How to Mix Infertility Medications Bravelle and Menopur

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Bravelle and Menopur are two common injectable hormonal medications used to treat infertility. Both medications are follicle-stimulating hormones, which work to stimulate your ovaries to make eggs.

Once you're taking these hormones, you can expect to be visiting your doctor’s office frequently, even every day, to have a blood test and ultrasound. The purpose of all this testing is to limit the risk of complications and monitor how your body is responding to the medication.

According to Ferring (the maker of these drugs), up to six powders of Bravelle, Menopur, or a combination of both can be mixed together into one milliliter of diluent (liquid). Bravelle and Menopur are packaged the same way and come with five vials of powder and five vials of liquid. Also included are mixing devices known as Q-caps.

If your doctor has prescribed both Bravelle and Menopur, you should be able to mix them, so that you can take them both together. However, first talk it over with your doctor to make sure this fits into your treatment strategy.

Preparing to Mix Bravelle and Menopur

Wash your hands well with soap and water before preparing to do any type of injection. Also, make sure that your workstation is clean and dry.

You will need:

  • Medication dosage and the appropriate number of vials (up to six vials in one injection)
  • 3cc syringe with a 27 G 1/2 inch needle
  • Alcohol pad
  • Q-cap (mixing device included with the medicine)
  • One vial of diluent (comes with the medicine)

Remove all the plastic caps on top of the vials of medicine and diluent. Clean the rubber stoppers underneath with the alcohol pad. Remove the needle from the syringe (if attached) and make sure to place on a clean surface or ideally back in the packaging. Screw the Q-cap onto the syringe.

Place the vial of diluent onto a stable workplace. Pop the syringe with the Q-cap onto the vial of diluent. Invert the vial and drawback 1 ml into the syringe. Remove the vial from the Q-cap.

Mixing the Medications

Pop the Q-cap (still attached to the syringe) onto the first vial of medication. Depress the plunger to inject the diluent into the powder. Allow the powder to dissolve, then invert to draw the liquid back into the syringe. Remove the vial from the Q-cap.

Use that same syringe/Q-cap with the medicine in it and pop onto the second vial of medication. Again, depress the plunger to inject the liquid into the vial. Once the powder has dissolved, invert and draw the liquid back into the syringe. Remove the vial from the Q-cap.

Repeat this procedure, mixing up to six powders in the same syringe of diluent. In doing this, you are concentrating all the medicine into the diluent.

After Mixing the Bravelle and Menopur

When you've finished mixing the medications, remove the Q-cap from the syringe and reattach the 27G, 1/2 inch needle. Take care to not touch the connecting parts as that can introduce bacteria into the system. Clean your skin where you will be doing the injection with an alcohol pad.

If you're injecting more than six vials, you must break up the vials into 2 injections. Mix and prepare the first in the manner above, then give the injection. Discard the entire set up and use an entirely new syringe, needle, and Q-cap to mix the second injection.

Bravelle and Menopur are to be given subcutaneously (in other words, just below your skin) into your lower abdomen, about an inch away from your belly button, or into the front part of the thigh, right in the middle.

It does not matter which injection site you choose, as long as you are comfortable with it. However, make sure to rotate your sites with each injection so that you do not irritate your skin.

Properly Dispose of the Needle

Make sure to place any used needles, syringes or Q-caps into a labeled Sharps container, which you can obtain from your local pharmacy. Don't ever place dirty needles into the trash. Once the Sharps container is full, ask your doctor's office about the easiest way to properly dispose of it.

Again, wash your hands before doing anything else. Clean your work area and put away your supplies.

It's normal to feel a bit overwhelmed the first few times you do this. But with practice, it will get easier, and eventually become almost second nature.

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  1. Di Stefano AF, Rusca A, Radicioni MM, et al. Pharmacokinetics and pharmacodynamics of follicle-stimulating hormone in healthy women receiving single and multiple doses of highly purified human menotrophin and urofollitrophinClin Drug Investig. 2016;36(12):1031-1044. doi:10.1007/s40261-016-0451-6

  2. U.S. Food and Drug Administration. Menopur: Highlights of prescribing information. Updated February 2014.