What Are the Different Clomiphene Side Effects?

[Main ingredients] The main ingredients of this product are: clomiphene citrate. Its chemical name is: N, N-diethyl-2- [4- (1,2-diphenyl-2-chlorovinyl) phenoxy] ethylamine cis-trans isomer mixture of citrate .

Clomiphene

[Main ingredients] The main ingredients of this product are: clomiphene citrate. Its chemical name is: N, N-diethyl-2- [4- (1,2-diphenyl-2-chlorovinyl) phenoxy] ethylamine cis-trans isomer mixture of citrate .

Chinese name

Clomiphene

Foreign name

Clomifene Citrate Capsules

Molecular formula

C26H28ClNO · C6H8O7

Molecular weight

598.09

Common name; Clomiphene citrate

English name: Clomifene Citrate Capsules

Chinese Pinyin: Juyuansuan Lümifen Jiaonang

Structural formula:

Molecular formula: C26H28ClNO · C6H8O7

Molecular weight: 598.09

[Character] This product is a capsule, the content is white or almost white powder; odorless.

[Indications]

Treatment of female infertility without ovulation, suitable for those who have a certain level of estrogen in the body;

Treatment of luteal dysfunction;

test ovarian function;

detect the abnormal function of male hypothalamus-pituitary-gonadal axis;

Treatment of male infertility due to too little sperm.

[Specifications] 50mg

Oral 50mg daily for 5 days. Medications start on the 5th day of the menstrual cycle. If the patient is amenorrhea, it should be taken on the 5th day of progesterone withdrawal bleeding. Patients who have ovulated after treatment but are not pregnant can repeat the course of the original treatment until conception, or repeat 3 to 4 courses. If the patient does not have ovulation after treatment, the dose can be increased to 100 mg daily for the next 5 days. Individual patients can ovulate only when the dose reaches 150 mg per day.

Adverse reactions

1. The more common adverse reactions are: swelling, stomach pain, pelvic or lower abdominal pain (enlarged ovary or cyst formation or enlarged ovarian fibroma, more pronounced ovarian enlargement, which usually occurs within a few days after discontinuation).

2. Rarely: blurred vision, diplopia, flashes in front of the eyes, sensitive eyes to light, decreased vision, yellowing of the skin and sclera.

3 Care should be taken when the following reactions persist: hot flashes, breast discomfort, constipation or diarrhea, dizziness or dizziness, headaches, increased menstrual flow or irregular bleeding, appetite and weight gain, hair loss, depression, stress, good Movement, insomnia, tiredness, nausea and vomiting, skin rash, allergic dermatitis, rubella, frequent urination, etc., may also have weight loss. There are very few reports of breast cancer and testicular cancer abroad.

Unexplained irregular vaginal bleeding, uterine fibroids,

1. Animal experiments prove that this product can cause teratogenicity. Basal body temperature should be measured daily during medication to monitor ovulation and conception of the patient, and the drug should be discontinued as soon as the conception is achieved.
2. Use with caution in polycystic ovary syndrome.
3. Perform the following determinations as needed during medication:
1) Ovulation-stimulating hormone (FSH) and luteinizing hormone (LH);
2) Long-term drug users measure the content of 24-dehydrocholesterol in the plasma to find out whether the drug has any effect on cholesterol synthesis.
3) The content of corticosteroids in plasma. If you have any questions, please click to consult online experts. 4) Serum thyroxine content.
5) Content of sex hormone binding globulin.
6) Liver function test of sodium sulfobromophthalate (BSP).
7) Thyroxine-binding globulin content (may increase).
4. Please pay attention to check during the medication: the ovarian size must be correctly estimated before the start of each course of treatment; the basal body temperature should be measured every day, and the estrogen and serum progesterone levels should be measured if necessary; the urinary diol content should be measured to determine whether ovulation occurs; Liver function must be measured, and those who have been treated for more than 1 year must have fundus and slit lamp examinations; if visual impairment occurs during the medication, the drug should be discontinued immediately and checked accordingly.

[Medication for pregnant and lactating women]

Animal experiments have teratogenic effects and fetal toxicity and are contraindicated in pregnant women.

[Children's medication] Not clear

[Medicine for the elderly] Unclear

[Drug interactions] Unclear

[Overdose] Unclear

[Pharmacology and Toxicology]

Antihormonal drugs. The mechanism by which this product stimulates ovulation is not fully understood. Because this product has both weak stimulus and strong antagonistic effects on estrogen, stimulation of ovulation may be in the hypothalamus site. Antagonism is dominant first, and it will interfere with the negative effects of endogenous estrogen by competitively occupying the hypothalamic estrogen receptor. The feedback promoted the secretion of luteinizing hormone and follicle-stimulating hormone, followed by stimulation of follicle growth. After the follicle matured, the release of estrogen increased. Positive feedback stimulated the release of gonadotropin before ovulation reached its peak, so ovulation and treatment Male infertility may be associated with elevated FSH and LH and the promotion of spermatogenesis.

After oral administration, it is absorbed through the intestine and enters the blood circulation of the liver. T1 / 2 is generally 5 to 7 days. This product is metabolized in the liver. It enters the intestinal tract with bile, and is then eliminated from feces. Part of it is reabsorbed through the hepato-enteric circulation. Half excreted from feces within 5 days. It can still be detected in feces within 6 weeks.

[Storage] Store at normal temperature (10 -30 ), keep out of reach of children. Shaded and sealed.

[Specifications] 1. Tablets: 50mg each. 2. Capsules: 50mg per capsule.

[Validity] 24 months

[Executive standards] The second part of the 2005 edition of the Chinese Pharmacopoeia.

Clomiphene has anti-estrogen and weak estrogen effects, but mainly induces ovulation by anti-estrogen effects, without progesterone or androgenic effects.
Clomiphene binds to the "estrogen receptor" in the hypothalamus and pituitary gland, so that the central nervous cells are at a low estrogen level.
Induces the release of gonadotropin-releasing hormone (GnRH), which in turn causes the pituitary to release FSH and LH.
FSH promotes follicle development and maturation. The peak of LH after 5 days of drug withdrawal is called clomiphene peak. At the same time, a sharp increase in estradiol levels causes a positive feedback effect.
Promote the central release of a large amount of GnRH, the pituitary release LH and FSH peaks, through the triggering action of estrogen, induce ovulation.
Clomiphene induces ovulation through a series of biologically active effects, does not change the frequency of gonadotropin secretion, only increases its amplitude,
It also increases the sensitivity of the pituitary to hypothalamus GnRH and the sensitivity of the ovary to pituitary Gn.
Clinically, it was found that oral EE 0.1mg daily from the 5th to the 25th of the cycle can inhibit ovulation, but if the addition of clomiphene can eliminate this inhibitory effect. ^[1]

[Alias] clomiphene;

Those with menstruation will start with 50mg once a day for 5 days, and those without menstruation will start with 50mg once a day for 5 days. Generally, ovulation occurs about 7 days after taking the medicine, and menstruation occurs naturally after 3 weeks. Consecutive service for 3 cycles is 1 course of treatment. Amenorrhea patients can first use progesterone (20mg intramuscularly once a day) or artificial cycle (diethylstilbestrol 1mg once daily for 20 days, and then daily progesterone 10mg intramuscularly, once daily) Take this product on the 5th day of withdrawal bleeding. The daily dose should not exceed 100mg. Used for

1. There may be adverse reactions such as facial flushing, nausea, dizziness, fatigue, abdominal distension, breast distension, rash, liver dysfunction, etc., which can disappear after stopping the medicine.

2. In the treatment of male infertility, semen examination, endocrine examination, and testicular biopsy must be performed before taking the medicine to determine that the cause of infertility is mainly due to the decrease in sperm count; regular check of semen routine, FSH and testosterone levels during medication; Effective from 2 to 3 months. The principle of medication is low dose and long course of treatment. It should be noted that high dose will inhibit spermatogenesis.

3. Male sperm patients should not be used except for testicular biopsy evidence of spermatogenesis.

4. Patients with liver disease, kidney disease, ovarian cyst and other gynecological tumors should not use it. Patients with severe allergic reactions after taking the drug should be discontinued.

5. Excessive dosage can cause ovarian hypertrophy.

6. Blurred vision and flickering blind spots are dose-dependent, and withdrawal can be reversed.

7. Visual abnormalities should be used as contraindications to the use of this product.

Clomiphene has many side effects, such as headache, abdominal pain, gastrointestinal symptoms (nausea, vomiting, bloating), etc., and may have enlarged ovaries, cystic changes, and sometimes unruptured follicular luteinization. Large doses and long-term cases may have multiple pregnancies. In addition, cervical mucus becomes sticky after administration, which prevents sperm from passing and reduces the pregnancy rate. Sometimes there are even side effects such as ascites, pleural effusion, or pleural effusion. In severe cases, it can even cause death, which is medically called "ovarian hyperstimulation". Therefore, clomiphene ovulation-promoting treatment, patients should not be used without permission, must be taken under the guidance of a physician. During the medication, a pelvic examination should be performed to observe the changes in the ovaries. Those who have enlarged ovaries must stop the medication.