Clomiphene citrate
Clomiphene citrate (Clomid)
Clomiphene citrate
( KLOH-mih-feen) Clomid Serophene (Rx)

Classification: Ovarian stimulant

Action/Kinetics: Combines with estrogen receptors, thus decreasing the number of available receptor sites. Through negative feedback, the hypothalamus and pituitary are thus stimulated to increase secretion of LH and FSH. Under the influence of increased levels of these hormones, an ovarian follicle develops, followed by ovulation and corpus luteum development. Most women ovulate after the first course of therapy. Further treatment may be inadvisable if pregnancy fails to occur after ovulatory responses. Readily absorbed from the GI tract and excreted in the feces. t 1/2: 5-7 days. Time to peak effect: 4-10 days after the last day of treatment for ovulation.

Uses: To treat ovulatory failure in women desiring pregnancy and whose partners are fertile and potent. Normal liver function and normal levels of endogenous estrogen are necessary criteria to clomiphene use. Therapy is ineffective in clients with ovarian or pituitary failure. Investigational: Male infertility (controversial).

Contraindications: Pregnancy, liver disease or history thereof, abnormal bleeding of undetermined origin. Ovarian cysts or enlargement not due to polycystic ovarian syndrome. Uncontrolled thyroid or adrenal dysfunction, organic intracranial lesion (e.g., pituitary tumor). The absence of neoplastic disease should be established before treatment is initiated.

Special Concerns: Multiple births are possible.

Side Effects: Ovarian: Ovarian overstimulation and/or enlargement and subsequent symptoms resembling those of PMS. Ophthalmologic: Blurred vision, spots, or flashes, probably due to intensification of after images. Although cause and effect have not been established, the following have been noted in users of clomiphene: posterior capsular cataract, detachment of the posterior vitreous, spasm of retinal arteriole, and thrombosis of temporal arteries of retina. GI: Abdominal distention, pain, bloating, or soreness; N&V.; GU: Abnormal uterine bleeding, breast tenderness, increased urination. CNS: Insomnia, nervousness, headache, depression, fatigue, lightheadedness, dizziness. Other: Hot flashes, allergic dermatitis, urticaria, weight gain, alopecia (reversible).

Laboratory Test Alterations: Serum thyroxine, thyroxine-binding globulin, BSP retention.

How Supplied: Tablet: 50 mg

Dosage
?Tablets First course.
50 mg/day for 5 days. Therapy may be initiated at any time in clients who have had no recent uterine bleeding.
Second course.
Same dosage if ovulation has occurred. In absence of ovulation, dose may be increased to 100 mg/day for 5 days. This course may be started as early as 30 days after the previous one.
Third course.
Most clients who are going to respond will do so during the first course of therapy. Three courses are an adequate therapeutic trial. If ovulatory menses has not occurred, reevaluate diagnosis.