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Clostilbegyt® is an anti-estrogen drug of non-steroid structure.
The mechanism of action is due to specific binding to the estrogen receptors of the ovaries and pituitary. With a low content in the body, estrogen exhibits a moderate estrogenic effect, with a high content - anti-estrogenic effect. In small doses, increases the secretion of gonadotropins (prolactin, FSH and LH), stimulates ovulation; in high doses inhibits the secretion of gonadotropins. Progestin and androgenic activity does not possess.
- Anovulatory infertility (induction of ovulation).
- Amenorrhea (disgonadotropic form).
- Secondary amenorrhea.
- Post-contraceptive amenorrhea.
- Stein-Leventhal syndrome (polycystic ovary syndrome).
- Galactorrhea (on the background of a pituitary tumor).
- Chiari-Frommel syndrome (long postpartum amenorrhea-galactorrhea syndrome).
- Androgen deficiency.
- In men: oligospermia.
1 tablet contains:
Active substance: clomiphene citrate 50 mg;
Excipients: gelatin, magnesium stearate, stearic acid, talc, potato starch, lactose monohydrate.
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Dosage and Administration
With infertility, the dose and duration of treatment depend on the sensitivity (reaction to the drug) of the ovaries.
Patients with a regular menstrual cycle are advised to begin treatment on the 5th day of the cycle (or on the 3rd day of the cycle for early ovulation or the follicular phase of less than 12 days). With amenorrhea, treatment can begin any day.
Scheme I: 50 mg / day for 5 days while controlling the reaction of the ovaries using clinical and laboratory studies. Ovulation usually occurs between 11 and 15 days of the cycle. If such treatment does not lead to ovulation, then scheme II should be applied.
Scheme II: From day 5 of the next cycle, 100 mg / day is prescribed for 5 days. If at this time ovulation is not observed, then you should repeat the same scheme again (100 mg / day). In case of continuing anovulation, the drug should be discontinued for 3 months, and then repeat the treatment for 3 months. With the ineffectiveness of the second course, subsequent drug treatment is also not effective. The maximum total dose of the drug taken during each course is 750 mg.
In case of polycystic ovary, due to the tendency to overstimulation, the initial dose of the drug is 50 mg / day.
In postcontraceptive amenorrhea, the drug should be administered at a dose of 50 mg / day daily. As a rule, when using Scheme I, a five-day course of treatment is successful.
Men in accordance with the indications of the drug is prescribed 50 mg 1-2 times / day for 6 weeks under the systematic control of sperm.
From the digestive system: nausea, vomiting; rarely - gastralgia, flatulence, diarrhea, acute abdomen syndrome, increased appetite.
From the side of the central nervous system: headache, dizziness, drowsiness; rarely - slowing of mental and motor reactions, irritability, depression, insomnia.
From the senses: visual impairment (including disturbance of light perception, doubling, blurring of contours, photophobia).
From the urinary system: increased urination, polyuria.
From the reproductive system: abdominal pain, vaginal dryness.
On the part of the endocrine system: breast seal, dysmenorrhea, abnormal uterine bleeding, an increase in the size of the ovary (including cystic); rarely - tenderness in the chest.
The treatment of clomiphene increases the likelihood of multiple pregnancy, ectopic pregnancy, endometriosis, and growth of the existing fibroma of the uterus.
Perhaps cystic enlargement of the ovaries, especially with Stein-Leventhal syndrome. In these cases, the size of the ovaries can reach 4-8 cm. At the same time, it is necessary to monitor the body temperature and discontinue treatment as soon as it becomes biphasic.
Dermatological reactions: rarely - alopecia.
Metabolism: rarely an increase or decrease in body weight.
Allergic reactions: rarely - rash, urticaria, allergic dermatitis, vasomotor disorders.
Other: feeling a rush of blood to the face with a feeling of fever (stop after taking the drug).
- Hepatic and / or renal failure.
- Ovarian cyst (except polycystic ovarian syndrome).
- Tumor or hypofunction of the pituitary gland.
- Thyroid dysfunction.
- Adrenal dysfunction.
- Metrorrhagia unclear etiology.
- Long-term or recently developed visual impairment.
- Neoplasms of the genitals.
- Lack of ovarian function on the background of hyperprolactinemia.
- Lactation (breastfeeding).
- Galactose intolerance, lactase deficiency or glucose malabsorption.
- Hypersensitivity to the drug.
Compatible with gonadotropic hormone preparations.
Pregnancy and Lactation
Contraindicated use during pregnancy and during breastfeeding.
Prior to taking the drug, it is recommended to investigate the function of the liver. Before treatment, a thorough gynecological examination should be carried out. Treatment begins when the total content of gonadotropin in the urine is normal or below the lower limit of normal, the state of the ovaries during palpation is normal, the functions of the thyroid gland and the adrenal glands correspond to the norm. In the absence of ovulation prior to the use of the drug, all other possible forms of infertility should be eliminated or cured.
If an ovarian increase or cystic change occurs while taking the drug, treatment should be stopped until the size of the ovaries returns to normal. In the future, you can resume, but at the same time reduce the dose of the drug or the duration of treatment.
In the process of treatment, it is necessary to constantly monitor the gynecologist, it should monitor ovarian function, conduct vaginal examinations, observe the phenomenon of the "pupil". Often during the course of treatment it is difficult to determine the moment of ovulation, and there is often deficiency of the corpus luteum. Therefore, after conception, prophylactic progesterone treatment is recommended.
The drug is contraindicated in patients with galactose intolerance, lactase deficiency or glucose malabsorption, because Each tablet contains 100 mg of lactose.
Since the drug can cause visual impairment, during the period of treatment, patients should be careful when driving vehicles and engaging in other potentially hazardous activities that require increased concentration and psychomotor speed.
Symptoms: nausea, vomiting, vasomotor reactions, sensations of flushing to the face, visual disturbances (reduced visual acuity, outbreaks, scotoma), ovarian enlargement and pain in the pelvic organs and in the abdomen.
Treatment: measures aimed at removing clomiphene from the body; conducting maintenance therapy. Data on the possibility of excretion of clomiphene during dialysis are not available.
- Brand name: Clopidogrel-SZ
- Active ingredient: Clopidogrel
- Dosage form: pills, film coated from pink to dark pink, round, biconvex.
- Manufacturer: Canonpharma
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- Histochemical study of estrogenic and antiestrogenic effects of clomiphene citrate on glycogen synthesis by myometrium and luminal epithelium of rat uterus
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- Treatment of senile dementia with thyrotrophin releasing hormone and clomiphene
- Ultrasound diagnosis of quintuplets following clomiphene-induced ovulation
- Transabdominal ultrasonographic evaluation of endometrial thickness in clomiphene citrate-stimulated cycles in relation to conception
- Ovarian stromal blood flow following clomiphene citrate challenge test in infertile women
- The preparation of carbon-14 labelled 1-[4-(2-diethylamino-ethoxy) phenyl]-1, 2-diphenyl-2-chloroethene (clomiphene) and 1-[4-(2-(N-pyrrolidinyl) ethoxy) phenyl]-2-(4-methoxyphenyl)-2-nitro-2-phenylethene (CI-628, nitromiphene)
- Reduction of iminium ethers with sodium boro[3H] hydride. Preparation of tritium labelled clomiphene and nitromiphene (CI 628)
- Synthesis of carbon-14 labeled clomiphene
- Regulation of lipid biosynthesis in Chlorella kessleri by clomiphene
- Stereochemistry of geometric isomers of clomiphene: A correction of the literature and a reexamination of structure-activity relationships
- Uterine abnormalities in rats exposed neonatally to diethylstilbestrol, ethynylestradiol, or clomiphene citrate
- Pituitary-related weight changes affecting the liver, uterus and adrenal glands of rats treated with hexoestrol and clomiphene in high doses
- Simple and rapid determination of clomiphene cis and trans isomers in human plasma by high-performance liquid chromatography using on-line post-column photochemical derivatization and fluorescence detection
- Analysis of clomiphene isomers in human plasma and detection of metabolites using reversed-phase chromatography and fluorescence detection
- Multivariate analysis of capillary electrophoresis separation conditions for Z-E isomers of clomiphene