DrugindexOnline^{2nd edition}

Pronouncation: (KLOE-mih-feen SIH-trate)
Class: Ovulation stimulant

Trade Names:
Clomid
- Tablets 50 mg

Trade Names:
Milophene
- Tablets 50 mg

Trade Names:
Serophene
- Tablets 50 mg

Mechanism of Action

Pharmacology

Induces ovulation in selected anovulatory women.

Pharmacokinetics

Absorption

Readily absorbed.

Elimination

About 42% is excreted in feces; about 8% is excreted in urine. May still be detectable in feces 6 wk after administration. May exhibit enterohepatic recycling.

Indications and Usage

Treatment of ovulatory failure in women desiring pregnancy when partner is fertile and potent.

Unlabeled Uses

Treatment of male infertility.

Contraindications

Liver disease; history of liver dysfunction; abnormal bleeding of undetermined origin; pregnancy.

Dosage and Administration

Initial Therapy

PO 50 mg/day for 5 days.

Second and Third Courses

PO 100 mg/day for 5 days.

Drug Interactions

None well documented.

Laboratory Test Interactions

None well documented.

Adverse Reactions

Cardiovascular

Vasomotor flushes.

CNS

Headache, dizziness; lightheadedness.

EENT

Visual symptoms; blurring spots or flashes; diplopia; photophobia.

GI

Abdominal pain/discomfort; distension; bloating; nausea; vomiting.

Genitourinary

Abnormal uterine bleeding; abnormal ovarian enlargement, luteal cyst formation.

Hepatic

Sulfobromophthalein retention.

Miscellaneous

Breast tenderness.

Precautions

Monitor Side effects Notify health care provider if patient experiences abdominal pain, abnormal uterine bleeding, visual changes, or jaundice.

Pregnancy

Category X .

Lactation

Undetermined.

Multiple pregnancy

May increase chance for multiple pregnancies.

Ophthalmologic effects

May cause blurring of vision.

Patient Information

• Caution patient that this medication must not be taken during pregnancy or when pregnancy is possible. Advise patient to use reliable form of birth control while taking this drug.
• Counsel patient and partner in purpose of scheduling clomiphene citrate, sexual intercourse and ovulation time to be successful in achieving pregnancy.
• Advise women that increased midcycle ovarian discomfort may be experienced and can assist in planning intercourse.
• Instruct patient of importance of well-balanced diet, mild exercise routine, and avoidance of drugs, caffeine and alcohol while attempting to achieve pregnancy.
• Inform patient of possibility for multiple pregnancies.
• Explain that medication may cause dizziness, hot flashes, headache, nausea and weight gain but that these effects will subside after medication is stopped.
• Instruct patient to report these symptoms to health care provider: abnormal uterine bleeding, yellowish skin or eyes, blurred vision.
• Advise patient to use caution while driving or using heavy equipment because blurring of vision can occur.