Jump to navigation Jump to search Not to be confused with Citrate drug. Clomifene, also known as clomiphene, is a medication used to treat infertility in women who do not ovulate. This includes those who have polycystic ovary syndrome. Common side effects include pelvic pain and hot flushes.
Clomifene was approved for medical use in the United States in 1967. Clomifene is useful in those who are infertile due to anovulation or oligoovulation. Evidence is lacking for the use of clomifene in those who are infertile without a known reason. Clomifene has also been used with other assisted reproductive technology to increase success rates of these other modalities. Serial transvaginal ultrasound can reveal the size and number of developing follicles. 9 days after ovulation being regarded as adequate. Repeat dosing: This 5-day treatment course can be repeated every 30 days. The dosage may be increased by 50-mg increments in subsequent cycles until ovulation is achieved. It is not recommended by the manufacturer to use clomifene for more than 6 cycles.
It is no longer recommended to perform an ultrasound examination to exclude any significant residual ovarian enlargement before each new treatment cycle. Clomifene is sometimes used in the treatment of male hypogonadism as an alternative to testosterone replacement therapy. It has been found to increase testosterone levels by 2- to 2. Clomifene has been used in the treatment of gynecomastia. It has been found to be useful in the treatment of some cases of gynecomastia but it is not as effective as tamoxifen or raloxifene for this indication. Some studies have suggested that clomifene citrate if used for more than a year may increase the risk of ovarian cancer. This may only be the case in those who have never been and do not become pregnant. Subsequent studies have failed to corroborate those findings. The incidence of fetal and neonatal abnormalities for patients on clomifene for fertility is similar to that seen in the general population. There is no data to suggest a higher rate of congenital anomalies or spontaneous abortions after using this drug.
Compared to letrozole, another drug used for ovarian stimulation, a study found no significant difference in the rate of overall abnormalities, but found that congenital cardiac anomalies was significantly higher in the clomifene group compared to the letrozole group. Therapeutically, clomifene is given early in the menstrual cycle. It is typically prescribed beginning on day 3 and continuing for 5 days. By that time, FSH level is rising steadily, causing development of a few follicles. Follicles in turn produce the estrogen, which circulates in serum. In the presence of clomifene, the body perceives a low level of estrogen, similar to day 22 in the previous cycle. Clomifene has been found to decrease insulin-like growth factor 1 levels in women. The drug is widely considered to have been a revolution in the treatment of female infertility, the beginning of the modern era of assisted reproductive technology, and the beginning of what in the words of Eli Y. Adashi, was “the onset of the US multiple births epidemic”. The company was acquired by Dow Chemical in 1980, and in 1989 Dow Chemical acquired 67 percent interest of Marion Laboratories, which was renamed Marion Merrell Dow.
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It became the most widely prescribed drug for ovulation induction to reverse anovulation or oligoovulation. Clomifene is included on the World Anti-Doping Agency list of illegal doping agents in sport.
Clomifene was studied for treatment and prevention of breast cancer, but issues with toxicity led to abandonment of this indication, as did the discovery of tamoxifen. Archived from the original on 20 September 2016. Safety of clomiphene citrate: a literature review”. The American Society of Health-System Pharmacists. Archived from the original on 5 November 2017. Principles and Practice of Controlled Ovarian Stimulation in ART. Centers for Medicare and Medicaid Services. Archived from the original on 24 December 2016. Use of clomiphene citrate in infertile women: a committee opinion”. Clomiphene citrate for unexplained subfertility in women”.
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