Estrogens, progestins; antagonists, and their homologs
E28.2 – polycystic ovary syndrome
E29.1 – Testicular hypofunction
N46. – Male infertility
N91. – The absence of menstruation, scanty and rare menstruation
N91.1 – Secondary amenorrhea
N93. – Other abnormal bleeding from the uterus and vagina
N97. – Female infertility
O92.6 – galactorrhea
The composition and the form of the drug issue
Tablets 1 tab.
Clomiphene citrate 0.05 g
Other ingredients: milk sugar (lactose), potato starch, gelatin food, magnesium stearate, talc
in blisters or in the bank 10 pcs .; In the paper cartons 1, 2, 3, 4 or 10 packs or one bank.
Description of the dosage form from the manufacturer
Tablets white or white with Valium a color shade, Valium forms, with a facet.
The pharmacological action of the drug
Mode of action – anti-estrogen.
If ingestion is well absorbed from the gastrointestinal tract. It is metabolized in the liver. Treated enterohepatic recirculation. T 2.1 – 7.5 days. It is shown mainly in the bile.
Nonsteroidal antiestrogen structure, the effect of which is caused by specific binding to the estrogen receptors of the ovaries and the pituitary. In small doses, it increases the secretion of gonadotropins: prolactin, FSH and LH. It stimulates ovulation. At a low content in the body of estrogen hormones exhibits moderate estrogenic effect. At a high content of estrogen has anti-estrogenic effects. In large doses slows secretion of gonadotropins. Progestogens, and androgen activity is not.
Indications for use of the drug
anovulatory infertility (ovulation induction),
amenorrhea (disgonadotropnaya form); secondary amenorrhea; postkontratseptivnaya amenorrhea,
galactorrhea (on the background of pituitary tumor);
polycystic ovary syndrome (Stein-Leventhal syndrome);
diagnosis disorders pituitary gonadotrophic function.
Contraindications specified by the manufacturer
liver and / or kidney failure,
metrorrhagia of unknown etiology,
malignant and benign neoplasms of genital organs,
tumor or hypofunction of the hypophysis,
ovarian failure on the background of hyperprolactinemia;
the propensity to thrombosis,
hemorrhage, non-infringement of ovulation,
Pregnancy and breast-feeding
Contraindicated during pregnancy.
Side effects when applying
From the nervous system: dizziness, headache, sleepiness, slowing of mental and motor reactions, depression, irritability, insomnia.
From the digestive system: nausea, vomiting, gastralgia, flatulence, diarrhea.
Allergic reactions: seldom – rash, allergic dermatitis , vasomotor disturbances.
From the urogenital system: rarely – polyuria, frequent urination, lower abdominal pain, dysmenorrhea, menorrhagia, increased ovarian size (including cystic).
Other: weight gain, flushing, rarely – reduction visual acuity, alopecia, pain in the breast.
The appearance of symptoms of ovarian hyperstimulation, and common side effects require dose reduction or discontinuation of the drug.
Interactions with drugs
Compatible with drugs gonadotropins.
Overdose at reception
Symptoms: Nausea, vomiting, flushing, blurred vision.
Treatment: removal of the drug (overdose symptoms disappear on their own).
Dosing and dose
to stimulate ovulation administered at 50 mg 1 time per day at bedtime, starting with day 5 of the menstrual cycle, for 5 days (in the absence of the cycle – at any time). If there is no effect (ovulation does not develop within 30 days) increase the dose to 150 mg / day or lengthen the course to 10 days. Heading dose should not exceed 1 g ovulation development is determined by the presence of a biphasic basal body temperature, the Buy clomiphene citrate average cyclical increase in production of LH, increased serum progesterone during the luteal phase of the likely medium or menstruation women with amenorrhea. If ovulation occurs and pregnancy is not, it should be repeated reception of the same dose of the next treatment course. If after ovulation probably held was no menstrual bleeding, you should take into account the possibility of pregnancy, and before a new course of treatment is necessary to eliminate this possibility.
Men are appointed to 50 mg 1-2 times a day for 3-4 months (requires systematic monitoring of semen) .
Special instructions for use
It increases the chance of a multiple pregnancy.
The drug is effective when a sufficient level of endogenous estrogen, is less effective at low levels of estrogen and practically ineffective at a low concentration of gonadotropic pituitary hormones. In the course of treatment must be continued monitoring gynecologist should monitor ovarian function, vaginal studies, watch the phenomenon of “pupil.”
In the period of treatment must be careful when driving and occupation of other potentially hazardous activities that require high concentration and psychomotor speed reactions.
Clomiphene citrate: user manual, application reviews
“Clomiphene” – a stimulant gonadotropins products agent having estrogen and anti-estrogen activity. The preparation consists of the active ingredient of clomiphene citrate and auxiliary components.
Mode of action and pharmacokinetics
Means a non-steroidal structure, its action is achieved through specific binding to estrogen receptors of the pituitary and hypothalamus, thereby increasing gonadotropin secretion of pituitary hormones. As a consequence, stimulated the maturation and endocrine activity of follicle in the ovary, formed by the corpus luteum and provides support for its life. Use of high doses of the drug leads to inhibition of gonadotropin secretion.
The drug is absorbed quickly and well from the gastrointestinal tract, undergoes enterohepatic recycling and metabolism in the liver. The main part excreted in the feces (42%), small – with urine (about 8%).
Indications for use of the drug “Clomiphene”
The drug “clomiphene citrate” is shown with such problems:
- anovulatory infertility;
- oligospermia in men;
- hypofunction of the testicles;
- Stein-Leventhal syndrome, polycystic ovary disease is manifested;
- Chiari-Frommelya syndrome;
- functional uterine bleeding;
- androgen deficiency;
- galactorrhea as a consequence of pituitary tumors;
- expressed oligomenorrhea;
- amenorrhea (disgonadotropnaya, postkontratseptivnaya, secondary).
With “Clomiphene” diagnose diseases of the endocrine system.
- hypersensitivity to an active substance;
- pregnancy, suspected pregnancy, lactation;
- failure of the pituitary gland;
- tumors of the pituitary and reproductive organs (benign and malignant nature);
- blurred vision;
- uterine bleeding of unknown etiology;
- the tendency to form blood clots;
- violation of ovarian function, which is a consequence of hyperprolactinemia;
- ovarian cysts;
- severe renal and hepatic insufficiency.
The use of the drug, the dosage
Admission is carried out taking into account the drug problem, which is to eliminate clomiphene citrate. Guide contains detailed information on the use of funds for the treatment of various diseases. “Clomiphene” is intended for ingestion, it is taken regardless of meals.
Every day before going to sleep take 50 mg of the drug. The five-day course of treatment start on the fifth day of the menstrual cycle. In the absence of treatment cycle performed at any time.
In the absence of the desired effect (for 30 days, ovulation has not occurred) the treatment is repeated, but the dosage was increased to Clomid Anfarm (12 tab.) (clomiphene citrate) of drug per day increases the rate or duration of up to ten days. The amount received for the entire course of medication should not exceed 1 g
Checking ovulation by means of ultrasound, by the presence of a biphasic basal body temperature, increased production of LH, increased content of serum progesterone during the luteal possible (the third phase) or presence of menstruation in women with amenorrhea.
If after taking the drug, containing clomiphene citrate, women’s health has improved, and there was ovulation but no pregnancy, appoint another cure with the same dose. If after ovulation menstruation is not doing a pregnancy test. Prior to re-treatment course as a mandatory rule out the chance of pregnancy.
In the case of missing reception “Clomiphene” it is necessary to visit the doctor. During therapy and prior to the start of required monitoring gynecologist, conducting research and testing of vaginal ovaries work.
In identifying their increasing presence of cystic or transformation treatment should be stopped as long as the ovaries do not acquire the former size, and then continue the course with minimal doses of medication or reducing the duration of therapy.
Treatment of male infertility
If oligospermia patients are often prescribed therapy with agents such as clomiphene citrate. For men it is an effective method for the treatment of infertility. Its application is necessary in cases when not able to identify the cause of such a condition. In the treatment it is important to take into account the state of women’s health.
Men to eliminate sterility prescribed course “Clomiphene” duration of 3-4 months. The dose of drug to achieve therapeutic effect of 50 mg. Receiving means is performed 1-2 times per day. Use of the drug is accompanied by constant supervision of the content of blood hormones, increasing testosterone levels as a negative impact on spermatogenesis.
In the treatment of women and men periodically check liver function, during which doctors determine the effect on the body of clomiphene citrate. Men are further subjected to such a procedure, as a systematic control of semen in order to understand what is the outcome of therapy.
Possible side effects
Many drugs have side effects. In “Clomiphene” they are:
- allergic (vasomotor disturbances, allergic dermatitis, rash);
- fatigue, drowsiness; depression;
- mental retardation and motor responses;
- headache, dizziness;
- irritability, restlessness;
- nausea, flatulence, gastralgia;
- vomiting, diarrhea;
- blurred vision;
- increasing the size of the ovaries, cyst formation;
- multiple pregnancy;
- pain in the abdomen, chest, appendages, men – in the testicles;
- weight gain;
- reversible hair loss;
- alopecia (slight, reversible);
- frequent urination.
Due to the large number of side effects, which has clomiphene citrate, the use of this tool should only be prescribed by a doctor. If any adverse reactions doctor reduces the dose or appoint another drug.
The product is suitable only for those women who have preserved ovarian function, and there are no contraindications for pregnancy.
If any side effects of the adjustment of the dosing – a prerequisite for further treatment.
“Clomiphene” effect on the ability to drive vehicles and mechanisms, so it is not indicated for patients whose work requires quick psychomotor reactions and attention.
Compatibility with other drugs
Clomiphene citrate is compatible with preparations of gonadotropins, its interactions with other drugs are not currently installed.
The use of “Clomiphene”: reviews
“Clomiphene” – a potent tool with a lot of side effects. But for some couples taking this medication – the only chance to have a Terpafen 50 (clomiphene citrate) complete family. The most common use of clomiphene citrate women. In a review of the drug, many of them often point to such side effects as multiple pregnancy. It mentioned about the negative impact of increased estrogen levels in the embryos.
Responses vary, ie. A. On the body of every human medicines can affect different, due to the individual characteristics. Basically, the use of “Clomiphene” resorted to in extreme cases, when the effectiveness of other agents have no hope.
A woman can successfully give birth to a child after undergoing a course of therapy with this drug, but its re-use is less effective or not at all helpful.
It is not always possible to get the desired effect of the treatment, which is based on clomiphene citrate. Reviews of therapy is different, which is quite understandable, because the same drug may not help everyone.
“Clomiphene” has a large number of analogues. Structural (active substance) include the following medicaments: “Serpafar” “Serofen” “Clomid” “Clomid”. List of analogues of the drug for pharmacological group can cure female infertility include: “abergin”, “Buserelin” Buserelin Long FS “and” Buserelin Depot “,” Bromergon “,” bromocriptine “,” Bilem “,” Gonadotropin Chorionic ” (means for injection), “Djufaston” “Diferelin” “Dekapeptil” “Danol” “Danodiol” “Danazol,” “Clomid” “Clomid” “Luveris” “Metov” “Menopur “” menogon “” Mastodinon “” Non ovlon “” Novofen “” Orgalutran “” Puregon “” Pregnil “” Pyrogenalum “” Pergonal “” Sinestrol “” Serpafar “” Tamoxifen ” “Humegon” “Horagon” “Ethinylestradiol” “Egestrenol”.
When infertility treatment is effective not only clomiphene citrate. Analogs of the drug have a similar effect and can be used for the same purpose.
“Clomiphene” – a drug that has a significant impact on the human body. His administration may lead to undesirable consequences. This medicine is used only on prescription, which examines the state of health of the patient, takes into account the peculiarities of his body and possible risks.