clomiphene citrate


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clomiphene citrate (clomifene (UK))

Clomid, 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 folliclestimulating 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.

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.

clomiphene citrate

Clomid® Obstetrics An ovulation-inducing agent–'fertility drug', which acts by releasing gonadotropins from the pituitary; CC ↑ multiple gestations, and ↑ the risk–RR = 2.3 of borderline or invasive ovarian tumors
References in periodicals archive ?
Univariate and multiple logistic regression were used to study the various predictors of non-responsiveness to clomiphene citrate. Receiver operating characteristic (ROC) curve was used to assess the area under the curve (AUC), sensitivity, and specificity of each predictor.
Mathieu et al., "Clomiphene citrate or hMg: which ovarian stimulation to chose before intra-uterine inseminations?
Comparison of metformin and clomiphene citrate therapy for induction of ovulation in the polycystic ovary syndrome.
What is the optimal follicular size before triggering ovulation in intrauterine insemination cycles with clomiphene citrate or letrozole?
Clomiphene citrate resistance together with side effects like multifollicular development and cyst formation are areas of concern.
The recommended first-line treatment for ovulation induction remains the anti-estrogen clomiphene citrate (CC).
Evaluation of clomiphene citrate and human chorionic gonadotropin treatment: A prospective, randomized, crossover study during intrauterine insemination cycles.
Objective: To determine the efficacy of clomiphene citrate therapy in improving seminal parameters of idiopathic oligospermic male partners.
"While confined to a small group in our study, this is of particular concern as clomiphene citrate is now very widely available at low cost, and may easily be used contrary to manufacturers' very specific instructions to avoid use if pregnant, as it may cause fetal malformations.
Average transplantation rate in IVF is 25% Clomiphene Citrate and Gonada Trophin Injection are the two drugs for ovulation.