Clomid

Clo·mid (klmd)

A trademark for the drug clomiphene.

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Clomid,

trademark for a nonsteroidal fertility drug (clomiphene citrate).

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clomiphene citrate (clomifene)

Clomid, Milophene, Serophene

Pharmacologic class: Chlorotrianisene derivative

Therapeutic class: Fertility drug, ovulation stimulant

Pregnancy risk category X

Action

Binds with estrogen receptors in cytoplasm, increasing secretion of follicle-stimulating hormone, luteinizing hormone, and gonadotropin in hypothalamus and pituitary gland. These actions induce ovulation.

Availability

Tablets: 50 mg

⊘Indications and dosages

➣ Ovarian failure

Adults: 50 mg/day P.O. for 5 days starting any time in patients with no recent uterine bleeding; or 50 mg/day P.O. starting on fifth day of menstrual cycle. If ovulation doesn't occur, increase to 100 mg/day P.O. for 5 days. Start next course of therapy as early as 30 days after previous course. If patient doesn't respond after three courses, no further doses are recommended.

Off-label uses

• Male sterility (controversial)

Contraindications

• Hepatic disease
• Organic intracranial lesions
• Uncontrolled thyroid or adrenal dysfunction
• Ovarian cyst
• Abnormal uterine bleeding or bleeding of undetermined origin
• Pregnancy

Precautions

None

Administration

• Obtain pregnancy test before therapy begins.
• Be aware that patient should undergo pelvic and eye examinations before starting therapy.

Route	Onset	Peak	Duration
P.O.	5-8 days	Unknown	6 wk

Adverse reactions

CNS: nervousness, insomnia, dizziness, light-headedness

CV: vasomotor flushing

EENT: visual disturbances

GI: nausea; vomiting; abdominal discomfort, distention, and bloating

GU: breast tenderness, ovarian enlargement, multiple pregnancies, birth defects in resulting pregnancies, ovarian hyperstimulation syndrome, uterine bleeding

Interactions

None significant

Patient monitoring

• Monitor patient for bleeding and other adverse reactions.

Patient teaching

☞ Instruct patient to immediately report signs and symptoms of ovarian hyperstimulation syndrome, including nausea, vomiting, diarrhea, abdominal or pelvic pain, and swelling in hands or legs.
• Tell patient to report bleeding.
• Advise patient not to take drug if she is or may become pregnant.
• Inform patient that drug increases risk of multiple births, which heightens maternal risk.
• As appropriate, review all other significant and life-threatening adverse reactions.