Clostilbegyt® [Clomiphene]

Pharmacological properties

Clomiphene (2- [4- (2-chloro, -1, 2-diphenylenethenyl) phenoxy] -n, n-diethylamine dihydrocytrate (mixture of e- and z-isomer)). the active ingredient of the drug is a non-steroidal antiestrogen that stimulates ovulation. the mechanism of action is explained by the ability to specifically bind to estrogen receptors in the hypothalamus and ovaries. the drug in low doses enhances the secretion of gonadotropic hormones (prolactin, follicle-stimulating and luteinizing) and stimulates ovulation. clostilbegit in high doses inhibits the secretion of gonadotropins. does not reveal gestagenic and androgenic activity.

After use, it is completely absorbed in the digestive tract. Metabolized in the liver. It is excreted mainly with bile, is subject to enterohepatic recirculation, excreted in the body with feces. The elimination half-life makes 5–7 days.

Indications

For treatment of anovulatory disorders of the menstrual cycle, including the induction of ovulation in women with anovulatory cycle, ciaari - Frommel syndrome, Stein - Leventhal syndrome, secondary amenorrhea of ​​various etiologies (including aminorrhea after contraceptive use), oligomenorrhea, galactorrhea (non-tumor genesis) ), oligospermia.

Application

In case of regular cyclic bleeding, treatment is recommended to start on the 5th day of the cycle.

Scheme I: a daily dose of 50 mg (1 tablet) daily for 5 days, under the control of the ovarian reaction through clinical and laboratory studies. Ovulation mostly occurs between the 11th and 15th day of the cycle.

Scheme II: this scheme should be used in case of failure during treatment according to scheme I. Daily doses of 100 mg (2 tablets) must be taken for 5 days, starting from the 5th day of the next cycle. If therapy has not led to ovulation, a second course (100 mg) can be prescribed. In the absence of ovulation, and in this case, after a 3-month break, you can try another 3-cycle course of treatment. If ovulation did not take place after this, it is not recommended to repeat treatment.

The total dose during the cycle should not exceed 750 mg.

In the absence of menstruation after the use of contraceptives, it is recommended to take 50 mg (1 tablet) per day for 5 days.

Regarding infertility in men, oligospermia is treated with a daily dose of 50 mg (1 tablet) for 6 weeks.

It is important not to exceed the indicated doses.

Contraindications

Clostilbegit should not be prescribed for allergies to the active ingredient and / or other components of the drug; during pregnancy; with liver disease; ovarian cyst; the presence of a tumor; decreased pituitary function; uterine bleeding of unknown etiology; visual impairment.

Side effects

Side effects that occur mainly only when the drug is used in high doses include headache, dizziness, nausea, sometimes vomiting, depression, fatigue, anxiety, insomnia, weight gain, abdominal pain, hot flashes. symptoms such as blurred vision disappear after discontinuation of treatment. in some women, ovarian enlargement is possible, sometimes the ovaries can increase to 4–8 cm, therefore it is necessary to control the basal temperature and if a two-phase temperature curve appears, treatment should be discontinued. with prolonged administration of the drug, hair loss is possible. in some cases, skin rashes accompanied by itching, allergic dermatitis, chest pain, painful menstruation, and urination disorders are noted. the probability of multiple pregnancy increases.

special instructions

Before starting the use of tablets, it is necessary to determine the function of the liver, the hormonal state and the level of gonadotropin in renal excretion. A thorough gynecological examination is also necessary.

Liver function and ovarian size should also be controlled in dynamics.

The drug can be taken only under the supervision of a gynecologist, who can reduce the dose of the drug or prescribe it only for a short time.

After successful completion of the course of therapy with Clostilbegitum, progesterone treatment can be prescribed.

At the beginning of treatment with Clostilbegyt, a temporary visual impairment is possible. In this case, driving and working with other mechanisms are contraindicated.

Each tablet of Clostilbegyt contains 100 mg of lactose, which should be considered when prescribing the drug to patients with diabetes mellitus.

Interactions

The drug does not interact with other drugs. complex therapy is considered rational, carried out according to the indications with the use of clostilbegit and preparations of gonadotropic hormones.

Overdose

Symptoms: nausea, vomiting, flushing, blurred vision, ovarian hypertrophy, stomach pain.

Storage conditions

At a temperature of 15–25 ° C.