Clomifene


Thông tin thuốc gốc
Chỉ định và Liều dùng
Oral
Anovulatory infertility
Adult: 50 mg once daily for 5 days, starting at any time if there is no uterine bleeding or on the 5th day of the menstrual cycle. If ovulation does not occur w/in 5-10 days, a 2nd course of 100 mg once daily for 5 days may be given, starting as early as 30 days after the previous course. Max: 3 courses.
Hepatic Impairment
Contraindicated.
Cách dùng
May be taken with or without food.
Chống chỉ định
Abnormal uterine bleeding of unknown origin, ovarian cyst or enlargement not due to polycystic ovarian syndrome, organic intracranial lesion (e.g. pituitary tumour), uncontrolled thyroid or adrenal dysfunction. Active liver disease or history of hepatic impairment. Pregnancy.
Thận trọng
Patient w/ uterine fibroids, polycystic ovarian syndrome (PCOS). Lactation.
Phản ứng phụ
Significant: Mild to moderate OHSS, visual disturbance (e.g. blurring, scotomata, diplopia, photophobia), endometriosis, ovarian enlargement and cyst formation, risk of multiple or ectopic pregnancy. Rarely, risk of borderline or invasive ovarian cancer.
Nervous: Headache, convulsion, restlessness, insomnia, dizziness, vertigo, lightheadedness, depression, nervous tension, fatigue, insomnia.
GI: Nausea, vomiting, constipation, diarrhoea, increased appetite.
Genitourinary: Increased urinary frequency and volume, vag dryness, menorrhagia, uterine haemorrhage, endometriosis.
Endocrine: Vasomotor flushes, hypertriglyceridemia, wt gain.
Dermatologic: Urticaria, rash, dermatitis, hair loss and dryness.
Others: Breast discomfort.
Potentially Fatal: Severe OHSS manifesting as gross ovarian enlargement, pericardial effusion, severe abdominal pain, ascites, dyspnoea, acute resp distress syndrome, hypotension, tachycardia, thromboembolism, hypovolemic shock, and haemoconcentration.
Thông tin tư vấn bệnh nhân
This drug may cause visual disturbances, dizziness, and lightheadedness, if affected, do not drive or operate machinery.
Monitoring Parameters
Monitor serum oestrogen prior to therapy. Perform pelvic exam and endometrial biopsy before each course and pregnancy test prior to repeat courses. Monitor for ovulation through basal body temp, ultrasound, serum progesterone, oestradiol, and urinary LH. Assess signs and symptoms of ovarian hyperstimulation syndrome (OHSS).
Quá liều
Symptoms: Nausea, vomiting, vasomotor flashes, blurring of vision, scotomata, ovarian enlargement w/ pelvic or abdominal pain. Management: Supportive treatment. Perform GI decontamination.
Tương tác
May enhance adverse effect of ospemifene.
Tác dụng
Description: Clomifene is a nonsteroidal compound that has both oestrogenic and anti-oestrogenic effects. It stimulates ovulation by inhibiting the negative feedback effect of oestrogens at receptor sites in the hypothalamus and pituitary, thereby increasing hypothalamic GnRH secretion w/ subsequent release of pituitary FSH and LH.
Onset: 5-10 days.
Pharmacokinetics:
Absorption: Readily absorbed from the GI tract. Time to peak plasma concentration: Approx 6 hr.
Metabolism: Metabolised in the liver; undergoes enterohepatic recirculation.
Excretion: Via faeces (42%) and urine (8%). Elimination half-life: Approx 5 days.
Đặc tính

Chemical Structure Image
Clomifene

Source: National Center for Biotechnology Information. PubChem Database. Clomiphene, CID=1548953, https://pubchem.ncbi.nlm.nih.gov/compound/Clomiphene (accessed on Jan. 21, 2020)

Bảo quản
Store below 25°C. Protect from light, heat, and excessive humidity.
Use appropriate personal protective equipment (e.g. gloves) for receiving, handling, admin and disposal.
Phân loại ATC
G03GB02 - clomifene ; Belongs to the class of synthetic agents used as ovulation stimulants.
References
Anon. Clomiphene. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 08/03/2017.

Buckingham R (ed). Clomifene Citrate. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com . Accessed 08/03/2017.

Clomiphene Citrate Tablet (A-S Medication Solutions). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 08/03/2017.

Joint Formulary Committee. Clomifene Citrate. British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 08/03/2017.

McEvoy GK, Snow EK, Miller J et al (eds). Clomiphene Citrate. AHFS Drug Information (AHFS DI) [online]. American Society of Health-System Pharmacists (ASHP). https://www.medicinescomplete.com. Accessed 08/03/2017.

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