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CLOMIFENE (CLOMIPHENE, CLOMID® , SEROPHENE® ) IN POLYCYSTIC OVARIAN SYNDROME

Available as tablets containing 50 mg Clomiphene Citrate and supplied under the trade names ClomidÒ and SeropheneÒ .

Clomifene is an anti-oestrogen which blocks the action of this female type hormone at target sites in the body. This by a complex process makes the hypothalamus (a specialised area of the brain) produce extra quantities of a substance called gonadotropin releasing hormone (GnRH) so triggering a series of events resulting in ovulation. This occurs because GnRH stimulates the release of follicle stimulating hormone (FSH) and luteinizing hormone (LH) by the pituitary gland and these hormones in turn stimulate ovulation within the ovary. Thus Clomifene is used to restore fertility in polycystic ovarian syndrome associated with a disturbance of the menstrual cycle (amenorrhoea) and hence failure to ovulate.

Clomifene is taken in a dose of 50 mg for 5 days commencing within 5 days of the onset of a menstrual bleed. It may be taken at any time if cycles have ceased altogether or alternatively within 5 days of a menstrual bleed which is induced by a prior course of a second type of female hormone called a progestogen. Patients with polycystic ovarian syndrome are very sensitive to the effects of Clomifene to the extent that a lower dose of 25 mg daily for 5 days may be tried initially. If the first or a subsequent course fails to induce ovulation, a third course of Clomifene of 100 mg daily for 5 days can be given. It is unusual to require more than 3 courses in total. The dose should be taken at the same time each day usually in the morning before breakfast.

What side effects can be expected?

• Treatment of infertility with clomifene is associated with an increased likelihood of multiple pregnancies, most often twins but very rarely triplets, quadruplets or quintuplets. There is also a very small risk of ectopic pregnancy (pregnancy occurring outside of the womb) and of problems arising during the pregnancy. For example it has been suggested that there is an increase in the number of cases of Down's syndrome although the risk of Down's syndrome is still nevertheless very small.
• Polycystic ovarian syndrome excepted, clomifene should not be taken by women who have ovarian cysts until the cause has been investigated. Treatment is also likely to futher enlarge uterine fibroids where these already exist. A degree of enlargement of the uterus (womb) often occurs but does not appear to be of any special significance though rarely excessive uterine enlargement has occurred with larger than normal doses.
• Women who commence treatment with Clomifene may experience hot flushes, abdominal bloating or discomfort, nausea and vomiting, breast discomfort, visual disturbances and headaches.
• Eye symptoms have been reported as blurring of vision, spots or flashes especially in very bright conditions.
• Skin rashes may occur especially in people who develop an allergy to Clomifene.
• Very rarely liver problems including jaundice have been encountered. Clomifene is therefore best avoided in people with existing severe liver disease.

There are none of note.

Clomifene Tablets are stored at room temperature. Choose a cool dry place - not next to a radiatoror fire or in the bathroom.

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Ó NHS Tayside; 2006; version 1.0

Disclaimer; no liability whatsoever is accepted for information given and all such information, especially with regard to drug usage (UK version provided), must be checked with a person’s health provider.