Fermid

Indications

Clomiphene Citrate is a fertility medicine used to help women who do not ovulate (release an egg) regularly, for example because of polycystic ovary syndrome (PCOS), to become pregnant. It is prescribed by a doctor, usually a gynaecologist or fertility specialist, after checking the cause of infertility.

How It Works

It blocks the effect of oestrogen in the brain. The brain responds by releasing more of the hormones (FSH and LH) that make the ovaries grow and release an egg.

Dosage and Administration

Take exactly as prescribed. It is usually taken by mouth once a day for 5 days early in the menstrual cycle, starting on the day the doctor advises. The dose may be adjusted in later cycles depending on whether ovulation happens. Treatment is normally limited to a few cycles (usually no more than six in total). The doctor may use scans or blood tests to check the response.

Interactions

No major interactions are well established. Tell the doctor about all medicines you take, including other fertility treatments, hormones and herbal products.

Contraindications

• Pregnancy
• Liver disease or a history of liver problems
• Abnormal bleeding from the womb whose cause has not been found
• Ovarian cysts or enlarged ovaries not caused by PCOS
• Uncontrolled thyroid or adrenal gland problems, or a tumour of the pituitary gland
• Hormone-dependent cancers, such as cancer of the womb lining
• Allergy to Clomiphene

Side Effects

Common: hot flushes, bloating or discomfort in the lower abdomen, enlarged ovaries, breast tenderness, nausea, headache, mood swings and trouble sleeping. There is a higher chance of twins or other multiple pregnancy.

Get urgent medical help if you notice:

• Severe pain or swelling of the abdomen, rapid weight gain, shortness of breath or passing very little urine (signs of ovarian hyperstimulation)
• Blurred vision, spots, flashes of light or other changes in eyesight (stop taking it and see a doctor)
• Swelling of the face, lips or throat, or difficulty breathing

Pregnancy and Lactation

It must not be taken during pregnancy. If your period does not come, a pregnancy test should be done before starting the next course. It may reduce breast milk and is not recommended while breastfeeding.

Precautions and Warnings

• If eyesight changes, stop treatment and do not drive or use machines until it has been checked.
• Women with PCOS can be more sensitive to the medicine and may need a lower dose.
• Do not use for more cycles than advised; long-term use is not recommended.
• Tell the doctor about high blood fats (triglycerides), liver problems or unusual vaginal bleeding.

Overdose

Symptoms may include nausea, vomiting, hot flushes, blurred vision, abdominal pain and enlarged ovaries. Seek medical help.

Therapeutic Class

Ovulation stimulant (selective oestrogen receptor modulator).

Storage

Store below 30°C in a dry place, away from light and out of the reach of children.