follitropin beta

follitropin beta

Follistim AQ

Indications

Action

Pharmacokinetics

Time/action profile

Contraindications/Precautions

Adverse Reactions/Side Effects

Central nervous system

• dizziness
• headache

Cardiovascular

• thromboembolism (life-threatening)
• tachycardia

Gastrointestinal

• nausea (most frequent)
• flatulence (most frequent)
• constipation

Genitourinary

• ovarian hyperstimulation syndrome (life-threatening)
• abdominal/pelvic pain (most frequent)
• dysmenorrhea
• irregular bleeding
• ovarian enlargement
• ovarian neoplasm
• ovarian torsion

Endocrinologic

• breast pain/enlargement (most frequent)

Musculoskeletal

• back pain

Respiratory

• acute respiratory distress syndrome (life-threatening)
• dyspnea
• tachypnea
• upper respiratory tract infection

Dermatologic

• acne
• rash

Local

• injection site reactions (most frequent)

Miscellaneous

• flu-like symptoms
• multiple births

Interactions

Drug-Drug interaction

Route/Dosage

Ovulation and Pregnancy Induction in Anovulatory Infertile Women (Follistim AQ Single-Use Vial)

Ovarian and Pregnancy Induction in Anovulatory Infertile Women (Follistim AQ Cartridge)

Assisted Reproduction Technologies (Follistim AQ Single-Use Vial)

Pregnancy in Normal Ovulatory Women Undergoing IVF or ICSI (Follistim AQ Cartridge)

Spermatogenesis Induction (Follistim AQ Single-Use Vial or Cartridge)

Availability

Nursing implications

Nursing assessment

• Monitor follicular maturation during therapy via ovarian ultrasound and serum estradiol levels.
• Assess for ovarian enlargement (abdominal distention, abdominal pain). Usually regresses without treatment within 2–3 weeks.
Assess patient for signs of ovarian hyperstimulation syndrome (severe ovarian enlargement, abdominal pain and distention, nausea, vomiting, weight gain, diarrhea, dyspnea, oliguria). May be accompanied by ascites, pleural effusion, hypovolemia, electrolyte imbalance, hemoperitoneum, thromboembolic events.

Potential Nursing Diagnoses

Implementation

• When converting from single-use vial to cartridge, dose must be reduced by 18%. See manufacturer's recommendations for specific dose conversions.
• Intramuscular: Subcutaneous: Follistim AQ single-use vial: Administer via subcutaneous or IM injection. Best place for subcutaneous injection is area below navel (belly button) or in upper thigh. Best place for IM injection is upper outer quadrant of buttock muscle. May be stored in refrigerator until expiration date or at room temperature for 3 mo or until expiration date, whichever occurs first. Protect from light.
• Subcutaneous: Follistim AQ cartridge: Administer via subcutaneous injection. Remove protective cap on pen. Unscrew the entire pen body from cartridge holder. Place Follistim AQ Cartridge into cartridge holder (placing metal rimmed cap end first). Screw pen body onto cartridge holder. Screw cartridge holder into BD Micro-Fine Pen Needle. Best place for injection is area below navel (belly button) or in upper thigh. Unused cartridges may be stored in refrigerator until expiration date or at room temperature for 3 mo or until expiration date, whichever occurs first. Used cartridges may be stored in refrigerator or at room temperature for up to 28 days. Protect from light.

Patient/Family Teaching

• Prior to initiation of therapy discuss with patient the duration of therapy, required monitoring, potential adverse reactions, and risk of multiple births.
• Encourage couple to have intercourse daily, beginning on the day prior to administration of hCG until ovulation becomes apparent based on indices to determine progestational activity. Care should be taken to ensure insemination.
• Advise patient to notify health care professional if worsening or strong abdominal pain occurs or if any side effect that is persistent or bothersome occurs.
• Advise female patients to notify health care professional if breastfeeding.

Evaluation/Desired Outcomes

• Successful pregnancy.