Characteristic of the substance Clomiphene is a white or white crystalline powder with a cream tint. Slightly soluble in water, moderately soluble in alcohol.
Pharmacological action is antiestrogenic. Binds estrogen receptors in the hypothalamus and ovaries. When ingested, it is well absorbed from the gastrointestinal tract. It is metabolized in the liver. It is excreted with bile, undergoes enterohepatic recirculation. It is excreted from the body with feces. T1/2 is 5-7 days. In small doses, it enhances the secretion of gonadotropins, stimulates ovulation. With a low content of endogenous estrogens in the body, it has a moderate estrogenic effect, with a high level — antiestrogenic. By reducing the level of circulating estrogens, it promotes the secretion of gonadotropins. In large doses, it inhibits the secretion of gonadotropins. It does not have gestagenic and androgenic activity.
Application of the substance Clomiphene
Anovulatory infertility (ovulation induction), dysfunctional uterine bleeding, amenorrhea (dysgonadotropic form, secondary, postcontractive), galactorrhea (against the background of pituitary tumor), polycystic ovaries (Stein—Leventhal syndrome), Chiari-Frommel syndrome, androgen deficiency, oligospermia, for the diagnosis of disorders of the gonadotropic function of the pituitary gland.
Anovulatory infertility (ovulation induction); amenorrhea (dysgonadotropic form), secondary amenorrhea, post-contraceptive amenorrhea; Stein-Leventhal syndrome (polycystic ovary syndrome); oligomenorrhea; galactorrhea (on the background of a pituitary tumor); Chiari-Frommel syndrome (syndrome of prolonged postpartum amenorrhea-galactorrhea); androgen deficiency; in men – oligospermia.
Contraindications
Hypersensitivity, severe hepatic and/or renal insufficiency, uterine bleeding of unknown etiology, ovarian cyst, tumor or insufficiency of pituitary function, pregnancy (including suspicion of it).
Hypersensitivity to clomiphene; pregnancy, lactation (breastfeeding); ovarian cyst (with the exception of polycystic ovarian syndrome); tumor or hypofunction of the pituitary gland; thyroid or adrenal dysfunction; metrorrhagia of unclear etiology; long-term or recently developed visual disturbances; neoplasms of the genitals; endometriosis; ovarian insufficiency against hyperprolactinemia.
Special instructions
It is recommended to check liver function before using clomiphene.
Before using Clomid, it is necessary to conduct a thorough gynecological examination. The use of clomiphene is indicated in cases when the total level of gonadotropin in the urine is below the lower limit of the norm or at the normal level, ovarian palpation does not reveal deviations from the norm, and the functions of the thyroid gland and adrenal glands correspond to the norm.
In the absence of egg maturation, all other possible causes of infertility should be excluded or treated before the use of clomiphene. If an increase in the ovaries or their cystic transformation is detected, the use of clomiphene is not allowed until the ovaries return to normal size. In the future, the dose or duration of treatment should be reduced.
In the course of treatment, constant supervision of a gynecologist is necessary, ovarian function should be monitored, vaginal examinations should be performed, and the phenomenon of the “pupil” should be observed. Often during the course of treatment it is difficult to determine the moment of ovulation, and there is also often a deficiency of the corpus luteum. Therefore, after conception, it is recommended to start preventive administration of progesterone.