Clomiphene citrate

5. Uterine Fibroids. Caution should be exercised when using Clomiphene citrate in patients with uterine fibroids due to the potential for further enlargement of the fibroids.

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Q, 14: can we coprescribe Gonadotrophins / Bromo / oestrogens along with CC to promote folliculogenesis?? Ans:  Although the medical literature suggests various methods, there is no universally accepted standard regimen for combined therapy (ie., Clomiphene citrate in conjunction with other ovulation-inducing drugs. Coprescription  1:-Many ART specialist do coprecribe HMG 75 IU on day 3 with the idea it will recruit more no of follicles and also another dose of HMG on day 8 with the idea that this second dose will speed up any follicles which is lagging behind (late bloomers) .This picking up of slowly growing will hopefully increase serum Oestrgen and there will be no blunting  of LH surge and avoid hopefully LUF.  Coprescription  2; Low cost IVF:- Similarly, there is no standard Clomiphene citrate regimen for ovulation induction in vitro fertilization programs to produce ova for fertilization and reintroduction.

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Q. 15:-CONTRAINDICATIONS of  Clomiphene citrate

1)               Hypersensitivity 2) a known hypersensitivity or allergy to clomiphene citrate or to any of its ingredients. 3)

3)               Pregnancy .  But point is if she has consumes CC unknowingly will it cause harm ? Ans: research has shown  that 4.5 mg/kg/day for various periods during pregnancy did not have any abnormal offspring. 4) hepatic diseases :-

Clomiphene citrate therapy is contraindicated in patients with liver disease or a history of

liver dysfunction 6)Abnormal Uterine Bleeding. Clomiphene citrate is contraindicated in patients with abnormal uterine bleeding of undetermined origin

7) Ovarian Cysts. CC is contraindicated in patients with ovarian cysts or enlargement not due to polycystic ovarian syndrome .

8) CC is contraindicated in patients with uncontrolled thyroid or adrenal dysfunction

or in the presence of an organic intracranial lesion such as pituitary tumor

q 12: What near life threartening compl may occur ?? Visual Symptoms

Patients should be advised that blurring or other visual symptoms such as spots or flashes

(scintillating  scotomata) may occasionally occur during therapy with CC. These visual

symptoms increase in incidence with increasing total dose or therapy duration and generally

disappear within a few days or weeks after CC is discontinued. Patients should be warned

that these visual symptoms may render such activities as driving a car or operating machinery

more hazardous than usual, particularly under conditions of variable lighting.

These visual symptoms appear to be due to intensification and prolongation of afterimages.

Symptoms often first appear or are accentuated with exposure to a brightly lit environment.

While measured visual acuity usually has not been affected, a study patient taking 200 mg CC

daily developed visual blurring on the 7th day of treatment, which progressed to

severe diminution of visual acuity by the 10th day. No other abnormality was found, and the

visual acuity returned to normal on the 3rd day after treatment was stopped.

Ophthalmologic ally definable scotomata and retinal cell function (electroretinographic) changes

have also been reported. A patient treated during clinical studies developed phosphates and

scotomata during prolonged CC administration, which disappeared by the 32nd day after

stopping therapy. Post marketing surveillance of adverse events has also revealed other visual signs and symptoms during CC While the etiology of these visual symptoms is not yet understood, patients with any visual symptoms should discontinue treatment and have a complete ophthalmological evaluation

carried out promptly.

Ovarian Hyperstimulation Syndrome  by Clomiphen Citrate.

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