Clomid. Dosage, Side Effects, Interactions
CLOMID is indicated for the treatment of ovulatory dysfunction for women who wish to become pregnant. Obstacles to achieving pregnancy must be eliminated or appropriately addressed prior to initiating CLOMID therapy. Patients most likely to have success with clomiphene therapy include patients with polycystic ovarian syndrome, amenorrheal-galactorrhea syndrome, psychogenic amenorrhea, postoral contraceptive amenorrhea, and certain cases of secondary amenorrhea of undetermined etiology.
Properly timed coitus in relation to ovulation is important. A basal body temperature chart or other appropriate tests can help the patient and her doctor determine if ovulation has occurred. Once ovulation has been detected, any CLOMID course should be started on or around the 5th day of the cycle. Long-term cyclic therapy is not recommended beyond a total of approximately six cycles (including three ovulatory cycles)
CLOMID is only indicated in patients with established ovulatory dysfunction who meet the conditions described below:
- Patients who are not pregnant.
- Patients without ovarian cysts. CLOMID should not be used in patients with enlarged ovaries, except in patients with polycystic ovarian syndrome. A pelvic exam is required prior to the first and any subsequent treatment with CLOMID.
- Patients without abnormal vaginal bleeding. If abnormal vaginal bleeding is present, the patient should be carefully evaluated to ensure that no neoplastic lesions are present.
- Patients with normal liver function.
In addition, patients selected for CLOMID therapy should be evaluated for:
- Estrogen levels. Patients should have adequate levels of endogenous estrogen (as estimated from vaginal swab, endometrial biopsy, urine estrogen testing, or bleeding in response to progesterone). Although reduced estrogen levels are less favorable, they do not preclude successful therapy.
- Prior pituitary or ovarian failure. It is not expected that CLOMID therapy will replace the specific treatment of other causes of ovulation failure.
- Endometriosis and endometrial cancer. The incidence of endometriosis and endometrial cancer increases with age, as does the incidence of ovulation disorders. Endometrial biopsy should always be performed prior to CLOMID therapy in this population.
- Other obstacles to pregnancy. Obstacles to pregnancy can include thyroid disease, adrenal disease, hyperprolactinemia, and male infertility.
- Uterine fibroids. Caution should be exercised when using CLOMID in patients with uterine fibroids as the fibroids may continue to grow.
There are no adequate or well-controlled studies demonstrating the effectiveness of CLOMID in the treatment of male infertility. In addition, testicular tumors and gynecomastia have been reported in men using clomiphene. The cause-and-effect relationship between reports of testicular tumors and administration of CLOMID is unknown.
Although the medical literature suggests various methods, there is no universally accepted standard regimen for combined therapy (ie, CLOMID in conjunction with other ovulation-inducing drugs). Similarly, there is no standard CLOMID regimen for ovulation induction in in vitro fertilization programs to produce oocytes for fertilization and reinsertion. Therefore, CLOMID is not recommended for these purposes.
DOSAGE AND APPLICATION OF CLOMID
The processing and treatment of candidates for CLOMID therapy should be supervised by physicians experienced in the management of gynecologic or endocrine disorders. Patients should only be selected for therapy with CLOMID after careful diagnostic evaluation. The therapy plan should be determined in advance. Obstacles to achieving the therapy goal must be ruled out or adequately treated before starting the CLOMID. The therapeutic goal should be balanced against potential risks and discussed with the patient and others involved in achieving pregnancy.
Ovulation most commonly occurs 5 to 10 days after CLOMID treatment. Coitus should be timed to coincide with the expected time of ovulation. Appropriate tests to determine ovulation can be helpful during this period.
Recommended dosage of Clomid
Treatment of the selected patient should start with a low dose of 50 mg daily (1 tablet) for 5 days. The dose should only be increased in patients who do not ovulate in response to cyclic CLOMID 50 mg. A low dosage or duration of the course of treatment is particularly recommended in cases of suspected unusual sensitivity to pituitary gonadotropin, for example in patients with polycystic ovarian syndrome
The patient should be carefully evaluated to exclude pregnancy, ovarian enlargement or ovarian cyst formation between courses of treatment.
If progestin-induced bleeding is planned or if spontaneous uterine bleeding occurs prior to therapy, treatment should be started at 50 mg daily for 5 days on or about day 5 of the cycle. Therapy can be started at any time in patients who have not recently experienced uterine bleeding. If ovulation occurs at this dosage, there is no benefit in increasing the dosage in subsequent treatment cycles.
If ovulation does not occur after the first cycle of therapy, a second course of 100 mg daily (two 50 mg tablets as a single daily dose) should be administered for 5 days. This course can be started as early as 30 days after the previous one, having taken precautions to exclude the presence of pregnancy. It is not recommended to increase the dosage or duration of therapy beyond 100 mg/day for 5 days.
The majority of patients who will ovulate will do so after the first therapy. If ovulation does not occur after three cycles of therapy, further treatment with CLOMID is not recommended and the patient should be re-evaluated. If three ovulatory reactions occur but pregnancy has not been achieved, further treatment is not recommended. If menses do not occur after an ovulatory response, the patient should be reassessed. Long-term cyclic therapy is not recommended beyond a total of approximately six cycles
SIDE EFFECTS OF CLOMID
Table 2. Incidence of adverse events in clinical trials (events greater than 1%) (n=8029*)
|Abdominal pelvic discomfort / bloating / bloating||5.5|
|nausea and vomiting||2.2|
|Vision blurred, lights, swimmers, waves, visual discomfort unspecified, photophobia, diplopia, scotomas, phosphenes||1.5|
|Abnormal uterine bleeding||1.3|
|Intermenstrual spotting, menorrhagia|
|* Includes 498 patients whose reports may have been duplicated in event totals and could not be distinguished as such. Also excluded are 47 patients who did not report symptom data.|
The following adverse events were reported in less than 1% of patients in clinical trials: acute abdomen, increased appetite, constipation, dermatitis or rash, depression, diarrhea, dizziness, fatigue, hair loss/dry hair, increased urinary frequency/volume, insomnia, drowsiness , nervous tension, vaginal dryness, dizziness, weight gain / loss.
Looking where to buy Clomid (Clomiphene) online without a prescription? Order now on our website! We deliver orders all over United States. The best drug prices are only available in our authorized online pharmacy