Formulary
Clomifene citrate: Indications, Dosing, Side Effects and Interactions
Anti-oestrogen which induces gonadotrophin release by occupying oestrogen receptors in the hypothalamus, thereby interfering with feedback mechanisms;...
MedNext Academy | 3 min read
Clomifene citrate: Indications, Dosing, Side Effects and Interactions
Anti-oestrogen which induces gonadotrophin release by occupying oestrogen receptors in the hypothalamus, thereby interfering with feedback mechanisms;...
Drug action
Anti-oestrogen which induces gonadotrophin release by occupying oestrogen receptors in the hypothalamus, thereby interfering with feedback mechanisms; chorionic gonadotrophin is sometimes used as an adjunct.
Indications and dose
**Female infertility due to ovulatory dysfunction**
- **Adult** (By Mouth): (female) 50 mg once daily for 5 days, to be started at any time if no recent uterine bleeding or on or around the fifth day of cycle if progestogen-induced bleeding is planned or if spontaneous uterine bleeding occurs, then 100 mg once daily if required for 5 days, this second course to be given at least 30 days after the first course, only in the absence of ovulation; most patients who are going to respond will do so to first course, 3 courses should constitute adequate therapeutic trial; long-term cyclical therapy not recommended (beyond a total of 6 cycles).
Cautions
Ectopic pregnancy; incidence of multiple births increased; ovarian hyperstimulation syndrome; polycystic ovary syndrome (cysts may enlarge during treatment, also risk of exaggerated response to usual doses); uterine fibroids
Contraindications
Abnormal uterine bleeding of undetermined cause; hormone-dependent tumours; ovarian cysts
Side effects
Frequency not known Abdominal distension; alopecia; angioedema; anxiety; breast tenderness; cataract; cerebral thrombosis; depression; disorientation; dizziness; fatigue; headache; hot flush; hypertriglyceridaemia; insomnia; jaundice cholestatic; menstrual cycle irregularities; mood altered; nausea; neoplasms; nervous system disorders; optic neuritis; ovarian and fallopian tube disorders; palpitations; pancreatitis; paraesthesia; psychosis; seizure; skin reactions; speech disorder; stroke; syncope; tachycardia; uterine disorders; vertigo; vision disorders; visual impairment (discontinue and initiate ophthalmological examination); vomiting
Pregnancy
Possible effects on fetal development.
Breast feeding
May inhibit lactation.
Hepatic impairment
Manufacturer advises avoid in liver disease or history of liver dysfunction.
Medicinal forms
Clinical governance
**Author:** MedNext Clinical Team. **Clinical reviewer:** Dr Shameer Deen, MBBS, MS, MRCS. **Sources:** BNF, Indian Pharmacopoeia, CIMS India. **Correction:** Report errors at support@mednext.academy.
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