Clomiphene Citrate

Classification

Non-steroidal, anti-estrogen ovulation stimulation

Brand Names

Clomid ® (mfg. Hoescht Marion Roussel), Serophene ® (mfg. Serono), Milophene ® (mfg. Milex)

Form

Small, 50mg tablet

Indications

Demonstrated ovulatory dysfunction (in women) or (in men) Primary hypogonadotropic hypogonadism with:

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  • no current pregnancy
  • no current ovarian cysts
  • no abnormal vaginal bleeding
  • no fibroid tumors
  • normal liver function

Used for

  • Women - Inducing ovulation.
  • Men - Inducing sperm production.

How does it work?

Interacts with estrogen-receptor-containing tissues, such as the hypothalamus, pituitary, ovary, endometrium, vagina, and cervix. Initiates a series of hormonal messages, starting in the brain, resulting in a surge of reproductive hormones before ovulation and subsequent rupture of ovarian follicle, or in men, in the production of testosterone and more sperm.

Suggested Evaluations

Pre-RX

  • existence of current pregnancy
  • ovarian enlargement or cyst formation
  • estrogen levels
  • primary pituitary or ovarian failure
  • endometriosis or endometrial carcinoma
  • uterine fibroids

During RX

  • mid-cycle urine LH test (OPK)
  • mid-cycle ultrasound to detect follicle development
  • estrogen level

Usual Dosage

One (1) 50 mg. tablet daily for 5 days. If no ovulation occurs, increase to two (2) 50 mg. tablets (100 mgs. total) daily for 5 days. There are mixed recommendations on dosages beyond 100 mgs. daily.
The dose of clomiphene will be different for different patients. Follow doctor's instructions explicitly.

Instructions

Count the first day of your menstrual period as Cycle Day 1. Beginning on the cycle day prescribed by doctor, take the correct dose every day for as many days as your doctor ordered. To help you to remember to take your dose of medicine, take it at the same time every day. If you miss a dose of this medicine, take it as soon as possible. If you do not remember until it is time for the next dose, take both doses together; then go back to your regular dosing schedule. If you miss more than one dose, check with your doctor.

Common side effects

  • Hot flashes
  • Cervical mucus thickening
  • Thinning of uterine lining
  • Nausea
  • Headache
  • Emotional irritability
  • Breast discomfort
  • Fatigue
  • Sleep disturbances
  • Dizziness or lightheadedness

Side effects to report to your doctor

  • Blurred vision or other vision changes
  • Extreme pelvic or abdominal bloating sensation or pain

Precautions

  • Category X: If taken during pregnancy, may cause birth defects.
  • Use warrants appropriate monitoring via blood labs and ultrasound by trained professional.
  • Relatively low incidence of multiple pregnancy.
  • Exercise caution if nursing during use. May stop breastmilk production.
  • Prolonged use may increase risk of borderline or invasive ovarian cancer.

Drug interactions or incompatibility

No known drug interactions


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