clomifene citrate: clinical use

Prescribing considerations

• Confirm ovulatory dysfunction and assess or treat other infertility causes before prescribing.
• Discuss multiple pregnancy, ectopic pregnancy and ovarian hyperstimulation.
• Use particular caution with polycystic ovaries, uterine fibroids, seizure history and pre-existing or familial hypertriglyceridaemia.

Contraindications and cautions

• Pregnancy
• Current or previous liver disease or dysfunction
• Hormone-dependent tumour
• Unexplained abnormal uterine bleeding
• Ovarian cyst other than polycystic ovary
• Previous or current medically confirmed significant visual disorder associated with clomifene
• Hypersensitivity to clomifene or an excipient

Monitoring

• Assess for ovarian cyst or enlargement before further treatment.
• Confirm treatment response and exclude pregnancy before further treatment.
• Stop treatment and arrange ophthalmological assessment for any visual symptom.
• Consider triglyceride monitoring when hypertriglyceridaemia risk factors are present.
• Promptly assess symptoms suggesting ovarian hyperstimulation.

Clinical pharmacology

A non-steroidal ovulation stimulant that binds hypothalamic oestrogen receptors, increasing pituitary gonadotrophin output and promoting ovarian follicular maturation and endocrine activity.

Formulation and product differences

• The selected tablet contains lactose, maize starch and magnesium stearate; check for relevant hereditary sugar-intolerance conditions.

Tablet

Route: Oral

Strengths: 50 mg