Indications
- Clomiphene citrate is chiefly indicated for the treatment of ovulatory failure in female patients who wish to become pregnant. This therapy will not be successful unless the patient though unovulatory, is capable of ovulation & her partner is fertile.
- Polycystic ovary syndrome.
- Menorrhagia caused by hyperplastic endometrium.
- Amenorrhea with galactorrhea syndrome.
- Psychogenic amenorrhea syndrome.
- Secondary amenorrhea of unknown cause.
- Amenorrhea during post oral contraceptive period.
Dosage & Administration
For the treatment of ovulatory failure: 50 mg (1 tab) daily for 5 days, starting within about 5 days of onset of menstruation (or may be from the 1st day of menstruation). If this dose induces ovulation there is no need to increase the dose in the following courses. If this dose induces ovulation but not pregnancy, stimulation with Clomiphene citrate is to be continued up to 6 stimulative courses. If the1st course does not induce ovulation, 2nd dose of Clomiphene citrate is100 mg (2 tab at a time) daily for 5 days is recommended. Minimum 3 & maximum 6 simulative courses should constitute an adequate therapeutic trial. However, if menstrual bleeding does not occur, the patient should be examined carefully for the possible pregnancy & the next course should be delayed until correct diagnosis has been determined. The modern studies reveal that ultrasonographic monitoring for ovulation is most preferable.
For other indications: The recommended dose for other gynaecological problems is 50 mg (1 tab) for 5 days, starting from the 5th day of menstruation or according to the physician\\\\\\\\’s recommendation, but never more than 6 cycles in total.
Side Effects
Clomiphene citrate is well tolerated. However a few side effects like dizziness, headache, nausea, vomiting, depression, fatigue, insomnia, vasomotor flushing, and allergic reaction may occur. Rarely ovarian enlargement & cyst formation may occur. All these effects disappear promptly after the treatment is discontinued. There is a minimal chance of multiple pregnancies, about which the patient should be warned.
Precautions
Clomiphene citrate should be used with caution in the following conditions: longer maintenance therapy, with alcoholic drinks & antidepressants.
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Contraindications
Clomiphene citrate is contraindicated during pregnancy, in patients with liver diseases, ovarian cysts, bleeding of undetermined origin, patients with neoplasm of endometrium.
Use in Pregnancy & Lactation
Pregnancy: Not recommended in pregnancy.
Nursing mother: 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.
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