CLOMIFENE

Anti-oestrogen ovulation inducer which induces gonadotrophin release by occupying oestrogen receptors in the hypothalamus

Dosage Forms

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Tablet

50 mg

Uses

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  • Female infertility due to disturbances in ovulation

Dose and Duration

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Female infertility due to disturbances in ovulation
Adult:50 mg once daily for 5 days starting within 5 days of onset of menstruation preferably on the 2nd day. May be started at any time if menstruation cycles have ceased In the absence of ovulation, a second course of 100 mg once daily for 5 days may be given (see caution)

Contraindications

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  • Hepatic disease or history of hepatic dysfunction
  • Ovarian cysts
  • Hormone dependent tumours
  • Uterine bleeding of undetermined cause

Side Effects

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  • Visual disturbances
  • Ovarian hyper stimulation, hot flushes, breast tenderness, menstrual spotting, menorrhagia, endometriosis
  • Abdominal discomfort, nausea and vomiting
  • Depression, insomnia, dizziness, headache, convulsions
  • Weight gain
  • Rash
  • Hair loss

Pregnancy

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  • Do not use

Breastfeeding

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  • Do not use

⚠️ Caution

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  • Most patients respond to the first course. Long term cyclical therapy (more than 6 cycles) may increase risk of ovarian cancer
  • Discontinue treatment and initiate eye examination if visual disturbances occur
  • Discontinue treatment immediately if ovarian hyperstimulation syndrome occurs
  • In patients with polycystic ovary syndrome, cysts may enlarge during treatment
  • Risk of uterine fibroids, ectopic pregnancy and incidence of multiple births may be increased
  • TAvoid use of clomifene in severe liver disease
  • Use of clomifene in breast- feeding may inhibit lactation