Clomiphene Citrate
| (KLOE-mih-feen SIH-trate) |
| Clomid, Milophene, Serophene |
| Class: Ovulation stimulant |
Action Induces ovulation in selected anovulatory women.
Indications Treatment of ovulatory failure in women desiring pregnancy when partner is fertile and potent. Unlabeled use(s): Treatment of male infertility.
Contraindications Liver disease; history of liver dysfunction; abnormal bleeding of undetermined origin; pregnancy.
Route/DosageINITIAL THERAPY PO 50 mg/day for 5 days. SECOND AND THIRD COURSES PO 100 mg/day for 5 days.
Interactions None well documented.
Lab Test Interferences None well documented.
Adverse ReactionsCV: Vasomotor flushes. CNS: Headache, dizziness; lightheadedness. EENT: Visual symptoms; blurring spots or flashes; diplopia; photophobia. GI: Abdominal pain/discomfort; distension; bloating; nausea; vomiting. HEPA: Sulfobromophthalein retention. GU: Abnormal uterine bleeding; abnormal ovarian enlargement, luteal cyst formation. OTHER: Breast tenderness.
PrecautionsPregnancy: Category X. Lactation: Undetermined. Multiple pregnancy: May increase chance for multiple pregnancies. Ophthalmologic effects: May cause blurring of vision.
| PATIENT CARE CONSIDERATIONS |
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Administration/Storage- Administer initially over 5 days at approximately 50 mg/day. Follow with second course of 100 mg/day for 5 days.
Assessment/Interventions- Obtain patient history, including drug history and any known allergies.
- Monitor liver function tests before beginning therapy and throughout therapy in patients at risk for hepatotoxicity.
- Notify physician if patient experiences abdominal pain, abnormal uterine bleeding, visual changes or jaundice.
Patient/Family Education- Caution patient that this medication must not be taken during pregnancy or when pregnancy is possible. Advise patient to use reliable form of birth control while taking this drug.
- Counsel patient and partner in purpose of scheduling clomiphene citrate, sexual intercourse and ovulation time to be successful in achieving pregnancy.
- Advise female patient that increased midcycle ovarian discomfort may be experienced and can assist her in planning intercourse.
- Instruct patient of importance of well-balanced diet, mild exercise routine, and avoidance of drugs, caffeine and alcohol while attempting to achieve pregnancy.
- Inform patient of possibility for multiple pregnancies.
- Explain that medication may cause dizziness, hot flashes, headache, nausea and weight gain but that these effects will subside after medication is stopped.
- Instruct patient to report these symptoms to physician: abnormal uterine bleeding, yellowish skin or eyes, blurred vision.
- Advise patient to use caution while driving or using heavy equipment because blurring of vision can occur.
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