Recommended Dosing for Pregnyl (Human Chorionic Gonadotropin, hCG)
The recommended dosing for Pregnyl (human chorionic gonadotropin, hCG) is 10,000 USP Units administered intramuscularly as a single dose for most indications, with specific dosing regimens varying by clinical indication. 1
Dosing by Clinical Indication
Assisted Reproduction
- Standard dose: 10,000 USP Units intramuscularly as a single dose
- Administration timing: 36 hours after appropriate stimulation to trigger final follicular maturation and ovulation 2
- Alternative administration route: Subcutaneous injection of 10,000 USP Units has been shown to be bioequivalent to intramuscular administration and may be preferred for patient comfort and self-administration 3
Cryptorchidism in Prepubertal Boys
- Age 1-4 years: 250 USP Units twice weekly for 5 weeks (total 10 doses)
- Age 4-7 years: 500 USP Units twice weekly for 5 weeks (total 10 doses)
- Age 7-12 years: 1,000 USP Units twice weekly for 5 weeks (total 10 doses) 4
Threatened Miscarriage/Vaginal Bleeding in First Trimester
- Initial dose: 10,000 USP Units intramuscularly (bolus dose)
- Maintenance dosing:
- 5,000 USP Units intramuscularly twice weekly until 10 weeks of pregnancy
- 5,000 USP Units intramuscularly weekly between 10-14 weeks of pregnancy 5
Prevention of Ovarian Hyperstimulation Syndrome (OHSS) in High-Risk IVF Patients
- Reduced dose: 5,000 USP Units intramuscularly (instead of standard 10,000 USP Units) to minimize OHSS risk while maintaining efficacy 6
Administration Guidelines
Reconstitution:
- Pregnyl is supplied as a lyophilized powder requiring reconstitution
- Use the provided solvent (water for injection with sodium chloride 0.56% and benzyl alcohol 0.9%)
- Reconstituted solution is stable for 60 days when refrigerated 1
Storage:
- Store at controlled room temperature 15-30°C (59-86°F)
- Reconstituted solution should be refrigerated 1
Administration route:
- Primary route: Intramuscular injection
- Alternative: Subcutaneous injection (bioequivalent to IM for 10,000 USP Units) 3
Clinical Considerations and Monitoring
- Pharmacokinetics: After administration of 10,000 USP Units, peak serum concentrations occur at approximately 20 hours, with an elimination half-life of 32-33 hours 3
- Detection period: hCG remains detectable in serum and urine for 7-11 days after administration of 10,000 USP Units 7
- Monitoring: When used for ovulation induction, transvaginal ultrasound should be used to confirm follicular development before hCG administration 2
Important Precautions
- Patients at high risk for OHSS should receive reduced dosing (5,000 USP Units) or alternative ovulation triggering agents 6
- Careful monitoring is required in patients with risk factors for thromboembolic events
- Avoid use in patients with primary ovarian failure, uncontrolled thyroid or adrenal dysfunction, or hormone-responsive malignancies
Remember that dosing should be adjusted based on the specific clinical scenario, patient characteristics, and response to treatment. The FDA-approved product labeling should always be consulted for the most current and comprehensive information.