Medication Instructions

When you receive your shipment of medications, the first thing you should do is review its contents. Verify that you received all of the medications you may require, and call your nurse with any questions prior to the start of your treatment Cycle. Please follow the recommended manufacturer storage instructions that come with each medication. Please contact your Village Manager's office, local waste management company, or health department to ask about the proper disposal of sharps containers in your area. Please note that we are not able to accept them at any FCI office.

Please be aware of how much medication you have at all times and alert your nurse if you are running low, to inquire if more is needed. You may call your pharmacy directly for refills, but please do not wait until you are completely out to do so. The pharmacy can typically get you more medication within 24-48 hours. There is no delivery on Sundays, so please plan accordingly.

Injection technique is clearly demonstrated on the Freedom Fertility Pharmacy link (also listed on the bottom of this page). Please view the video for each medication that your nurse has ordered for you. *If you do not have Internet access, please tell your nurse so that you can be given printed materials and a DVD or CD-Rom.

The website may show more than one way of giving certain medications. Please use the attached medication chart in conjunction with the website; the chart lists FCI's requirements for route, preparation, and administration of each medication.

If you have questions after viewing these materials, please contact your nurse for further instruction prior to the start of your treatment cycle.

"SQ"= subcutaneous injection: Administration of medication with a fine, small needle just below the surface of the skin, into fatty tissue.Injection sites: lower abdomen (below and at least one inch away from belly button) or upper, outer thigh. Rotate sites daily.

"IM"= intramuscular injection: Administration of medication deep into the muscle. Injection site: upper, outer quadrant of buttocks.Rotate sites daily.

"Transdermal"= Medication applied to the skin (often in the form of a patch).Application sites: lower abdomen (below and at least one inch away from belly button), upper area of buttocks, backs of upper arms, thighs. Rotate sites.

"PO"= Oral: Medication taken by mouth.

"TV"= Transvaginal: Medication inserted into the vagina.

"CC" (cubic centimeter) is the same as "ML" (milliliter)

INJECTABLE MEDICATIONS

Medications	Route	Mixing/Preparing Medication	Administering Medication
Lupon/Leuprolide Acetate, Microdose Lupron, Low-dose HCG	SQ	Already reconstituted- no mixing required. Use insulin syringes that come with kit to draw prescribed dose out of vial	Use same insulin syringe with attached needle to inject
Ganirelix Acetate Full dose= 250 mcg/0.5ml *Note: unless otherwise instructed, use a full dose. Half dose= 125 mcg/0.25ml *Note: half-dose syringes are good for 30 days.	SQ	Full dose: comes in prefilled Ganirelix syringe with attached needle- no mixing required Half dose prepared by pharmacy: comes in prefilled 1cc syringes with either a cap or attached needle. Half dose: not prepared by pharmacy: inject half of the liquid from the Ganirelix syringe into the barrel of the supplied 1cc syringe (fill 1cc syringe to 0.25 mL). Use what's left in the Ganirelix syringe for one day's dose and what you injected into the 1cc syringe for another day's dose. Repeat as needed for the rest of treatment cycle.	Using Ganirelix syringe: Use prefilled Ganirelix syringe with attached needle to inject. Using 1cc syringes for half-dose: Attach 27g ½" or 25g 5/8"needle to 1cc syringe and inject.
Cetrotide	SQ	Comes with prefilled syringe of diluent and 20g 1.5" needle. Attach 20g 1.5" needle to syringe and inject all of the diluent into powder. Once diluted, draw up mixture back into syringe	Change to 27g 1/2" needle to inject
Follistim AQ cartridge	SQ	Load cartridge into Follistim pen device. Dial up prescribed dose.	Twist on pen needle unit included in package to inject
Follistim AQ vial	SQ	Use 3cc syringe and 22 g 1.5" needle to mix 1 cc of diluent with powder. Using same supplies, draw 1cc of mixture back into syringe	Change to 27g 1/2" needle to inject
Gonal-F MultiDose Vial	SQ	Comes with prefilled syringe of diluent; inject all of the diluent into powder then dispose of that syringe. Use 1 ml syringe with attached needle that comes in the kit to draw prescribed dose out of vial	Use same 1ml syringe with attached needle to inject
Gonal-F RFF Pen	SQ	Already reconstituted in pen- no mixing required. Dial up prescribed dose.	Twist on pen needle unit included in package to inject.
Bravelle Menopur and Luveris	SQ	Use 3cc syringe and 22g 1.5" needle (or Q-cap to inject) 1cc of diluent into powder. Use same supplies to draw 1cc of mixture back into syringe. Use that mixture to dilute and mix additional vials as needed for total dose.	change to 27g 1/2" needle to inject.
Repronex	IM	Use 3cc syringe and 22g 1.5" needle (or Q-cap) to inject 1cc of diluent into powder. Use same supplies to draw 1cc of mixture back into syringe. Use that mixture to dilute and mix additional vials as needed for total dose.	Change to 25g 1.5"needle to inject
HCG ( Chorionic Gonadotropin, Novarel, Profasi, and Pregnyl).	IM	Use 3cc syringe and 22g 1.5" needle to inject 1cc of diluent into powder. Use same supplies to draw the amount of mixture back into the syringe directed by your physician or nurse	Change to 25g 1.5" needle to inject
Ovidrel (same action as HCG)	SQ	Comes in prefilled syringe with the attached needle-no mixing required	Use prefilled syringe with attached needle to inject
Progerterone in Oil, delestrogen	IM	No mixing required. Use 3cc suringe and 18g or 22g 1.5" needle to draw prescribed dose out of vial	Change to fresh 22g 1.5" needle to inject
Lovenox	SQ	Comes in prefilled syringe with attached needle- no mixing required.	Use prefilled syringe with attached needle to inject

NON-INJECTABLE MEDICATIONS

Medication	Route	Preparing Medication	Administering Medication
Crinone	TV	Comes in prefilled applicator	Use prefilled applicator to insert vaginally
Endometrin	TV	Comes with disposable applicators	Place tablet in applicator then insert vaginally
Progesterone Vaginal Suppositories	TV	N/A	Using finger, insert suppository vaginally
Prometrium	PO or TV	N/A	Using finger, insert suppository vaginally
Estrogen patches (Estraderm, Vivelle, Climera)	Transdermal	N/A	Apply to skin as directed by physician or nurse
Estradiol (Estrace)	Po or TV	N/A	Take tablet orally or insert vaginally, per your physician or nurse instructions.**Please note: although this medication is in tablet form, we often ask patients to insert tablet vaginally to increase absorbtion to the Uterus. Please follow your physician or nurse's instructions and do not hesitate to ask if you have questions.
Clomiphene Citrate (Clomid)	PO	N/A	Take tablet orally at the prescribed dose
Doxycycline	PO	N/A	Take tablet orally at the prescribed dose
Zithromax (Z-Pack)	PO	N/A	Take tablet orally at the prescribed dose
Baby Aspirin	PO	N/A	Take tablet orally at the prescribed dose
Metformin (Glucophage)	PO	N/A	Take tablet orally at the prescribed dose

How to Administer Your Medications

CAUTION: The instructions set forth herein are solely for the benefit of FCI patients who have visited FCI and met with its physicians and nursing staff regarding the applicable treatment to be followed. All other persons are warned that they should not follow or use these instructions in the absence of having met with an FCI physician or nursing staff at an FCI clinic.

The following information is ONLY for FCI patients on how to mix and administer the many injectable drugs used for fertility therapy. The information contained on this page contains information that is both generated from our FCI nursing staff and from the different companies that make the drugs themselves. If you have questions, please call your primary RN for detailed answers. Please click on the icon below for further details on how to mix and administer the particular drug of interest.