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warnings and cautions
5 WARNINGS AND PRECAUTIONS Cardiovascular or Cerebrovascular Disorders: Life-threatening arterial or venous thromboembolic disorders may occur during hormone treatment, including treatment with ENDOMETRIN. Discontinue ENDOMETRIN if any of these are suspected. ( 5.1 ) Depression: Closely observe ENDOMETRIN-treated women with a history of depression. Consider ENDOMETRIN discontinuation if symptoms worsen. (5.2) 5.1 Cardiovascular or Cerebrovascular Disorders Life-threatening arterial or venous thromboembolic disorders may occur during hormone treatment, including treatment with ENDOMETRIN. The healthcare provider should be alert to earliest signs of myocardial infarction, cerebrovascular disorders, arterial or venous thromboembolism (venous thromboembolism or pulmonary embolism), thrombophlebitis, or retinal thrombosis. ENDOMETRIN should be discontinued if any of these are suspected. 5.2 Depression ENDOMETRIN-treated women with a history of depression should be closely observed. Consider ENDOMETRIN discontinuation if symptoms worsen.
6 ADVERSE REACTIONS The most common adverse reactions reported (greater than 2%) were post-oocyte retrieval pain, abdominal pain, nausea, and ovarian hyperstimulation syndrome. ( 6 ) To report SUSPECTED ADVERSE REACTIONS, contact Ferring Pharmaceuticals Inc. at 1-888-FERRING (1-888-337-7464) or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch . 6.1 Clinical Studies Experience Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in practice. The safety data reflect exposure to ENDOMETRIN in 808 infertile women in a single Assisted Reproductive Technology 10 week clinical study conducted in the U.S. [see Clinical Studies (14)]. ENDOMETRIN was studied at vaginally administered doses of 100 mg twice daily and 100 mg three times daily for 10 weeks and compared to a vaginally administered active comparator. The adverse reactions that occurred at a rate greater than or equal to 2% in either ENDOMETRIN group are summarized in Table 1. Other less common reported adverse reactions in ENDOMETRIN-treated women included vaginal irritation, itching, burning, discomfort, urticaria, and peripheral edema. Table 1: Number and Frequency of Reported Adverse Reactions in Infertile Women Treated with ENDOMETRIN in an Assisted Reproductive Technology Study ENDOMETRIN 100 mg twice daily (N=404) ENDOMETRIN 100 mg three times daily (N=404) Post-oocyte retrieval pain 115 (28%) 102 (25%) Abdominal pain 50 (12%) 50 (12%) Nausea 32 (8%) 29 (7%) Ovarian hyperstimulation syndrome 30 (7%) 27 (7%) Abdominal distension 18 (4%) 17 (4%) Headache 15 (4%) 13 (3%) Uterine spasm 15 (4%) 11 (3%) Vaginal bleeding 13 (3%) 14 (3%) Vomiting 13 (3%) 9 (2%) Urinary tract infection 9 (2%) 4 (1%) Constipation 9 (2%) 14 (3%) Fatigue 7 (2%) 12 (3%) Adverse Reactions from Other Progesterone Products Adverse reactions from other progesterone products included breast tenderness, bloating, mood swings, irritability, and drowsiness.