Clostilbegyt, tablets 50 mg 10 pcs.

How to take, the dosage

In infertility, the dose and duration of treatment depend on the sensitivity (response to the drug) of the ovaries.

Patients with a regular menstrual cycle are recommended to start treatment on day 5 of the cycle (or on day 3 of the cycle with early ovulation or follicular phase duration less than 12 days). In case of amenorrhea, treatment can be started on any day.

Principle I: 50 mg/day for 5 days with simultaneous control of ovarian reaction by means of clinical and laboratory tests. Ovulation usually occurs between 11 and 15 days of the cycle. If this treatment does not result in ovulation, scheme II should be used.

The scheme II: from the 5th day of the next cycle 100 mg/day for 5 days. If there is no ovulation at this time, the same regimen should be repeated (100 mg/day). If anovulation continues, the drug should be interrupted for 3 months and then the treatment should be repeated for 3 months. If the second course is ineffective, the subsequent treatment with the drug is also ineffective. The maximum total dose of the drug taken during each course is 750 mg.

In polycystic ovaries, due to a tendency to hyperstimulation, the initial dose of the drug is 50 mg/day.

In postcontraceptive amenorrhea the drug should be prescribed at a dose of 50 mg/day daily. As a rule, a 5-day course of treatment is successful with regimen I.

Men as indicated should take 50 mg 1 to 2 times daily for 6 weeks with systematic control of spermograms.

Interaction

Compatible with preparations of gonadotropic hormones.

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Special Instructions

Pending administration of the drug, it is recommended that liver function be investigated. A thorough gynecological examination should be performed before starting treatment. Treatment is started when the total gonadotropin content in the urine is normal or below the lower limit of normal, the ovarian condition on palpation is normal, thyroid and adrenal functions are normal. If there is no ovulation before starting the drug all other possible forms of infertility should be excluded or treated.

If ovarian enlargement or cystic changes occur as a result of taking the drug, treatment should be stopped until the size of the ovaries returns to normal. Thereafter, treatment may be resumed, but the dose of the drug or the duration of treatment may be reduced.

In the course of treatment it is necessary to constantly monitor the gynecologist, monitor the function of the ovaries, conduct vaginal examinations, observe the phenomenon of the “pupil”. It is often difficult to determine the moment of ovulation during the course of treatment, also often there is an insufficiency of the corpus luteum. Therefore, progesterone prophylactic treatment is recommended after conception.

The drug is contraindicated in patients with galactose intolerance, lactase deficiency or glucose malabsorption because each tablet contains 100 mg of lactose.

As the drug may cause visual impairment, during the treatment period the patients should be careful when driving motor transport and engaging in other potentially dangerous activities requiring increased concentration and quick psychomotor reactions.

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Contraindications

• Hepatic and/or renal insufficiency.
• Ovarian cysts (except polycystic ovary syndrome).
• Tumor or pituitary gland hypofunction.
• Thyroid disorders.
• Adrenal disorders.
• Metrorrhagia of unclear etiology.
• Long-standing or recently developed visual disturbances.
• Generic neoplasms.
• Endometriosis.
• Inadequate ovarian function with hyperprolactinemia.
• Pregnancy.
• Lactation (breastfeeding).
• Galactose intolerance, lactase deficiency or glucose malabsorption.
  

Side effects

Digestive system disorders: nausea, vomiting; rarely – gastralgia, flatulence, diarrhea, acute abdominal syndrome, increased appetite.

CNS disorders: headache, dizziness, somnolence; rarely – delayed mental and motor reactions, increased excitability, depression, insomnia.

Senses: visual impairment (including visual perception disorders, double vision, blurred outlines, photophobia).

Urinary system disorders: increased frequency of urination, polyuria.

Perior genital system disorders: pain in the lower abdomen, vaginal dryness.

Endocrine system disorders: mammary gland thickening, dysmenorrhea, abnormal uterine bleeding, increased size of the ovary (including cystic); rarely – pain in the breast area.

The treatment with clomiphene increases the likelihood of multiple pregnancies, ectopic pregnancies, endometriosis, and growth of an existing uterine fibroma.

Cystic ovarian enlargement is possible, especially in Stein-Leventhal syndrome. In these cases, the size of the ovaries can reach 4-8 cm. In this case, body temperature should be monitored and treatment should be stopped as soon as it becomes biphasic.

Dermatological reactions: rarely – alopecia.

Metabolic reactions: rarely – increase or decrease in body weight.

Allergic reactions: rarely – rash, urticaria, allergic dermatitis, vasomotor disorders.

Others: feeling of blood rush to the face with a feeling of fever (stops after the end of the drug).

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Overdose

Symptoms: nausea, vomiting, vasomotor reactions, sensations of blood rush to the face, visual disturbances (decreased visual acuity, flashes, scotoma), ovarian enlargement and pain in the pelvic organs and abdomen.

Treatment: measures aimed at eliminating clomiphene from the body; conducting supportive therapy. There are no data on the possibility of excretion of clomiphene with dialysis.

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Pregnancy use

The use is contraindicated in pregnancy and during breastfeeding.

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