Generic Clomid

Drug Name

Clomid (Clomiphene Citrate)

Active Ingredient

Clomid Uses

Clomiphene citrate (Clomid, Serophene, Milophene) became clinically available in 1968 and remains the first choice for ovulation induction in most women because of its relative safety, effectiveness, and low cost. Clomid is used for treating female infertility and for certain conditions as determined by your doctor. Clomiphene citrate is a weak estrogen, but its predominant role is probably that of an antiestrogen. Clomiphene (Clomid) can cause production of several ovules at a time. That's why it makes multiple pregnancy (twin birth) quite possible.

Clomiphene is used to stimulate ovulation, increase ovarian progesterone secretion during the second half of the cycle, and make menstrual cycle lengths more predictable. Clomiphene is taken orally once a day for 5 days.

Clomiphene is only active in the month it is taken. It also need not be taken in a cycle where pregnancy will not be possible because of separation, illness, or other circumstances.

Clomid Treatment

If you have no menstrual cycles:

In women with no menstrual cycle, the initial course of clomiphene citrate is started after a progestin (Provera) induced menses. If no menses occurs after taking Provera only 10% of the women will ovulate after clomiphene citrate. After 5 days of progestin, the woman begins clomiphene citrate on the fifth day of bleeding. One 50-mg tablet of clomiphene citrate is taken for 5 days. Intercourse should begin 3 to 5 days later in anticipation of ovulation.

If you menstruate:

In women with spontaneous menses clomiphene citrate may be started on days 3, 4, or 5 of menses. Ovulation will be delayed if clomiphene citrate is started later than day 5 of the cycle, and starting clomiphene citrate prior to day 5 may result in recruitment of additional follicles. Ovulation predictor kits detecting the LH surge may demonstrate false positive results if testing begins near the time of clomiphene citrate administration.

In the first clomiphene citrate cycle no further testing is performed.

After the first treatment

If menses occurs:

If menses occurs, the same dose of clomiphene citrate is given after a normal pelvic examination or pelvic sonogram.

In the second cycle, serum progesterone is checked in the in the second half of the cycle to evaluate ovulation.

If normal progesterone concentrations are found, the same clomiphene citrate dose is repeated in the third cycle. Ultrasound should be performed a day or two prior to ovulation to assess the uterine lining (endometrium).

If menses does not occur:

If bleeding does not occur or if progesterone concentrations are low, the dose of clomiphene citrate is increased in 50-mg increments per day until a dose of 150 - 200 mg per day is reached. Pelvic examinations or sonograms should be performed after each increased dose of clomiphene citrate. Clomiphene citrate can result in residual follicles or cysts persisting into the next menstrual cycle. If these cysts are present clomiphene citrate should not be taken until they have resolved. Once an ovulatory dose is established, the current regimen is maintained for 3-6 months. Further increase in the dose of clomiphene citrate will not be of benefit.

Variations in treatment

Alternative regimens and adjunctive therapies have been used with clomiphene citrate therapy. The duration of clomiphene citrate therapy may range from 3-7 days and the dose may be decreased to 12.5 mg/day in patients who hyperstimulate on the routine dose. Although clomiphene citrate can be used to treat poor progesterone production, clomiphene citrate therapy also may result in poor progesterone production. If this occurs, progesterone vaginal suppositories, 50 mg a day can be added to clomiphene citrate beginning 2 days after ovulation and continuing until menses.

The addition of human chorionic gonadotropins (hCG) 10,000 IU intramuscularly, to the clomiphene citrate regimen is appropriate in cycles where a follicle develops but does not ovulate ovulation. Since only 15% of patient ovulate at doses of 150 mg or higher, timed HCG injections may be used in patients who fail to ovulate at 100 mg/day. The use of ultrasound to detect a follicular diameter of at least 18 mm prior to HCG injection is recommended since premature injection of HCG can inhibit ovulation.

How Clomid Works

Clomiphene works by providing a large discharge of 2 hormones which cause ovulation and the production of ovules. At the beginning of the treatment the medicine influences the hypophysis and makes it secrete more gonadotrophic hormones that stimulate maturation of ovarian follicles and prepare ovules for fertilization. As soon as the patient stops taking the drug the hypothalamus starts secreting other hormones which make the ovary produce a mature ovule that is going to be taken to one of the oviducts for fertilization. That process is called ovulation.

Unexplained infertility. There is limited evidence that clomiphene makes pregnancy more likely for couples with unexplained infertility. Clomiphene may be most effective when it is used to generate multiple eggs before an insemination procedure.

Infrequent or no ovulation. Of women whose infertility is caused only by absent or infrequent ovulation, with clomiphene treatment approximately 80% will ovulate. And within 9 cycles of treatment, 70% to 75% will become pregnant. Experts used to think miscarriage rates were slightly higher in women who became pregnant using clomiphene, but recent studies have not shown this to be true.

Polycystic ovary syndrome. Clomiphene alone may not be an effective treatment for most women with polycystic ovary syndrome (PCOS) and severe insulin resistance , which is closely linked to obesity. Women with PCOS who are overweight often begin ovulating when they reduce their body mass index (BMI) with diet and exercise.

How is Clomid Taken

Use Clomid as directed by your doctor. Check the label on the medicine for exact dosing instructions.

Clomid Drug Class and Mechanism

Clomid is an ovulatory stimulant. It works by helping to produce more hormones that cause your ovaries to release 1 or more eggs.

Clomid Missed Dose

In case you have missed to take the medicine take it when you recall it. But keep to the schedule if it's already the time for the next pill and don't take an additional one for the one you missed.

Storage

Store Clomid at 77 degrees F (25 degrees C). Brief storage between 59 and 86 degrees F (15 and 30 degrees C) is permitted. Store away from heat, moisture, and light. Do not store in the bathroom. Keep Clomid out of the reach of children and away from pets.

Clomid Warnings/Precautions

Do not use Clomid if:

Clomid Possible Side Effects

Check with your doctor if any of these most common side effects persist or become bothersome:

More Information

Clomid is to be used only by the patient for whom it is prescribed. Do not share it with other people.