Ovulation induction, Female infertility, Polycystic ovary syndrome, Amenorrhea-galactorrhea syndrome, Psychogenic amenorrhea Clomiphene citrate is contraindicated during pregnancy, in patients with liver diseases, ovarian cysts, bleeding of undetermined origin, patients with neoplasm of endometrium, hypersensitivity; abnormal bleeding; lactation; uncontrolled thyroid or adrenal dysfunction, patient with an organic intracranial lesions such as pituitary tumor.

Drugs for Infertility

Clomiphene has mainly antiestrogenic effects and some estrogenic effects. The mechanism in stimulating ovulation is unknown but is believed to be related to its antiestrogenic properties. By clomiphene competing with estrogen for binding sites at the hypothalamic level, the gonadotropins, follicle-stimulating hormone (FSH) and luteinizing hormone (LH), secretion is increased, which results in ovarian follicle maturation, followed by the preovulatory LH surge, ovulation, and the subsequent development of the corpus luteum. Usefulness in male infertility is also likely related to the increases in FSH and LH secretion.

Administration: May be taken with or without food. Adult Dose: Oral Anovulatory infertility Adult: 50 mg daily for 5 days starting on the 5th day of menstrual cycle or at any time if there is amenorrhoea. If ovulation does not occur, a 2nd course of 100 mg for 5 days may be used commencing as early as 30 days after the previous therapy. Further treatment may not be recommended if pregnancy has not occurred after a total of 6 treatment cycles.

Decreased response with danazol.

Clomiphene citrate is contraindicated during pregnancy, in patients with liver diseases, ovarian cysts, bleeding of undetermined origin, patients with neoplasm of endometrium, hypersensitivity; abnormal bleeding; lactation; uncontrolled thyroid or adrenal dysfunction, patient with an organic intracranial lesions such as pituitary tumor.

>10% Ovarian enlargement (14%),Vasomotor flushing (10%) 1-10% Abdominal discomfort (6%),Blurred vision (1.5%),Breast discomfort (2%),Nausea/vomiting (2%)

This is not recommended in pregnancy. In some cases Clomiphene citrate may reduce lactation, if it is administered to a woman during lactating period. So it should be avoided during lactational period.

Precaution: Clomiphene citrate should be used with caution in the following conditions: longer maintenance therapy, with alcoholic drinks & antidepressants. Polycystic ovaries, evaluate presence of ovarian cyst before each cycle treatment. Uterine fibroids; visual disturbances may develop which will impair ability to drive or operate machinery. There is a minimal chance of multiple pregnancies, about which the patient should be warned. Lactation: It is not known whether clomiphene is excreted in human milk. Use with caution in nursing women. In some patients, clomiphene may reduce lactation.

No such effects of acute over dosage of Clomiphene citrate have been reported. However, in case of over dosage, a few sign symptoms of nausea, vomiting, vasomotor flushes, scotoma, and ovarian enlargement with pelvic or abdominal pain may occur. In the event of over dosage appropriate supportive measures should be employed.

Clomiphene Citrate tablet should be stored below 25° C and protected from light & moisture.

Drugs for Infertility

Clomifene inhibits the negative feedback mechanisms of oestrogens in the hypothalamus and pituitary which stimulates the secretion of pituitary gonadotrophic hormones resulting in stimulation of ovulation.

Pregnancy Use in pregnant women is contraindicated, as treatment does not offer benefit in this population; to avoid inadvertent administration during early pregnancy, appropriate tests should be utilized during each treatment cycle to determine whether ovulation and/or pregnancy occurs; patients should be evaluated carefully to exclude ovarian enlargement or ovarian cyst formation between each treatment cycle; the next course of therapy should be delayed until these conditions have been excluded Available human data from epidemiologic studies do not show apparent cause and effect relationship between clomiphene citrate periconceptual exposure and an increased risk of overall birth defects, or any specific anomaly Lactation It is not known whether drug is excreted in human milk; because many drugs are excreted in human milk, caution should be exercised if drug is administered to a nursing woman; in some patients, therapy may reduce lactation