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Follistim Patient Instructions

Questions about Medications or Instructions

If you have questions, please call us at 216-285-5028, Monday through Friday, 8 a.m. – 4 p.m. If you need assistance over the weekend, call the same number to reach our on-call doctor.


Storage: Cartridges that have not been punctured must remain refrigerated and may be used until the manufacturer’s expiration date. However, once you start using a cartridge, it must be used within 28 days of the date it was punctured.

Once you start using a cartridge, you may refrigerate it or it may be left at room temperature.

Special Considerations: Rotate injection sites, this injection can occasionally cause bruising at the injection site – this is normal. Avoid bruised areas when doing future injections until the bruise is healed. If a site becomes tender, red, painful or warm the day after an injection, please contact the fertility clinic.

Dosage and Timing: Cartridges come in the following sizes: 300 IU, 600 IU, and 900 IU. These cartridges have some overfill in them. Please use each cartridge until you have run out of medication. You may be taking Follistim once or twice daily as instructed by the fertility clinic.

Supplies: Follistim pen, Follistim needles, Follistim medication cartridge, alcohol swabs.


  1. Wash your hands and work on a clean, dry surface.
  2. Remove the blue cap from the Follistim pen, then unscrew the yellow section from the blue section.
  3. Clean the rubber stopper on the end of your Follistim cartridge with an alcohol wipe, then insert it with the rubber stopper end first into the yellow section.
  4. Completely screw the yellow and blue sections back together- make sure the blue arrow us lined up with the yellow line. If you cannot screw the two piece back together, check to see if you inserted the cartridge backwards.
  5. Remove the seal from one of the needles and screw it completely onto the yellow end of the pen.
  6. Pull the outer white cap off the needle. There is another safety shield on the needle that is also white- pull that off also. Please be careful not to let the exposed needle touch anything. If it does, recap the needle with only the larger cap, remove and replace with a new needle.
  7. Dial your dose: turn dial until you reach the correct dose. Your dose should be lined up in the center of the clear window, between the two yellow lines.
    1. If you accidentally dial too far and go past your dose, do not turn the dial back to your dose. Instead, continue turning the dial toward you all the way to the end, until you reach a “blank” space on the dial, then push the plunger all the way in.
    2. You have now reset the pen and can dial your dose again by dialing toward you.
    3. You should always be dialing toward you with the Follistim pen. If you dial away from you, the pen will push medication out and then it will be wasted.


  1. Choose an injection site on your abdomen.
  2. Clean the area with an alcohol swab and allow to dry.
  3. When ready to inject: hold the pen with your thumb on the plunger, pinch the skin up, and insert the entire needle straight in, then push down on the plunger using your thumb.
  4. Wait five seconds before removing the needle from your skin.
  5. Check the dosage window:
    1. It should be back to zero.
    2. If it is not all the way back at zero, you did not get your whole dose because your cartridge likely ran out of medication, and you will notice the plunger probably did not go all the way down.
    3. The number in the window is the dose you still need to receive. Please do the following:
      1. Place the larger white cap back on the needle and remove the needle by unscrewing it. Discard used needle.
      2. Without touching the dose dial, unscrew the pen, take out the old cartridge and discard, clean rubber stopper of a new cartridge with alcohol swab, put in a new cartridge in the pen and put on a new needle. Remove both caps on the needle.
      3. You are now ready to inject into a new site. The dose that you still need to receive is already set. Select a new site, clean with alcohol swab, and inject as previously described.
  6. When you have received your whole dose, remove and discard the needle. Leave the cartridge in the pen and put the cap on the pen.