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Gonal-F RFF

follitropin alfa
Used for Fertility
Used for Fertility

Gonal-f (follitropin alfa) is used to treat infertility in females and males. It's a man-made version of follicle-stimulating hormone (FSH), which plays an important role in follicle and sperm development. Gonal-f (follitropin alfa) is injected under the skin, typically once daily. The dosage of Gonal-f (follitropin alfa) and the duration of treatment can differ from person to person, so follow your fertility specialist's instructions carefully. It's available under different brand names (Gonal-f, Gonal-f RFF, Gonal-f RFF Redi-ject), but not a generic. Some common side effects of this medication include headache and stomach pain.

Last reviewed on August 15, 2024
basics-icon

What is Gonal-f (follitropin alfa)?

What is Gonal-f (follitropin alfa) used for?

How Gonal-f (follitropin alfa) works

Gonal-f (follitropin alfa) contains a lab-made form of follicle-stimulating hormone (FSH), which is a gonadotropin. In females, FSH helps the ovaries develop follicles and helps the eggs mature. In males, FSH causes healthy sperm to grow.

Are you looking for information on Follistim AQ (follitropin beta) instead?

Drug Facts

Common BrandsGonal-f, Gonal-f RFF, Gonal-f RFF Redi-ject
Drug ClassGonadotropin
Controlled Substance ClassificationNot a controlled medication
Generic StatusNo lower-cost generic available
AvailabilityPrescription only

More on Gonal-f (follitropin alfa) essentials

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What are the side effects of Gonal-f (follitropin alfa)?

The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.

Common Side Effects

Females:Males
  • Acne (27%)
  • Injection-site pain (11%)
  • Tiredness (10%)

Other Side Effects

Females:
  • Bleeding between menstrual periods
  • Pain
Males
  • Oily, flakey skin
  • Growth of breast tissue
  • Lower sex drive

Serious Side Effects

Contact your healthcare provider immediately if you experience any of the following.
  • Allergic reactions: trouble breathing, facial swelling, itchy skin, rash
  • Ovarian hyperstimulation syndrome: severe pelvic or stomach pain and swelling along with nausea, vomiting, sudden weight gain, diarrhea, trouble breathing, trouble urinating
  • Lung problems: trouble breathing, fluid in the lungs, worsening of any current lung problems
  • Heart attack: chest pain or tightness, pain that radiates up to your shoulder, arm, neck, or jaw
  • Stroke: sudden trouble talking, trouble walking, numbness on one side of your body or face
  • Ectopic pregnancy: severe, unexplainable pelvic pain along with unusual vaginal bleeding
When do Gonal-f (follitropin alfa) possible side effects begin and end?
Time passed since treatment started:
HOURS
DAYS
WEEKS
MONTHS
Ovarian hyperstimulation syndrome
Seek immediate medical care if you experience this side effect.

Source: DailyMed

The following side effects have also been reported

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

More common

Acid or sour stomach

anxiety

backache

belching

bloating

chest pain or tightness

confusion

cough

diarrhea

difficulty breathing

difficulty in speaking

dizziness or lightheadedness

double vision

excess air or gas in the stomach or intestines

fainting

fast heartbeat

fast, weak pulse

full feeling

headache

heartburn

inability to move the arms, legs, or facial muscles

indigestion

loss of appetite

noisy breathing

passing gas

pelvic pain, discomfort, aching, or heaviness

rapid weight gain

severe nausea

slow speech

stomach discomfort, upset, or pain, or swelling

sudden increase in stomach or shoulder pain

sweating

trouble breathing

unusual or large amount of vaginal bleeding

uterine bleeding between menstrual periods

vomiting

Incidence not known

Difficulty swallowing

dizziness

hives, itching, skin rash

pain the chest, groin, or legs, especially the calves

puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue

slurred speech

sudden loss of coordination

sudden, severe weakness or numbness in the arm or leg

unusual tiredness or weakness

vision changes

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

Acne

bleeding, blistering, burning, coldness, discoloration of skin, feeling of pressure, hives, infection, inflammation, itching, lumps, numbness, pain, rash, redness, scarring, soreness, stinging, swelling, tenderness, tingling, ulceration, or warmth at the injection site

dandruff

oily skin

swelling of the breasts or breast soreness in both females and males

Less common

Decreased interest in sexual intercourse

inability to have or keep an erection

loss in sexual ability, desire, drive, or performance

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

pros-and-cons

Pros and cons of Gonal-f (follitropin alfa)

thumbs-up

Pros

Can inject yourself at home

Can be stored at room temperature or in the refrigerator

Available as an easy-to-use pre-filled pen (Gonal-f RFF Redi-ject)

thumbs-down

Cons

Only available as an injection

Multi-dose vials and single-dose vials need to be mixed before injection, which can be inconvenient

Brand name only; no generics available

pharmacist-tips

Pharmacist tips for Gonal-f (follitropin alfa)

pharmacist
  • If appropriate, your fertility specialist can teach you how to give Gonal-f (follitropin alfa) injections to yourself at home. Ask your healthcare team about home self-injections.

    • The dose of Gonal-f (follitropin alfa) and the number of days you will use it for will depend on how your body responds to this medication. Follow your fertility specialist's directions carefully to give the medication the best chance to work.

      • Let your healthcare team know right away if you notice symptoms of ovarian hyperstimulation syndrome (OHSS), such as severe pelvic pain, nausea, or weight gain. OHSS is a potentially serious side effect of Gonal-f (follitropin alfa) in females and needs medical attention right away.

        Tips on storing Gonal-f (follitropin alfa)

        • After mixing, Gonal-f multi-dose vial is only good for 28 days (either in the fridge or at room temperature), while Gonal-f RFF single-use vial must be used right away.

          • Gonal-f RFF Redi-ject is an autoinjector that can be used for multiple injections. Before you open it, you can store it in the refrigerator until the expiration date on the box or at room temperature for up to 3 months. But once you start to use it, this medication is only good for 28 days (in the fridge or at room temperature).

            Tips on using Gonal-f (follitropin alfa)

            • Always wash your hands with soap and water before injecting Gonal-f (follitropin alfa), and make sure to wipe the area of skin you are going to inject the medication into with an alcohol swab before injecting. Use a different area of the body for every dose. This will help prevent discomfort and pain during injections.

              • If you've stored the mixed Gonal-f multi-dose vial or Gonal-f RFF Redi-ject in the refrigerator, let the medication warm to room temperature on its own (at least 30 minutes) before injecting. Don't warm it up any other way.

                • If you're using Gonal-f RFF Redi-ject, you should inject it in your stomach around your belly button area. If you're using Gonal-f or Gonal-f RFF, you can inject it in your upper arms, upper legs, or your stomach around your belly button area.

                  • Use a new needle and syringe each time you give yourself Gonal-f (follitropin alfa). Throw away the used syringes and needles in a protective (sharps) container. These containers might be given to you by your fertility team, but if not, they can be purchased at most pharmacies. Don't throw needles and syringes away in the regular trash.

                    faqs

                    Frequently asked questions about Gonal-f (follitropin alfa)

                    How do you know that Gonal-f (follitropin alfa) is working?
                    You likely won't feel Gonal-f (follitropin alfa) working for you, so it's important to maintain appointments with your fertility specialist and any ultrasounds or blood tests they order for you. These tests and appointments will allow your fertility provider to check how well Gonal-f (follitropin alfa) is working for you.
                    Does Gonal-f (follitropin alfa) need to be refrigerated?
                    All Gonal-f (follitropin alfa) products can be stored in the refrigerator or at room temperature before use, but there are a few specific differences depending on which product you're using. Gonal-f multi-dose vial comes as a powder that needs to be mixed; after you've mixed it, this medication is only good for 28 days (in the fridge or at room temperature). Gonal-f RFF single-dose vial also comes as a powder that needs to be mixed; after you've mixed it, the medication needs to be used right away. Gonal-f RFF Redi-ject is an autoinjector that can be used for multiple injections. Before you open it, you can store it in the refrigerator until the expiration date on the box or at room temperature for up to 3 months. But once you start to use it, this medication is only good for 28 days (in the fridge or at room temperature).
                    What's the difference between Gonal-f and Menopur?
                    Both Gonal-f (follitropin alfa) and menotropins (Menopur) are once-a-day injections given under the skin to help stimulate the ovaries to produce mature eggs in females. The main difference between them is that Menopur contains two hormones, follicle stimulating hormone (FSH) and luteinizing hormone (LH), whereas Gonal-f (follitropin alfa) only contains FSH. It's possible that your fertility specialist will have you take Menopur along with Gonal-f (follitropin alfa). Another difference is that Gonal-f (follitropin alfa) is approved for use in males who are infertile; Menopur is not FDA-approved for use in male infertility.
                    Is Follistim the same as Gonal-f?
                    Both Gonal-f (follitropin alfa) and Follistim AQ (follitropin beta) are brand-name injectable forms of FSH used to stimulate the ovaries to make follicles and release mature eggs, but they're different medications; they have different doses and they come in different dosage forms. Your fertility specialist will not have you use both medications at the same time.
                    Can you drink alcohol while you're taking Gonal-f (follitropin alfa)?
                    It's best to avoid alcohol while taking Gonal-f (follitropin alfa). Research suggests that alcohol can affect the number and quality of eggs. In addition, alcohol might also affect sperm count. These factors mean Gonal-f (follitropin alfa) might not work as best as it can to help you become pregnant if you also drink alcohol at the same time.
                    What happens if you miss a dose of Gonal-f (follitropin alfa)?
                    If you miss a dose of Gonal-f (follitropin alfa), don't double up the next dose to make up for the mixed one. If you miss a dose, contact your fertility specialist for instructions on what to do.
                    Does Gonal-f (follitropin alfa) cause weight gain?
                    Weight gain isn't a typical side effect of Gonal-f (follitropin alfa). But it can be a symptom of ovarian hyperstimulation syndrome (OHSS), a potentially serious side effect of Gonal-f (follitropin alfa) in females. OHSS can happen when the ovaries make too many eggs. This can lead to sudden fluid build up in different areas of the body, which can result in weight gain. Let your fertility specialist know right away if you notice weight gain after starting Gonal-f (follitropin alfa) so they can check to see if you have OHSS.
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                    What are the risks and warnings for Gonal-f (follitropin alfa)?

                    Gonal-f (follitropin alfa) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.

                    risk-warning

                    Swollen ovaries

                    • Risk factors: High doses of Gonal-f (follitropin alfa) | Using Gonal-f (follitropin alfa) too long

                      Gonal-f (follitropin alfa) can cause females' ovaries to grow or swell. This is more likely to happen if you're using high doses of this medication or have used it for too long. Your fertility provider will monitor your ovaries closely with ultrasounds to make sure they aren't growing too much. If your ovaries are ever too swollen on an ultrasound, your fertility provider will tell you to stop injecting Gonal-f (follitropin alfa) and avoid having sex. Tell your healthcare team right away if you feel any cramps or pain in the pelvic or lower belly area while using this medication.

                      risk-warning

                      Ovarian hyperstimulation syndrome (OHSS)

                      • Risk factors: Pregnancy

                        In females, Gonal-f (follitropin alfa) can cause OHSS, a condition that occurs when the ovaries grow too large after you've finished your injections. It's very painful and can cause vomiting and diarrhea. It can also cause more serious conditions, including trouble breathing and bursting ovaries. It usually goes away on its own once your menstrual period starts. People who develop OHSS and also successfully become pregnant tend to have more severe OHSS symptoms. If you feel extreme belly pain, nausea, vomiting, or diarrhea within 7 to 10 days after finishing Gonal-f (follitropin alfa), tell your fertility provider right away.

                        risk-warning

                        Lung problems and blood clots

                        • Risk factors: Personal or family history of blood clots | Smoking | Ovarian hyperstimulation syndrome (OHSS) | People who are overweight

                          In females, Gonal-f (follitropin alfa) can raise your risk of life-threatening lung problems and blood clots. Smoking, a history of blood clots, and OHSS raise this risk even more. Blood clots can lead to a heart attack, a stroke, or a pulmonary embolism (life-threatening blood clot in the lungs). Be sure to discuss all your past and present medical conditions with your fertility provider before starting Gonal-f (follitropin alfa). Call 911 or get medical help right away if you have pain in your legs or arms, chest pain, sudden severe headaches, trouble breathing, or sudden changes in your speech or vision.

                          risk-warning

                          Ovarian twisting

                          • Risk factors: Ovarian hyperstimulation syndrome (OHSS) | Pregnancy | Previous stomach surgery | History of ovarian twisting | History of or current ovarian cysts | Polycystic ovary syndrome (PCOS)

                            Gonal-f (follitropin alfa) raises your risk of ovarian twisting in the future. This can cause blood flow to the ovary to be cut off. It's more likely to happen if you have polycystic ovary syndrome (PCOS), had stomach surgery in the past, or have OHSS. Tell your fertility provider before you start Gonal-f (follitropin alfa) if you have a history of cysts on your ovaries and/or any surgeries you have had in the past.

                            risk-warning

                            Getting pregnant with more than one baby

                            All gonadotropin fertility treatments, including Gonal-f (follitropin alfa), make females much more likely to conceive and deliver more than one baby (twins, triplets). This is due to how the medication works to prepare the body to ovulate. Please discuss this possibility with your partner before starting Gonal-f (follitropin alfa).

                            risk-warning

                            Problems during pregnancy

                            All gonadotropin fertility treatments, including Gonal-f (follitropin alfa), make it more likely for you to experience problems during pregnancy than if you were to conceive without medication. These include birth defects, miscarriages, and pregnancies outside the uterus. It isn't clear why this happens. Your fertility provider might want to follow up with you more often to make sure you and your baby are healthy.

                            risk-warning

                            Allergic reactions

                            Severe allergic reactions to Gonal-f (follitropin alfa) are possible, including life-threatening problems like anaphylaxis (closing of the throat). Call 911 if this happens. If you notice hives, a rash, swelling of the lips or tongue, or difficulty breathing after using Gonal-f (follitropin alfa), call your healthcare professional right away.

                            dosage

                            Gonal-f (follitropin alfa) dosage forms

                            Typical dosing for Gonal-f (follitropin alfa)

                            The dose of Gonal-f (follitropin alfa), how often you take it, and the length of treatment are unique for every person. Follow your fertility specialist's instructions carefully and double check with them if you're unsure of your dose.

                            The typical dose of Gonal-f (follitropin alfa) ranges from 75 to 300 international units (IU) injected beneath the skin (subcutaneously). Typically, females will receive injections daily, while males will receive injections 3 times a week. Your fertility specialist will adjust the dose based on how your body responds to the medication.

                            interactions

                            Interactions between Gonal-f (follitropin alfa) and other drugs

                            Gonal-f (follitropin alfa) may interact with certain medications or supplements. Always let your doctor and pharmacist know about any other medications or supplements (including prescribed and over-the-counter medications, vitamins, and dietary or herbal supplements) that you are currently taking. The list below does not include all possible drug interactions with Gonal-f (follitropin alfa). Please note that only the generic name of each medication is listed below.

                            Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. Tell your healthcare professional if you are taking any other prescription or nonprescription (over-the-counter [OTC]) medicine.

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                            contraindications-icon

                            Gonal-f (follitropin alfa) contraindications

                            Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Gonal-f (follitropin alfa) will not be safe for you to take.
                            • High levels of FSH that could be a sign of ovarian failure

                            • Currently pregnant

                            • Uncontrolled disease(s) of the endocrine glands (caused by a hormonal imbalance)

                            • Sex hormone dependent tumors

                            • Tumors of pituitary gland or hypothalamus

                            • Abnormal uterine bleeding (with an unknown cause)

                            • Ovarian cysts or enlargement (with an unknown cause)

                            alternatives

                            What are alternatives to Gonal-f (follitropin alfa)?

                            There are a number of medications that your doctor can prescribe in place of Gonal-f (follitropin alfa). Compare a few possible alternatives below.
                            Gonal-f (follitropin alfa)
                            Used for:
                            $1728.00 Lowest GoodRx priceView Prices
                            Used for:
                            • Female infertility not caused by ovarian failure

                            • Male infertility not caused by testicular failure

                            $6071.64 Lowest GoodRx priceView Prices
                            Used for:
                            $1799.00 Lowest GoodRx priceView Prices
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                            Gonal-f (follitropin alfa) images

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                            This medicine is White Carton.white - GONAL-f 450unit Powder for Injection

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                            References

                            Best studies we found
                            View All References (5)

                            Kumar, P., et al. (2011). Ovarian hyperstimulation syndrome. Journal of Human Reproductive Sciences.

                            MedlinePlus. (2023). Follicle-stimulating hormone (FSH) levels test.

                            MedlinePlus. (2023). Hypogonadotropic hypogonadism.

                            National Institute of Diabetes and Digestive and Kidney Disease. (2018). Gonadotropins. LiverTox: Clinical and Research Information on Drug-Induced Liver Injury.

                            Orlowski, M., et al. (2023). Physiology, follicle stimulating hormone. StatPearls.

                            GoodRx Health has strict sourcing policies and relies on primary sources such as medical organizations, governmental agencies, academic institutions, and peer-reviewed scientific journals. Learn more about how we ensure our content is accurate, thorough, and unbiased by reading our editorial guidelines.
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