Mixing Medications

Medications are given as a subcutaneous or an intramuscular injection once or twice daily beginning early in the cycle and continuing through the monitoring phase of treatment until the day of the initial human chorionic gonadotropin (HCG) injection.

Dosage may change within any given cycle. Morning doses are given between 7  and 10 a.m. and evening doses are given between 4  and 6 p.m. (Most patients will have just an evening dose.)

General Mixing Directions

The medications are supplied in a powder form and require mixing. The term dilutent refers to the fluid that is packaged with the medication. This fluid is inactive and serves only as a transport mechanism for the drug.

The amount of dilutent used varies with the drug and dose you will be taking. The dilutent amount is adjusted with several things in mind. The medication must be able to dissolve in the dilutent while not using too much. Too much dilutent will make the injections more uncomfortable. Using too little dilutent may cause increased burning or irritation.

Below you will find our recommendations on the proper mixing ratios. Keep in mind you may have small amounts of medication left in the syringe or containers.

When you are storing medications, you should keep them in the syringe or vial to prevent evaporation.

1. Using a 3-ml syringe for intramuscular injections (IM) and a Tb syringe for subcutaneous injections (SQ), draw up the desired amount of dilutent.
2. Inject the dilutent into the powder.
3. After the powder is dissolved into the liquid, draw the medication into the syringe. Be sure to draw the medication out of the needle also.
4. Switch to the appropriate needle for injection (25 gauge for IM and 27 gauge for SQ).

Repronex

Intramuscular injection.

Mix as follows: 0.5 ml dilutent in each powder (amp/vial), never to exceed 1.5 ml.

We recommend using a 3 ml 22-gauge, 1.5-inch syringe for mixing and changing to a 25-gauge, 1.5-inch needle for the injection.

Follistim/Gonal F (SC)

Mix as follows: 0.5 ml total dilutent for doses one to three powders (amps/vials). One ml total dilutent for doses over three powders (amps/vials).

We recommend using a tuberculin syringe with a 22-gauge, 1.5-inch needle for mixing and changing back to the 27-gauge needle for the injection.

Lupron

Dosage may vary from 0.5 mg to 1 mg given daily as a subcutaneous injection. It comes premixed and should be refrigerated.

We recommend using a 0.5 ml insulin syringe for this injection. There are two types of syringes that may be given. One of the syringes has marks that are in units (10, 20, etc.) while the other has tenths of a ml (0.1, 0.2, etc). Please note that the 10 is equal to the 0.1 and 0.2 is equal to 20.

Mixing Lupron for a Lupron Flare will be different from the directions above. This mixture will be much more dilute (a lower dose). Start with a 10 ml bottle of 0.9 percent sodium chloride (normal saline), draw up 20 units (or 0.2 ml) of the saline and discard it.

Next add 20 units (or 0.2 ml) of full strength Lupron to the bottle of normal saline. This bottle is now ready for use with a Lupron Flare. Each 20 units of dilute solution contains 0.02 mg of Lupron.

Human Chorionic Gonadotropin

When Used to Trigger Ovulation
5,000 units by intramuscular injection to be given at a time designated by the physician. Mix 10,000 units in 2 ml of dilutent.

Inject 1 ml which will equal 5,000 units.

Refrigerate the remaining medication to be given as below (0.5 ml now equals 2,500 ml).

When Used to Maintain Progesterone Production after Ovulation
2,500 units intramuscular injections on the first and fourth day after insemination (the third and sixth day after ovulatory human chorionic gonadotropin (HCG) is given).

Using the remaining medication from the first injection (see above) give 0.5 ml for first dose and 0.5 ml for second dose.

Refrigerate mixed HCG between doses.

Dosage and mixing instructions of HCG will be reviewed with you during monitoring clinic prior to administration. Written directions will also be provided.

Learn More

Learn more about fertility medications below.

• Estrace
• Human Chorionic Gonadotropin
• Progesterone
• Injections
• Clomid
• Gonadotropins
• Lupron
• Tamoxifen
• Medication Risks
• Pharmacies