Clomiphene (Oral)

Used to stimulate the production of ova in women who are not naturally generating their own eggs, clomiphene works by causing an increase in the hormones which grow and trigger the release of eggs.

Overview

One of the most common uses of clomiphene is to help women become pregnant, and the drug assists in this regard by triggering an increase in the hormones which help with ova growth, as well as the release of those ova, so that they can be fertilized. It is most effective when used by women who are still capable of producing their own normal eggs, but for whom egg production is low.

It is not generally recommended for women who no longer produce their own healthy eggs, possibly because of ovarian failure or some other medical condition. The medication comes in a tablet which is to be orally ingested, and for best results should be taken at the same time every day. Its effects on women are very similar to that of estrogen, since both stimulate the growth and release of eggs in healthy women who wish to become pregnant.

Condition Treated

  • Infertility in women, menstrual abnormalities, suppression of lactation

Type of Medicine

  • Ovulatory stimulant

Side Effects

Besides the desired effects of producing more eggs, clomiphene may also be accompanied by some unwanted side effects which vary in their severity from person to person. Some of these can be relatively minor and do not require any kind of medical attention, some are uncomfortable enough that you may need advice from your doctor, and some are severe enough to call for immediate medical action.

It is rare that clomiphene causes any serious side effects in women taking the drug, but there is always a potential for some kind of serious reaction after taking any new drug. It is possible that an individual could be allergic to clomiphene, and this is one of the conditions which would call for immediate medical attention, because the side effects could be extremely severe. Things to look for in an allergic reaction are swelling of the facial area, in or in the lips, mouth, tongue, and throat. Some people will also notice a severe rash or inflammation which develops on the skin immediately after taking clomiphene. If you should observe any of these symptoms after ingesting the drug, go to an emergency room as soon as possible for treatment, and call your doctor.

Below is a list of some of the other possible side effects which may be manifested after taking clomiphene. If you experience any of these side effects which are considered more serious, contact your doctor immediately:

  • style="font-weight: 400;"> shortness of breath or difficulty breathing
  • unexplained weight gain
  • swelling or bloating of the stomach
  • blurry vision, double vision, or other difficulties with your normal vision
  • spots and or flashes which appear before your eyes
  • pain or cramping in the stomach or lower stomach.

The group of side effects below is considered to be somewhat less serious, but you should still contact your doctor immediately if you feel that it's causing you more discomfort than you can handle:

  • 400;">headaches or fevers
  • abnormal vaginal bleeding
  • discomfort in the area of the breasts
  • nausea and/or vomiting
  • persistent upset stomach or cramping in the stomach
  • an unexplained feeling of warmth (flushing).

Clomiphene can also cause a condition which is known as ovarian hyperstimulation syndrome (OHSS). If this condition develops, there is a potential for fluid to rapidly build up in the areas of the heart, chest, or stomach, and this can occur either during your treatment program or in the first days and weeks afterwards. Medical attention should be sought immediately if any of the following symptoms become present:

  • pronounced chest pain
  • an irregular or more rapid than normal heartbeat
  • inflammation, swelling, or pain through the legs
  • difficulty breathing or shortness of breath
  • severe diarrhea
  • nausea and/or vomiting
  • unexplained rapid weight gain
  • extreme swelling and pain in the lower abdomen.

Long-term usage of clomiphene has the potential to increase the possibility of ovarian cancer, and for that reason, it should not be used for any longer than six menstrual cycles. It's always a good idea to discuss with your doctor the potential risks of taking any drug including clomiphene, so those risks can be weighed against the potential desirable effects.

Dosage

A typical adult dosage of clomiphene for the purpose of inducing ovulation would be 50 mg taken orally, once each day for a period of five consecutive days. The optimal time for commencing a program of treatment is either on the fifth day of the menstrual cycle, or as close to it as possible. For patients who have had no recent uterine bleeding, treatment can be started at any time whatsoever.

If it is known that ovulation is triggered by taking clomiphene, but the patient still does not become pregnant, one or two additional treatment cycles of 50 mg per day over a period of five consecutive days may be indicated. In any of these follow-up treatment cycles, the program can be started as soon as 30 days after the previous treatment cycle, and it is known with certainty that pregnancy has not been achieved.

It is typical for most patients being treated with clomiphene to ovulate after the initial course of treatment, but if ovulation is not achieved, it is allowable to increase the dosage to 100 mg per day over five consecutive days. However, this is an option which should be discussed with your doctor, since any increase of the medication can also cause a corresponding increase in any side effects which may be experiencing.

If ovulation has not been achieved through two courses of treatment, a third course of taking 100 mg per day over five consecutive days is still a possibility and is considered safe for patients. If pregnancy and ovulation have not been achieved after three courses of treatment, and the maximum recommended dosage of 100 mg per day has been used without success, it is not advisable to continue with additional cycles of treatment.

The manufacturer of clomiphene recommends against extended use of the drug beyond three cycles, although in specific cases, after consulting with a family doctor such programs of treatment have been successful. For instance, some women have become pregnant after undergoing four or more cycles of treatment, or after being prescribed dosages up to 200 mg for five days, and even for programs of treatment which have extended into 10 days. All these treatment options which exceed manufacturer recommendations should be carefully reviewed with the family doctor.

For women who are attempting to suppress lactation after having become pregnant, it is generally only necessary to take 50 to 100 mg orally over a period of five days. In almost all cases, breast milk is no longer produced after a single five-day treatment program.

Interactions

There are only a few drugs which are known to interact adversely with clomiphene, so the risk is low of any such interactions. However, you should prepare a list of any medications which you are taking, so you can review this with your doctor, and any possible interactions can be avoided. The medications known to interact with clomiphene are as follows:

  • bexarotene
  • ospemifene
  • gonadorelin

Warnings

Before clomiphene is taken, it should be discussed with your doctor if you think you may be allergic to it, or to any of the ingredients used in the manufacture of the drug. In fact, it's a good idea to alert your doctor to the fact of your being allergic to any other medications, pets, or foods, since there is a possibility that inactive ingredients within clomiphene may interact with other substances.

Clomiphene should not be taken if you have existing medical conditions which are known to be impacted by the drug. For instance, you should point out to your doctor if you have ever had ovarian cysts or enlarged ovaries, any kind of abnormal vaginal bleeding, liver disease, brain tumors, problems with your adrenal gland, or thyroid gland issues.

If there is a medical history in your family which involves problems such as uterine fibroids or endometriosis, this should be discussed with your doctor, as well as any history of polycystic ovarian syndrome.

There is a potential when taking clomiphene to increase the likelihood of multiple births because there's greater egg production in the body. If this is of concern to any woman wishing to become pregnant, it should be discussed with the family doctor, since the statistics regarding multiple births are known, and can be considered before taking clomiphene.

One possible reaction to taking clomiphene is that it can make you become dizzy or disoriented and can affect your vision, e.g. blurred vision, double vision, flashes and spots appearing before your eyes. With this being a possibility, it is inadvisable to drive a motor vehicle after taking clomiphene, or to operate any kind of machinery which could cause an accident if you were to lose focus while operating. This also makes it inadvisable to be consuming alcohol around the time that you are taking clomiphene since this can multiply the effects of the medication.

When a woman becomes pregnant, she should immediately stop taking clomiphene. If you suspect you are pregnant, you should at least discontinue the usage of the drug temporarily, until you've had a chance to confirm pregnancy. It is not known with certainty whether clomiphene is passed on to an infant through breast milk, but it is not advisable to take clomiphene while breastfeeding, since it can inhibit the production of breast milk.

Storage

Clomiphene should always be stored in the same container that it came in, and should be tightly sealed against access by children, pets, or anyone in the household is not actually taking the drug. Bathrooms are typically poor locations to store clomiphene, because they have the potential to become very hot and very humid during times of bathing and showering, and these conditions can degrade the effectiveness of the medication.

Instead, clomiphene should be stored at room temperature in an area which is not subject to extremes of temperature or humidity. It is inadvisable to store clomiphene or any other drug in a weekly pill reminder container since these do not have access locks on them to prevent unwanted access by children and others. Any container you use to store clomiphene in should be child-resistant and for extra protection, should be located somewhere well out of the reach of younger children.

If you have any unused medications, they should be disposed of in a proper manner, and that means not just flushed down the sink, or down the toilet. The best way to dispose of unused clomiphene is to surrender it in a medical take-back program so that knowledgeable medical personnel can dispose of it properly. If your area lacks one of these take-back programs, you can consult with your doctor or pharmacist about proper disposal methods. If none of these is convenient or available, you can also check the FDA's website for the safe disposal of medicines.

Summary

Clomiphene is a medication which has been used with great success in helping women ovulate and become pregnant since it stimulates the growth and release of ova in the reproductive system. Treatment is generally only needed for a period of up to three cycles, and it has even been known to increase the likelihood of multiple births. Similar to estrogen in its capabilities, clomiphene is a drug which has very few side effects or interactions with other drugs, and that makes it a very popular choice for women wishing to become pregnant. The medication is also used to suppress lactation, and clomiphene is equally effective at achieving this result.