Clomiphene

 

Ingredients

Active ingredients: Clomiphene citrate

Non active: Corn starch, lactose, magnesium stearate, pregelatinized cornstarch, and sucrose.

 

Indications

Clomid is a fertility drug for woman who want to get pregnant but suffer from ovulatory dysfunction and other conditions: polycystic ovary syndrome, ovarian hyperstimulation syndrome, amenorrhea-galactorrhea syndrome, psychogenic amenorrhea, post-oral-contraceptive amenorrhea, and certain cases of secondary amenorrhea of undetermined etiology. It may also be used in cases of unexplained infertility, or when a couple prefers not to use the more expensive and invasive fertility treatments.

 

How It Works

Clomid is a selective estrogen receptor modulator (SERM) that increases production of gonadotropins. Clomid works by competing with the estrogen receptors at the hypothalamus. Clomid occupies receptors and makes it seem like estrogen levels are low. This "competing" action causes the hypothalamus to produce more Gonadotropin releasing hormones, stimulating the pituitary to increase production of follicle stimulating hormone. Clomid is known to jumpstart ovulation in 80% of patients, and about 40% to 45% of women using Clomid will get pregnant within six cycles of use.

 

Dosage

Oral Tablet (25 mg, 50 mg, 100 mg)

Initial Dosage: The most common dosage of Clomid is 50 mg, taken for five days, on days 3 through 7 of your cycle, or days 5 through 9 of your cycle. (With day one of your cycle being the first day of real menstrual bleeding, and not just spotting.) The dose should be increased only in those patients who do not ovulate in response to cyclic 50 mg Clomid, sometimes your doctor will recommend trying the 50 mg dosage treatment several times before switching to a higher dose.

 

If progestin-induced bleeding is planned, or if spontaneous uterine bleeding occurs prior to therapy, the regimen of 50 mg daily for 5 days should be started on or around the 5th day of the cycle. Patients should be evaluated carefully to exclude pregnancy, ovarian enlargement, or ovarian cysts. Once ovulation has begun to occur, the dosage should be maintained, there is no advantage to increasing the dose in subsequent cycles of treatment and dosage should not exceed 150 mg. If ovulation does not appear to occur after trying a 50 mg course of therapy, a 100 mg daily (two 50 mg tablets given as a single daily dose) for 5 days should be given, started 30 days after the initial dosage.

 

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Precautions

Clomid is contraindicated in patients with a known hypersensitivity or allergy to Clomiphene citrate or to any of its ingredients, pregnant, abnormal uterine bleeding of undetermined origin, in patients with ovarian cysts or enlargement not due to polycystic ovarian syndrome. Be advised that there is the potential of blurring vision and other strange visual symptoms like spots and flashes that may occur while you are on this medication. These symptoms with usually clear up on their own. If experiencing vision problems operating a car or any machinery is extremely hazardous; Intense physical activity should be avoided.

 

Ovarian hyper-stimulation syndrome (OHSS) has been reported in patients on Clomiphen Citrate therapy. Clinical signs of this syndrome may include: gastrointestinal symptoms, ascites, dyspnea, oliguria and excessive fluid that accumulates in the pleura (space that surrounds the lungs), hepatic dysfunction has also been associated with ovarian hyperstimulation syndrome.

 

Patients should have adequate levels of endogenous estrogen (as estimated from vaginal smear) endometrial biopsy assay of urinary estrogen, or from bleeding in response to progesterone. Reduced estrogen levels, while less favorable, do not preclude successful therapy. Clomid therapy cannot be used to treat conditions relating to ovulatory failure.

other possible impediments to pregnancy may include: thyroid problems, adrenal gland problems, high levels of prolactin in the blood, and male factor infertility. Caution should be exercised when using Clomid in patients with uterine fibroids due to the potential for further enlargement of the fibroids.

 

To minimize the hazard associated with occasional abnormal ovarian enlargement associated with Clomid therapy, the lowest dose consistent with expected clinical results should be used. If enlargement of the ovary occurs treatment should be stopped and a review conducted by doctor. Examination is important before begining each Clomid treatment, consult your doctor.

 

The incidence of multiple pregnancy (including twins, triplets, quadruplets, and quintuplets) can be up to 10 times greater when conception occurs during a cycle in which clomiphene therapy is taken. There is an however an increased chance of the baby developing in one of the fallopian tubes instead of in the uterus) in women who conceive following Clomiphene therapy. It is important to have an early ultrasound to ensure that the baby is developing inside the uterus.

clomid should never be administered to woman who are already pregnant, this may harm the unborn child.

 

There have been reports of fetal abnormalities with Clomid in less than 1% of cases: lesions, down sydrome, club foot, congenital gut lesions,hyposspasia, harelip and cleft palate, congenital hip, undescended testicles, polydactyl, conjoined twins and teratomatous, malformation, patentductus arteiosus, amaurosis, arteriovenous fistula, inguinal hernia, umbilical hernia, syndactyly pectus excavatum, myopathy dermoid cyst of scalp, omphalocele, icthyosis, persistent lingual frenulum, neonatal death, still birth and fetal death have been reported in rare instances.

 

Adverse/Side Effects

Contact you doctor should you experience these common side effects and they persist and or become bothersome; breast discomfort, depression, dizziness or lightheadedness, headache, heavy menstrual periods or bleeding between periods, hot flashes, nausea or vomiting (not severe or continuing), nervousness, restlessness, tiredness, or trouble sleeping.

 

Check with your doctor as soon as possible if any of the following uncommon side effects occur: blurred vision, double or decreased vision, or other vision problem, occurrences of "flashes of light", sensitivity of eyes to light, symptoms of liver problems (yellow eyes or skin, abdominal pain, poor appetite, dark urine, or pale stools).

 

If you experience the following rare side effects contact a doctor immediately: Stop taking the medication and seek immediate medical attention if any of the following occur: symptoms of ovarian hyperstimulation syndrome (difficulty breathing, abdominal or pelvic pain or discomfort, bloating, nausea, vomiting, diarrhea, decreased amount of urine, rapid weight gain) symptoms of a severe allergic reaction (shortness of breath, swelling of the face or throat, or hives)

 

Long term use of Clomid may increase the risk of ovarian cancer.

 

Drug Interactions

Tell your doctor  about all non-prescription and prescription drugs as well as all herbal medications that you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, and nicotine from cigarettes can affect the action of many medications, you should let your doctor know if you use them. 

 

Overdose

In case of overdose immediately seek medical attention. Symptoms include: nausea, vomiting,vasomotor flushes, visual blurring, spots or flashes, scotomata, ovarian enlargement with pelvic or abdominal pain.

 

Storage Instructions

Store tablets at controlled room temperature 59-86°F (15-30°C). Protect from heat, light, and excessive humidity, and store in closed containers. Always keep medication away from pets and children.

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