will tell you when to stop using Merional. Like all medicines Merional can cause side effects, although not everybody gets them, anabolic 250. Using Merional can cause overstimulation of the ovaries. The first signs of this are: ‘ Lower stomach pain, ‘ Feeling thirsty and sick and sometimes being sick, ‘ Passing reduced quantities of concentrated urine. Seek immediate medical help if you. The condition is characterised by: ‘ Swelling of the ovaries with large ovarian cysts. Very common side effects (affect more than 1 in 10 people): ‘ Pain and/or inflammation at the injection site. Common side effects (affect less than 1 in 10 people): ‘ Mild to moderate over-stimulation of the ovaries. Uncommon side effects (affect less than 1 in 100 people): ‘ Severe over-stimulation of the ovaries. Rare side effects (affect less than 1 in 1000 people) ‘ Twisting of the ovary (ovarian torsion) seen as extreme lower stomach pain. Very rare side effects (affect less than 1 in 10,000 people) ‘ Blood clots in blood vessels. Common side effects (affect less than 1 in 10 people): Very rare side effects (affect less than 1 in 10,000 people) ‘ Blood clots in blood vessels. Reporting of side effects. If you get any side effects, talk to your doctor, pharmacist or nurse. This includes any possible side effects not listed in this leaflet.
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Powder and solvent for solution for injection Appearance of the powder: white lyophilised pellet Appearance of the solvent: clear colourless solution. Merional is indicated for use in adults only. Posology and method of administration. Treatment with Merional should be initiated under the supervision of a physician experienced in the treatment of fertility issues. Male infertility: Spermatogenesis is stimulated with hCG (1,000 to 2,000 IU hCG 2-3 times per week) then Merional (75 IU or 150 IU) is administered 2-3 times per week. This treatment should be continued for at least 3 months before any improvement in spermatogenesis can be expected. Current clinical experience indicates that treatment for at least 18 months may be necessary to achieve spermatogenesis. Females with anovulation (including PCOD) The objective of treatment with Merional is to develop a single mature Graafian follicle from which the ovum will be released after the administration of hCG Merional may be given as a course of daily injections. In menstruating patients treatment should be started within the first seven days of the menstrual cycle. The treatment should be adjusted to the individual patient’s response as assessed by measuring follicle size by ultrasound and/or oestrogen secretion. A commonly used regimen commences at 75-150 IU of Merional and is increased according to the patient’s response. The maximum daily dose is usually not higher than 225 IU. If a patient fails to adequately respond after 4 weeks of treatment, the cycle should be abandoned and the patient should recommence at a higher initial dose than in the previous cycle. When an ideal response is obtained a single injection of 5,000-10,000 IU of hCG should be administered 24-48 hrs after the last Merional injection. The patient should be recommended to have coitus on the hCG injection day and the following day. Alternatively intrauterine insemination (IUI) may be performed. In the event of an excessive response treatment should be suspended and hCG withheld (see section 4. Treatment should recommence in the next cycle at a lower dose than in the previous cycle. Females undergoing controlled ovarian stimulation for multiple follicular development prior to in-vitro fertilization or other assisted reproductive technologies. A commonly used protocol for superovulation involves the administration of 150-225 IU of Merional daily commencing on days 2 or 3 of the cycle and continued until sufficient follicular development has been achieved as assessed by monitoring serum oestrogen concentrations and/or ultrasound examination with the dose adjusted according to the patient’s response but usually not higher than 450 IU daily. Adequate follicular development is usually achieved by the tenth day of treatment (range 5-20 days). A single injection of 5,000 IU-10,000 IU of hCG should be administered 24-48 hours after the last injection to induce follicular maturation. Pituitary down-regulation in order to suppress the endogenous LH surge and to control tonic levels of LH is now commonly achieved by administration of a gonadotrophin releasing hormone (GnRH) agonist. 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