Pharmacy FAQ
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Your prescriptions can be filled at the RFP Pharmacy or transferred to another pharmacy of your choice. If the prescriptions are transferred to another pharmacy, the pharmacy that fills the prescriptions will be responsible for teaching you how to use the medications and ensuring the proper supplies are included. We recommend talking to your pharmacy ahead of time to get all questions answered and ensure you will get the support you need.
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The total coast of medication is dependent upon the protocol being used, the dose of follicle stimulating hormone (FSH) necessary, and the number of days of stimulation required. The cost of medications are in addition to any treatment costs.
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Depending protocol being used, prices for FET will vary, but are considerably less than IVF. The cost of medications are in addition to any treatment costs.
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Group insurance plans available through your employer may cover the cost of fertility medications. Please remember that it is your employer who decides which medications are covered under the plan and to what extent. The coverage options vary for each plan. There may be no restrictions on coverage, and you would pay your usual co-pay. In other cases, you may have an annual dollar limit, a lifetime dollar limit or a cycle limit (which may include Clomiphene Citrate cycles). It is best to review your benefit plan brochure to determine if there are any limits or restrictions on your coverage. You can also contact your insurance company and determine coverage based upon the DIN (Drug Identification Number) list.
Unfortunately, if you are not covered by a group insurance plan, there are no individual drug plans that cover fertility medications. Fertility medications include injectable hormones (FSH, LH and hCG). Any additional medications may be covered under most drug plans with the usual restrictions. -
Hormone medications are administered via subcutaneous injection. This means they are injected into the fatty tissue under the skin for absorption into the bloodstream. The system used for injection is different depending on the medication (e.g. needle and syringe, pen, prefilled syringe). Overall, the technique is similar, and the same size needle is used.
Instructional videos are available for the most commonly used fertility medications to provide information and instructions on how to inject them. Due to Pharmacy Regulations, instructional videos are available to those who obtain medication from the RFP Pharmacy. The RFP Pharmacy will review the instructions in person or by telephone and refer you to the appropriate written information and visual teaching tools.
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Injection site irritation can sometimes occur and may include redness, a bump or lump, bruising and itching. You may see a small drop of blood on the skin as you pull the needle out. These local reactions are common and not cause for concern. They will most likely be resolved in 1 or 2 days. For this reason, we recommend using a different site for each injection. If the irritation is bothersome, you can use an icepack to ice the site before and after the injection.
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Local irritation is the most common side effect. Other side effects include a feeling of fullness, bloating and tenderness in the lower abdomen due to the increasing size of the ovaries. These effects are most noticeable during the second week of injections. Additionally, changes in hormone levels can contribute to mood swings and fatigue during this time.
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The RFP pharmacy provides a sharps container to safely store your used needles and syringes. At the end of your treatment, the container can be returned to the clinic or to your local pharmacy for safe disposal.
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No, according to the Alberta College of Pharmacy (Standard 5.1) – “The pharmacist shall not accept the return for use or re-use of any portion of any drug or non-prescription medication.”
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The timing of medications is important for the overall success of the treatment cycle. Please pay close attention to your instructions for suggested times. There is flexibility in these times based upon your own circumstances, but once you select your schedule, it is important to stick with it.
The FSH injection is taken once every 24 hours. We recommend the afternoon since monitoring is done in the morning, and we do not want you to take your injection before we have confirmed your dose. Choose the time in the afternoon that will work best for your schedule that you can commit to each day.
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The Suprefact® injection is used to stop or reduce your own hormone production and prevent you from ovulating too early. This results in a lower estrogen level. Common side effects include hot flashes, mood swings and headaches. You can treat headaches with acetaminophen (or Tylenol) if needed. Please let the clinic know if you notice any effects with your vision.
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You will have a period while on Suprefact®, as the endometrial lining is shed. It may be the same or different from your usual menstrual cycle. It is not unusual for the timing or amount of flow to differ from your typical cycle.
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If you have menstrual cramps during your period while taking just the Suprefact® injection, you can take prescription or over the counter anti-inflammatories (e.g. Advil, Motrin, Ibuprofen or others) to relieve symptoms. Once you have started your hormone injections, we recommend that you AVOID these medications, as they may interfere with successful implantation of the embryo.
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Medications include prescription, over the counter, herbal, vitamin and homeopathic products. It is best to review each one based upon your personal situation. Generally, it is best to continue only those medications that are safe in pregnancy from the time your FSH injections begin. Some medications require a longer wash-out period. Others may require slow tapering over time. You may also need to switch completely to a different medication that is safe in pregnancy. We advise you to check with your family doctor or prescribing physician. Your pharmacist or RFP physician may also be able to provide advice.
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The current Canadian recommendation is to supplement a healthy diet with 0.4-1.0 mg of folic acid daily starting 3 months prior to conception and through the first trimester. Folic acid 1-mg tablets are available as a single entity product available over the counter. Prenatal vitamins also contain 1-mg of folic acid. Ask your pharmacist for a prenatal vitamin supplement. Each regular multivitamin tablet contains .4-mg of folic acid. Please read the label to confirm the amount in the product you choose.
Some patients may require a higher dose of folic acid (5 mg). Examples include, but are not limited to, patients with a personal or family history of neural tube defects, co-existing medical conditions such as epilepsy and diabetes and patients on medications such as methotrexate, carbamazepine and valproic acid. Please talk to your family doctor or RFP physician if you have any concerns.
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There is some scientific evidence to support the use of antioxidants and certain amino acids to improve sperm health. This is specifically intended for males known to have poor sperm quality (number, movement or shape). In conjunction with a vitamin manufacturer, the RFP pharmacy has designed a product called “Mito-Motile”. This product combines antioxidants and amino acids important for sperm health. The recommended dose is to take one package daily. The clinic recommends trying to take the antioxidants for approximately 3 months before repeating the semen analysis.
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Smoking adversely affects egg quality, sperm quality and the success of IVF treatments. Smoking can also affect the developing fetus and increase the risk of complications during pregnancy and delivery. It is best to stop smoking as soon as possible. There are many programs, support groups and smoking cessation products available to help you through this difficult process. Make sure you discuss your concerns with your family doctor, RFP physician or local pharmacist.
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“Low-dose” Aspirin is 81 mg of ASA (common brand name is Asaphen). There is some potential benefit in improving endometrial blood flow and development. Low-dose Aspirin is taken once daily starting with down-regulation depending upon the protocol. It does not matter what time of day it is taken, and it can be taken with food. Low-dose Aspirin is taken until the pregnancy test and can be discontinued in most cases regardless of whether your pregnancy test is positive. In some situations, your physician may recommend continuing low-dose Aspirin throughout pregnancy.