Drug reference

clomiphene citrate

Selective estrogen receptor modulator (SERM) · Ovulation Inducer, Infertility Agent

Selective estrogen receptor modulator (SERM)Ovulation Inducer, Infertility Agent

CDSCO approved

EXCRETION

—

not curated

INTERACTIONS

—

none in our sources

PREGNANCY

FDA category + note

Mechanism

It binds to both ERα and ERβ and acts as a pure estrogen antagonist in all human tissues, but the racemate displays weak agonistic action in rats. It induces Gn secretion in women by blocking estrogenic feedback inhibition of pituitary. The amount of LH/FSH released at each secretory pulse is increased. In response, the ovaries enlarge and ovulation occurs if the ovaries are responsive to Gn.

Indications

Infertility due to failure of ovulationAid in vitro fertilizationOligozoospermia

Dosing

Adult: For infertility: 50 mg once daily for 5 days starting from 5th day of cycle. Treatment given monthly. If 1–2 months treatment does not result in conception, daily dose may be doubled for 2–3 cycles. No more than 6 treatment cycles should be tried. For male infertility: 25 mg daily given for 24 days in a month with 6 days rest for up to 6 months.

Pharmacokinetics

Half-life

~6 days

Excretion

largely metabolized and excreted in bile

Contraindications

Ovaries unresponsive to Gn

Side effects

Common

Polycystic ovariesMultiple pregnancyHot flushesGastric upsetVertigoAllergic dermatitis

Serious

Increased risk of ovarian tumour

Pregnancy & lactation

Pregnancy

Drug interactions

Menotrophin

Moderate

Database

Increased risk of ovarian hyperstimulation syndrome (OHSS) and multiple gestations.

Concurrent use is common in fertility treatments, but requires careful monitoring of ovarian response (ultrasound and estradiol levels) to adjust menotrophin dosage and prevent OHSS. Start with lower doses of menotrophin.

Urofollitropin

Moderate

Database

Increased ovarian response, potentially leading to a higher risk of ovarian hyperstimulation syndrome (OHSS) and multiple gestations.

Concurrent use is often intentional in fertility protocols to enhance follicular development. However, careful monitoring of ovarian response (ultrasound, estradiol levels) is crucial to adjust urofollitropin dosage and prevent OHSS. Dosage of urofollitropin may need to be reduced when used after clomiphene.