Clomiphene citrate: instructions, application, reviews
"Clomiphene" is a stimulator of gonadotropin production, an agent with estrogenic and anti-estrogenic activity. The drug consists of the active substance clomiphene citrate and auxiliary components.
Pharmacological action and pharmacokinetics
The tool has a nonsteroidal structure, its action is achieved through specific binding to the estrogen receptors of the pituitary and hypothalamus, resulting in increased secretion of gonadotropic hormones of the pituitary. As a result, the maturation and endocrine activity of the follicle in the ovary is stimulated, the corpus luteum is formed and support for its vital activity is provided. The use of the drug in high doses leads to inhibition of the secretion of gonadotropins.
The drug is well and quickly absorbed in the gastrointestinal tract, undergoes enterohepatic recirculation and metabolism in the liver.The main part of it is excreted from the body with feces (42%), insignificant - with urine (about 8%).
Indications for use of the drug "Clomifen"
The drug "Clomiphene citrate" is indicated for such problems:
- anovulatory infertility;
- oligospermia in men;
- hypofunction of the testes;
- Stein-Leventhal syndrome, manifested by polycystic ovaries;
- Chiari-Frommel syndrome;
- functional uterine bleeding;
- androgen deficiency;
- galactorrhea as a consequence of pituitary tumors;
- pronounced oligomenorrhea;
- amenorrhea (dysgonadotropic, post-contraceptive, secondary).
With the help of "Clomiphene" produce a diagnosis of diseases of the endocrine system.
- hypersensitivity to the active substance;
- pregnancy, suspected pregnancy, lactation;
- lack of pituitary function;
- tumors of the genital and pituitary (benign and malignant);
- visual impairment;
- uterine bleeding of unknown etiology;
- propensity to form blood clots;
- ovarian dysfunction resulting from hyperprolactinemia;
- ovarian cysts;
- severe forms of renal and hepatic failure.
Drug administration dosage
The medication is carried out taking into account the problem that clomiphene citrate should eliminate. The manual contains detailed information on the use of products for the treatment of various diseases. "Clomiphene" is intended for ingestion, it is taken regardless of the meal.
Stimulation of ovulation
Every day before bedtime take 50 mg of the drug. A five-day course of treatment begins on the fifth day of the menstrual cycle. In the absence of a cycle, therapy is carried out at any time.
In the absence of the desired effect (ovulation has not occurred within 30 days), the treatment is repeated, but the dosage is increased to 150 mg of the drug per day or the course is prolonged to ten days. The amount taken for the entire course of the drug should not exceed 1 g.
Checking the onset of ovulation is carried out using ultrasound, by the presence of biphasic basal temperature, enhanced LH production, elevated serum progesterone levels during the period of possible luteinization (third phase), or menstruation in women with amenorrhea.
If after taking the medication containing clomiphene citrate, the woman’s health has improved and ovulation has occurred, but there is no pregnancy, another treatment course is prescribed with the same dose. If, after ovulation, menstruation is not, do a pregnancy test. Before conducting a repeated course of therapy it is also mandatory to exclude the possibility of pregnancy.
In case of skipping the reception "Clomiphene" must necessarily visit the attending physician. During therapy and prior to its commencement, observation by a gynecologist, vaginal examinations and ovarian testing are required.
When their increase or the presence of cystic transformation is detected, treatment is stopped until the ovaries become the same size, after which the course is continued with the use of minimum doses of the medicine or a decrease in the duration of therapy.
Male Infertility Treatment
In oligospermia, patients are often prescribed therapy using a drug such as clomiphene citrate. For men, this is an effective way to treat infertility. Its use is necessary in cases where it was not possible to identify the cause of this condition.When treating it is important to take into account the state of health of the woman.
Men to eliminate infertility prescribed course "Clomiphene" lasting 3-4 months. The dose of the drug to achieve a therapeutic effect is 50 mg. Reception means carry 1-2 times a day. The use of the drug is accompanied by constant monitoring of blood hormone levels, since an increase in testosterone levels negatively affects spermatogenesis.
In the process of treatment, women and men periodically check the work of the liver, during which doctors determine how clomiphene affects citrate. Men are additionally subjected to such a procedure as systematic control of the spermogram in order to understand what the result of therapy is.
Possible side effects
Many drugs have side effects. In "Clomiphene" they are:
- allergic reactions (vasomotor disorders, allergic dermatitis, rash);
- fatigue, drowsiness; depression;
- slowing mental and motor reactions;
- headache, dizziness;
- irritability, anxiety;
- nausea, flatulence, gastralgia;
- vomiting, diarrhea;
- visual impairment;
- an increase in the size of the ovaries, the formation of cysts;
- multiple pregnancy;
- pain in the abdomen, chest, appendages, in men - in the testicles;
- weight gain;
- flushing of the face;
- reversible hair loss;
- alopecia (minor, reversible);
- frequent urination.
Due to the large number of side effects that clomiphene citrate has, the use of this tool should be carried out only as prescribed by a doctor. If negative reactions are detected, the doctor reduces the dose or prescribes another medicine.
The drug is only suitable for women who have preserved ovarian function and no contraindications to pregnancy.
If side effects are detected, the adjustment of the dosing regimen is a prerequisite for further treatment.
"Clomiphene" affects the ability to drive vehicles and mechanisms, so it is not prescribed to those patients whose activities require quick psychomotor reactions and increased attention.
Compatibility with other drugs
Clomiphene citrate is compatible with gonadotropic hormone preparations, its interaction with other drugs is currently not established.
Application "Clomiphene": reviews
Clomiphene is a potent drug with many side effects. But for some couples taking this medication is the only chance to create a full-fledged family. Clomiphene citrate is most commonly used by women. In reviews about the drug, many of them often point to such a side effect as a multiple pregnancy. Mention is also made of the negative effect of elevated estrogen levels on embryos.
Responses differ, because medicines can affect different bodies of each person in different ways, which is associated with individual characteristics. Basically, the use of Clomiphene is resorted to in extreme cases when there is no hope for the effectiveness of other means.
A woman can successfully give birth to a child after undergoing a course of therapy with this drug, but its repeated use is less effective or does not help at all.
It is not always possible to obtain the desired effect from the treatment, which is based on clomiphene citrate.Reviews of therapy are different, which is understandable, because the same drug can not help everyone.
"Clomiphene" has a large number of analogues. The following drugs are related to structural (by active substance): Serpafar, Serofen, Klostilbegit, Clomid. The list of drug analogues by pharmacological group capable of curing female infertility includes: "Abergin", "Buserelin", Buserelin-Long FS "and" Buserelin-Depo "," Bromergon "," Bromocriptine "," Beal "," Gonadotropin chorionic " (a means intended for injections), "Duphaston", "Diferelin", "Decapeptil", "Danol", "Danodiol", "Danazol", "Klostilbegit", "Clomid", "Louveris", "Metovit", "Menopur "," Menogon "," Mastodinon "," Non ovlon "," Novofen "," Orgalutran "," Puregon "," Pregnil "," Pyrogenal "," Pergonal "," Sinestrol "," Serpafar "," Tamoxifen " , "Humegon", "Horagon", "Et inilastradiol "," Egestrenol ".
In the treatment of infertility, not only clomiphene citrate is effective. Analogs of this 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.Its reception can lead to undesirable consequences. This medicine is used only on the prescription of a doctor who checks the patient's health, takes into account the characteristics of his body and possible risks.