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(core-ee-AHN-ik goe-NAD-oh-troe-pin)
Chorex-10
Powder for injection: 10,000 units/vial with 10 mL diluent (to make 1000 units/mL), 20,000 units/vial with 10 mL diluent (to make 2000 units/mL)
Chorionic gonadotropin
Powder for injection: 5000 units/vial with 10 mL diluent (to make 500 units/mL), 10,000 units/vial with 10 mL diluent (to make 1000 units/mL)
Novarel
Powder for injection: 10,000 units/vial with 10 mL diluent (to make 1000 units/mL)
Pregynl
Powder for injection: 10,000 units/vial with 10 mL diluent (to make 1000 units/mL)
Profasi
Powder for injection: 5000 units/vial with 10 mL diluent (to make 500 units/mL), 10,000 units/vial with 10 mL diluent (to make 1000 units/mL)
Class: Sex hormone/Ovulation stimulant

 Action Stimulates production of gonadal steroid hormones by stimulating interstitial cells (Leydig cells) of the testis to produce androgens and corpus luteum of the ovary to produce progesterone.

 Indications Prepubertal cryptorchidism not due to anatomical obstruction; selected cases of hypogonadotropic hypogonadism (eg, hypogonadism secondary to pituitary deficiency) in men; induction of ovulation in anovulatory, infertile women in whom the cause of anovulation is secondary and not caused by primary ovarian failure and who have been appropriately pretreated with human menotropins.

 Contraindications Precocious puberty; prostatic carcinoma or other androgen-dependent neoplasm; prior allergic reaction to human chorionic gonadotropin (hCG).

 Route/Dosage

Prepubertal Cryptorchidism

CHILDREN (4 YR AND OLDER): Various authorities have advocated the following regimens: IM (1) 4000 USP U 3 times/wk for 3 wk, (2) 5000 USP U qod for 4 injections, (3) 15 injections of 500 to 1000 USP U over a period of 6 wk, or (4) 500 USP U 3 times/wk for 4 to 6 wk (if not successful, another course is begun 1 mo later using 1000 USP U/injection).

Hypogonadotropic Hypogonadism in Men

ADULTS: Various authorities have advocated the following regimens: IM 500 to 1000 USP U 3 times/wk for 3 wk, followed by same dose twice a week for 3 wk, or 4000 USP U 3 times/wk for 6 to 9 mo, following which the dosage may be reduced to 2000 USP U 3 times/wk for an additional 3 mo.

 Interactions None well documented.

 Lab Test Interferences Interference with radioimmunoassay for gonadotropins, particularly luteinizing hormone.

 Adverse Reactions

CNS: Headache; irritability; restlessness; depression; fatigue. GU: Precocious puberty; gynecomastia. META: Edema. OTHER: Pain at injection site.

 Precautions

Pregnancy: Category C. Lactation: Undetermined. Children: Safety and efficacy in children less than 4 yr not established. Health care provider use: Use in conjunction with human menopausal gonadotropins only by health care provider experienced with infertility problems. Precocious puberty: May induce precocious puberty in patients treated for cryptorchidism. Special risk patients: Because chorionic gonadotropin may cause fluid retention, use with caution in patients with cardiac or renal disease, epilepsy, migraine, or asthma.

PATIENT CARE CONSIDERATIONS

 Administration/Storage

  • Follow manufacturer’s instructions for reconstituting the Powder for Injection.
  • Do not administer if particulate matter or discoloration noted.
  • Administer only by IM injection. Not for ID, SC, or IV administration.
  • With patient lying down or sitting, administer drug by IM injection. Rotate injection sites.
  • To minimize bleeding, do not rub site after injection.
  • Discard any unused reconstituted material.
  • Store vials at controlled room temperature (59° to 86°F). Store reconstituted solution in refrigerator (36° to 46°F) and use within 30 or 60 days per manufacturer’s recommendations.

 Assessment/Interventions

  • Obtain patient history, including drug history and any known allergies.
  • Review patient’s health history for any condition that could contraindicate chorionic gonadotropin (eg, previous allergic reaction to chorionic gonadotropin, precocious puberty, prostatic carcinoma, other androgen-dependent neoplasm).
  • Ensure that women have had a thorough gynecological and endocrinologic evaluation before starting therapy.
  • Ensure that men have had a thorough medical and endocrinological evaluation before starting therapy.
  • Monitor women for signs of overstimulation of the ovary (eg, difficulty breathing, severe pelvic pain, nausea, vomiting, weight gain, stomach pain or bloating, diarrhea, infrequent urination) and report to health care provider immediately if noted.

 Patient/Family Education

  • Explain name, dose, action, and potential side effects of drug. Review the treatment regimen including duration and monitoring that will be required.
  • If patient will be administering at home, teach patient how to store, prepare, and administer the dose, and dispose of used equipment and supplies.
  • Warn women that close monitoring for overstimulation of the ovary is required and to report any of the following immediately to health care provider: difficulty breathing, severe pelvic pain, nausea, vomiting, weight gain, stomach pain or bloating, diarrhea, or infrequent urination.
  • Advise patient that follow-up visits and laboratory tests will be required to monitor therapy and to be sure to keep appointments.

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