choriogonadotropin alfa (Rx)

Brand and Other Names:Ovidrel, Novarel, more...Pregnyl, chorionic gonadotropin
  • Print

Dosing & Uses


Dosage Forms & Strengths

prefilled syringe

  • 250mcg

powder for reconstitution

  • 10,000 units/vial

Induction of Ovulation & Pregnancy

Ovidrel: 250 mcg SC one day following last dose of follicle stimulating agent; use only after adequate follicular development has been determined; hold treatment if there is excessive ovarian response

Novarel, Pregnyl, Generics: 5,000-10,000 units 1 day following last dose of menotropins

Induction of Spermatogenesis

Novarel, Pregnyl, Generics

  • Hypogonadotropic and hypogonadism in males: 1000-2000 units 2-3 times/week (may require 2-3 months of therapy); if needed, add follitropin alfa or menopausal gonadotropin to induce spermatogenesis; continue hCG therapy at dose required to maintain testosterone levels

Other Indications & Uses

Novarel: Induction of ovulation & pregnancy in infertile women with secondary anovulation who have been appropriately pretreated with menotropins/FSH

Ovidrel: Induction of final follicular maturation & early luteinization in infertile women who have undergone pituitary desensitization & who have been appropriately retreated with follicle stimulating hormones

Novarel, Pregnyl

  • Prepubertal cryptorchidism not due to anatomical obstruction
  • Selected cases of male secondary hypogonadotropic hypogonadism

Dosage Forms & Strengths

prefilled syringe

  • 250mcg

powder for injection

  • 10,000 units

Prepubertal Cryptorchidism Not Caused By Anatomical Obstruction

Novarel, Pregnyl

  • May institute therapy between ages of 4 and 9
  • 4,000 units IM 3 times/week for 3 weeks
  • 5,000 units IM every second day for 4 injections
  • 15 injections of 500 to 1,000 units IM over a period of 6 weeks
  • 500 units IM 3 times/week for 4-6 weeks; if course of treatment not successful, begin another 1 month later, giving 1,000 units/injection

Male Hypogonadotropic Hypogonadism

Novarel, Pregnyl

  • 500-1,000 units IM 3 times/week for 3 weeks, followed by same dose twice/week for 3 weeks
  • 4,000 units IM 3 times/week for 6-9 months; following that dosage may be reduced to 2,000 units 3 times/week for an additional 3 months

Adverse Effects



  • Ovarian cyst (3%)
  • Ovarian hyperstimulation (2-3%)
  • Abdominal pain (3-4%)
  • Nausea (3%)
  • Vomiting (3%)
  • Injection site inflammation (<2%)



  • Breast pain
  • Cervical lesion
  • Cough
  • Albuminuria
  • Back pain
  • Breast pain
  • Cardiac arrhythmia
  • Dizziness
  • Emotional lability
  • Genial herpes
  • Hyperglycemia
  • Pruritus
  • Urinary tract infection
  • Vaginal hemorrhage
  • Vaginitis

Frequency Not Defined

Novarel, Pregnyl

  • Headache
  • Irritability
  • Depression
  • Edema
  • Restlessness
  • Gynecomastia
  • Precocious puberty
  • Fatigue
  • Arterial thrombus
  • Ovarian hyperstimulation syndrome
  • Overian cyst rupture




  • Hypersensitivity to component
  • Primary ovarian failure
  • Uncontrolled thyroid or adrenal dysfunction
  • Uncontrolled organic intracranial lesion such as pituitary tumor
  • Undiagnosed abnormal uterine bleeding
  • Ovarian cyst or enlargement of undetermined origin
  • Sex hormone dependent tumor of reproductive tract and accessory organs
  • Pregnancy

Novarel, Pregnyl

  • Hypersensitivity to drug or components
  • Precocious puberty
  • Prostatic carcinoma or other androgen-dependent neoplasm


Administer only after assessing adequate follicular development by serum estradiol & vaginal ultrasonography


  • Potent gonadotropic substance capable of causing ovarian hyperstimulation syndrome (OHSS) in women with or without pulmonary or vascular complications
  • Withhold where clinically significant ovarian enlargement or excessive estradiol production to reduce risk of ovarian hyperstimulation syndrome
  • Safe and effective induction of ovulation and use of prefilled syringe in women requires monitoring of ovarian response with serum estradiol and transvaginal ultrasound on a regular basis
  • Ovarian hyperstimulation syndrome is characterized by mild to moderate ovarian enlargement may occur, accompanied by abdominal distension and/or abdominal pain; usually regresses without treatment in 2-3 wk; may progress rapidly to a serious medical event characterized by dramatic increase in vascular permeability, which may result in rapid fluid accumulation in peritoneal cavity, thorax and/or pericardium
  • Potential for arterial thromboembolism
  • Risk of enlargement of preexisting ovarian cysts or rupture of ovarian cysts with resultant hemoperitoneum
  • If ovaries are abnormally enlarged on last day of FSH therapy, choriogonadotropin alfa should not be administered in this course of therapy; this will reduce risk of development of ovarian hyperstimulation syndrome
  • Early warning signs of development of OHSS are severe pelvic pain, nausea, vomiting, and weight gain; symptomatology seen with cases of OHSS include abdominal pain, abdominal distension, gastrointestinal symptoms including nausea, vomiting and diarrhea, severe ovarian enlargement, weight gain, dyspnea,and oliguria
  • Clinical evaluation may reveal hypovolemia, hemoconcentration, electrolyte imbalances, ascites, hemoperitoneum, pleural effusions, hydrothorax, acute pulmonary distress, and thromboembolic events
  • Transient liver function test abnormalities suggestive of hepatic dysfunction, which may be accompanied by morphologic changes on liver biopsy, reported in association with ovarian hyperstimulation syndrome
  • OHSS may be more severe and more protracted if pregnancy occurs; OHSS develops rapidly; therefore, patients should be followed for at least two weeks after hCG administration; most often, OHSS occurs after treatment has been discontinued and reaches its maximum at about seven to ten days following treatment; usually, OHSS resolves spontaneously with onset of menses; if there is evidence that OHSS may be developing prior to hCG administration hCG must be withheld
  • If severe OHSS occurs, treatment with gonadotropins must be stopped and patient should be hospitalized;a physician experienced in management of this syndrome, or who is experienced in management of fluid and electrolyte imbalances should be consulted
  • As with other hCG products, reports of multiple births have been associated with treatment; in ART, the risk of multiple births correlates to number of embryos transferred; multiple births were experienced by 30.9% of women receiving 250 μg in the ART studies. In the ovulation induction clinical trial, 2 of 15 live deliveries (13.3%) were associated with multiple births in women receiving therapy; the patient should be advised of potential risk of multiple births before starting treatment
  • Combination of both ultrasound and serum estradiol measurement are useful for monitoring development of follicles, for timing of ovulatory trigger, as well as for detecting ovarian enlargement and minimizing risk of ovarian hyperstimulation syndrome and multiple gestation; recommended that number of growing follicles be confirmed using ultrasonography because serum estrogens do not give an indication of size or number of follicles

Novarel, Pregnyl

  • To be used in conjunction with human menopausal gonadotropins only by physicians experienced with infertility problems who are familiar with criteria for patient selection, contraindications, warnings, precautions, and adverse reactions described in package insert for menotropins
  • Use with caution in cardiovascular disease, asthma, history of migraines, renal impairment, seizure disorders
  • Not effective in treatment of obesity
  • May induce precocious puberty in children being treated for cryptorchidism (discontinue if signs of precocious puberty occur
  • Safety and efficacy not established in children <4 years of age
  • Anaphylaxis reported with urinary-derived HCG products
  • Principal serious adverse reactions during this use are ovarian hyperstimulation, a syndrome of sudden ovarian enlargement, ascites with or without pain, and/or pleural effusion, rupture of ovarian cysts with resultant hemoperitoneum, multiple births, and arterial thromboembolism
  • For pediatric use, induction of androgen secretion by HCG may induce precocious puberty in pediatric patients treated for cryptorchidism; therapy should be discontinued if signs of precocious puberty occur

Pregnancy & Lactation


Intrauterine death and impaired parturition observed in pregnant rats given a dose of urinary-hCG (500 IU) equivalent to three times maximum human dose of 10,000 USP, based on body surface area


Not known whether drug is excreted in human milk; because many drugs are excreted in human milk, exercise caution if hCG is administered to a nursing woman

Pregnancy Categories

A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

NA: Information not available.



Mechanism of Action


  • Produced by recombinant DNA techniques: human chorionic gonadotropin; stimulates late follicular maturation & resumption of oocyte meiosis & initiates rupture of pre-ovulatory ovarian follicle

Novarel, Pregnyl

  • Obtained from the urine of pregnant women; stimulates production of gonadal steroid hornones by causing production of androgen by the testes
  • Stimulates ovulation by acting as a substitute for luteinizing hormone



  • Vd: 21.4 L
  • Time to peak: 12-24 hr
  • Bioavailability: 40%
  • Half-life: 4 hr
  • Time to peak: 12-24 hr
  • Excretion: Urine (10%)

Novarel, Pregnyl

  • Half-life: 11 hr intial; 23 hr terminal
  • Excretion: Urine


Ovidrel subcutaneous
250 mcg/0.5 mL solution

Copyright © 2010 First DataBank, Inc.


Patient Handout

Patient Education
choriogonadotropin alfa,human recombinant subcutaneous


(kor-ee-oh-go-NAD-oh-trow-pin alfa)


USES: This medication is used to treat certain fertility problems in women. It is the hormone (hCG) that causes the growth and release of a mature egg (ovulation). This medication is usually used in combination with another hormone (FSH) that helps cause healthy ovaries to produce eggs.This medication is not recommended for women whose ovaries no longer make eggs properly (primary ovarian failure).This medication has not been shown to be effective for weight loss and should not be used for this purpose due to risk of serious side effects.

HOW TO USE: Read the Patient Information Leaflet if available from your pharmacist before you start using this medication and each time you get a refill. If you have any questions, ask your doctor or pharmacist.Learn all the preparation and usage instructions in the product package. If any of the information is unclear, consult your health care professional.After injecting the mixing liquid into the vial, gently roll the vial to mix the drug. Do not shake the liquid. Doing so may make this medicine less effective. Before using, check this product visually for particles or discoloration. If either is present, do not use the liquid.Wash your hands with soap and water before using this medication. Before injecting the dose, clean the injection site with rubbing alcohol.Inject this medication under the skin as directed by your doctor, usually the day after your last dose of follicle stimulating medicine (such as menotropins). Dosage is based on your medical condition and response to treatment. Your doctor will do lab/medical tests (such as estrogen blood levels, ultrasound) to decide when it is time to use this medication.Be sure to keep all medical appointments so your doctor can closely monitor your response and determine the time you should use this medication.Learn how to store and discard needles and medical supplies safely. Consult your pharmacist for more information.

SIDE EFFECTS: Nausea, vomiting, mild abdominal pain/swelling, headache, and pain/bruising/redness/swelling at the injection site may occur. If any of these effects last or get worse, tell your doctor promptly.Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Tell your doctor right away if you have any serious side effects, including: unusual vaginal bleeding.This medication may cause a condition known as ovarian hyperstimulation syndrome (OHSS). This condition may occur during or after treatment. Rarely, serious OHSS causes fluid to suddenly build up in the stomach, chest, and heart area. Get medical help right away if you develop the following side effects: severe pain or swelling in the lower abdominal (pelvic) area, severe nausea/vomiting, sudden/rapid weight gain, or decreased urination.Get medical help right away if you have any very serious side effects, including: chest/jaw/left arm pain, sudden severe headache, confusion, weakness on one side of the body, trouble speaking, swelling of the hands/ankles/feet, sudden vision changes (such as double vision, loss of vision), pain/redness/swelling in the legs, sudden difficulty breathing.A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

PRECAUTIONS: Before using this medication, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: unusual vaginal bleeding, problems of the uterus, certain type of fertility problem (primary ovarian failure), thyroid problem, adrenal gland problem, cancer of the reproductive organs (breast, uterus, ovary), tumor in the brain (such as pituitary tumor), unexplained ovarian cyst/enlargement, liver disease, blood clots, stroke, heart disease (such as chest pain, heart attack), lung problems (such as asthma).Successful treatment with this medication (pregnancy) may result in multiple births. Discuss the risks and benefits of having such a pregnancy with your doctor.If you become pregnant or think you may be pregnant after treatment with this drug, stop using this medication and tell your doctor right away. This drug must not be used during pregnancy because it may cause harm to an unborn baby.It is not known if this medication passes into breast milk. Consult your doctor before breast-feeding.

DRUG INTERACTIONS: Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.A product that may interact with this drug is: gonadorelin.This product can affect the results of certain lab tests (such as hormone levels), possibly causing false test results. Make sure laboratory personnel and all your doctors know you use this drug.

OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center.

NOTES: Do not share this medication with others.Lab and/or medical tests (such as ultrasound, hormone levels) may be done while you are using this medication. Keep all medical and lab appointments. Consult your doctor for more details.

MISSED DOSE: If you miss a dose, ask your doctor or pharmacist right away for a new dosing schedule. Do not double the dose to catch up.

STORAGE: Store unopened vials at room temperature away from light and moisture. Do not freeze. Do not store in the bathroom. Once mixed, the vial must be used right away. Discard any unused solution. Keep all medications away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

Information last revised December 2022. Copyright(c) 2022 First Databank, Inc.

IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.



FormularyPatient Discounts

Adding plans allows you to compare formulary status to other drugs in the same class.

To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

Adding plans allows you to:

  • View the formulary and any restrictions for each plan.
  • Manage and view all your plans together – even plans in different states.
  • Compare formulary status to other drugs in the same class.
  • Access your plan list on any device – mobile or desktop.

The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

Tier Description
1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
NC NOT COVERED – Drugs that are not covered by the plan.
Code Definition
PA Prior Authorization
Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
QL Quantity Limits
Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
ST Step Therapy
Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
OR Other Restrictions
Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
Additional Offers
Email to Patient



The recipient will receive more details and instructions to access this offer.

By clicking send, you acknowledge that you have permission to email the recipient with this information.

Email Forms to Patient



The recipient will receive more details and instructions to access this offer.

By clicking send, you acknowledge that you have permission to email the recipient with this information.

Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.