Clomiphene
Clomiphene Uses, Dosage, Side Effects, Food Interaction and all others data.
Clomiphene citrate is the first non-steroidal preparation (a mixture of 2 geometric isomers-Cis [Zuclomiphene] & Trans [Enclomiphene]) that in many patients induces ovulation, which has failed previously. Clomiphene citrate stimulates the increased secretion of both gonadotropins (FSH & LH) from pituitary, which induce maturation of the ovarian follicle, ovulation & subsequent normal function of the corpus luteum. It does not interfere with the other functions of pituitary & thyroid & has no progesteronic or androgenic effect. Clomiphene citrate is taken orally & readily absorbed from gastro intestinal tract. Its biological half-life in plasma is 5-7 days. It is partially metabolized in the liver & through the bile is excreted in the faeces. A part is reabsorbed & enters into enterohepatic recirculation-pool.
| Trade Name | Clomiphene |
| Generic | Clomiphene Citrate |
| Type | |
| Therapeutic Class | Drugs for Infertility |
| Manufacturer | |
| Available Country | United States |
| Last Updated: | September 19, 2023 at 7:00 am |
Uses
- Clomiphene citrate is chiefly used for the treatment of ovulatory failure in female patients who wish to become pregnant. This therapy will not be successful unless the patient though unovulatory, is capable of ovulation & her partner is fertile.
- Polycystic ovary syndrome.
- Menorrhagia caused by hyperplastic endometrium.
- Amenorrhea with galactorrhea syndrome.
- Psychogenic amenorrhea syndrome.
- Secondary amenorrhea of unknown cause.
- Amenorrhea during post oral contraceptive period.
Dosage
Clomiphene dosage
For the treatment of ovulatory failure: 50 mg (1 tab) daily for 5 days, starting within about 5 days of onset of menstruation (or may be from the 1st day of menstruation). If this dose induces ovulation there is no need to increase the dose in the following courses. If this dose induces ovulation but not pregnancy, stimulation with Clomiphene citrate is to be continued up to 6 stimulative courses. If the1st course does not induce ovulation, 2nd dose of Clomiphene citrate is100 mg (2 tab at a time) daily for 5 days is recommended. Minimum 3 & maximum 6 simulative courses should constitute an adequate therapeutic trial. However, if menstrual bleeding does not occur, the patient should be examined carefully for the possible pregnancy & the next course should be delayed until correct diagnosis has been determined. The modern studies reveal that ultrasonographic monitoring for ovulation is most preferable.
For other indications: The recommended dose for other gynaecological problems is 50 mg (1 tab) for 5 days, starting from the 5th day of menstruation or according to the physician's recommendation, but never more than 6 cycles in total.
Side Effects
Clomiphene citrate is well tolerated. However a few side effects like dizziness, headache, nausea, vomiting, depression, fatigue, insomnia, vasomotor flushing, and allergic reaction may occur. Rarely ovarian enlargement & cyst formation may occur. All these effects disappear promptly after the treatment is discontinued. There is a minimal chance of multiple pregnancies, about which the patient should be warned.
Precaution
Clomiphene citrate should be used with caution in the following conditions: longer maintenance therapy, with alcoholic drinks & antidepressants.
Interaction
No drug interaction has been reported during the administration of Clomiphene citrate.
Pregnancy & Breastfeeding use
Pregnancy: Not recommended in pregnancy.
Nursing mother: In some cases Clomiphene citrate may reduce lactation, if it is administered to a woman during lactating period. So it should be avoided during lactational period.
Contraindication
Clomiphene citrate is contraindicated during pregnancy, in patients with liver diseases, ovarian cysts, bleeding of undetermined origin, patients with neoplasm of endometrium.
Acute Overdose
No such effects of acute over dosage of Clomiphene citrate have been reported. However, in case of over dosage, a few sign symptoms of nausea, vomiting, vasomotor flushes, scotoma, and ovarian enlargement with pelvic or abdominal pain may occur. In the event of over dosage appropriate supportive measures should be employed.
Storage Condition
Clomiphene tablet should be stored below 25° C and protected from light & moisture.
Innovators Monograph
You find simplified version here Clomiphene
FAQ
What is Clomiphene used for?
Clomiphene is a medication used to treat infertility in women who do not ovulate, including those with polycystic ovary syndrome. Use results in a greater chance of twins.
How safe is Clomiphene?
Clomiphene is not typically offered as primary treatment of hypogonadism in men who do not desire fertility preservation. These data demonstrate that Clomiphene is safe and effective with few side effects when used as long-term treatment of hypogonadism.
How does Clomiphene work?
Clomiphene works by making the body think that your estrogen levels are lower than they are, which causes the pituitary gland to increase secretion of follicle stimulating hormone, or FSH, and luteinizing hormone, or LH.
What are the common side effects of Clomiphene?
Common side effects of Clomiphene are include:
- flushing (feeling of warmth)
- upset stomach.
- vomiting.
- breast discomfort.
- headache.
- abnormal vaginal bleeding.
Is Clomiphene safe during pregnancy?
Clomiphene use in pregnant women is contraindicated, as Clomiphene does not offer benefit in this population. Available human data do not suggest an increased risk for congenital anomalies above the background population risk when used as indicated.
Is Clomiphene safe during breastfeeding?
Clomiphene is believed to be safe to take during breastfeeding, but it can decrease your supply of breast milk.
Can I drink alcohol with Clomiphene?
Do not stand or sit up quickly. This reduces the risk of dizzy or fainting spells. Drinking alcoholic beverages or smoking tobacco may decrease your chance of becoming pregnant. Limit or stop alcohol and tobacco use during your fertility treatments.
Can I drive after taking Clomiphene?
You may get drowsy or dizzy. Do not drive, use machinery, or do anything that needs mental alertness until you know how this drug affects you.
What is the best time to take Clomiphene ?
You should ideally take the Clomiphene at the same time every day, and some say that taking the pill before bed can help you sleep through some of the side effects. Some do better if they take the pill in the morning.
How many time can I take Clomiphene daily?
Clomiphene is usually taken once a day for 5 days.
Can I take Clomiphene everyday?
You'll take one dose every day for five days, but you won't take any Clomiphene on the first day of your cycle.
How long does it take for Clomiphene to start working?
The first pill of Clomiphene is usually started 2 to 5 days after the first day of your menstrual bleeding (cycle day 2-5) and ovulation usually happens 5-9 days after the last dose of Clomiphene.
What is the half life of Clomiphene?
Clomiphene has an onset of action of 5 to 10 days following course of treatment and an elimination half-life about 5 days.
Can I take Clomiphene for a long time?
Do not take it more often or for a longer time than prescribed by your doctor. Long-term treatment with this medication is not recommended and should not be more than 6 cycles.
Who should not take Clomiphene?
Do not use Clomiphene if you are already pregnant. You should not use Clomiphene if you have: liver disease, abnormal vaginal bleeding, an uncontrolled adrenal gland or thyroid disorder, an ovarian cyst (unrelated to polycystic ovary syndrome), or if you are pregnant.
What happens if I miss a dose?
Call your doctor for instructions if you miss a dose of Clomiphene.
What happen if I take too much Clomiphene?
Signs and symptoms of overdosage as a result of the use of more than the recommended dose during Clomiphene therapy include nausea, vomiting, vasomotor flushes, visual blurring, spots or flashes, scotomata, ovarian enlargement with pelvic or abdominal pain.
What happen If I stop taking Clomiphene?
Keep taking Clomiphene until your doctor tells you to stop. If you stop, the treatment may not work. If you have any further questions on the use of this product, ask your doctor or pharmacist. Like all medicines, Clomiphene can cause side effects, although not everybody gets them.
Can Clomiphene cause infertility?
A previous study showed that 87 percent of women who ovulated but failed to conceive with Clomid had an additional cause of infertility such as Adhesions, tubal disease, endometriosis, male factor infertility, or a combination of these factors.
Can Clomiphene affect my heart?
This Clomiphene may cause a condition known as ovarian hyperstimulation syndrome (OHSS). Rarely, serious OHSS causes fluid to suddenly build up in the stomach, chest, and heart area. This may occur during therapy or after treatment has been stopped.
Can Clomiphene affect my liver?
Clomiphene is well tolerated in most patients and rarely induces liver injury.
