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Clomid is a prescription medicine used to treat infertility. It contains Clomiphene citrate as the active ingredient and belongs to a class of drugs called ovulatory stimulants. Also, it is a selective estrogen receptor-modulating agent.

The drug is relatively safe, but you should not abuse it because there are increasing reports that bodybuilders and athletes use it to enhance performance. Clomid comes in 50 milligrams, an off-white round tablet form.

Uses (Indications) for Clomid

Clomid is used to treat infertility due to irregular ovulation in women who want to get pregnant. It is indicated for infertility in women with the polycystic ovarian syndrome (PCOS). Additionally, it is used to treat patients with persistent milk production, menstrual cycle abnormalities, and fibrocystic breasts.

In men, Clomid can be used to treat male infertility, especially in cases of low testosterone levels. However, there is a lack of adequate established data or reports of its effectiveness.

Clomid Dosage Considerations and Precautions

Since Clomid is a prescription medicine, the dosage your doctor will prescribe is dependent on the severity of the condition, other health conditions as well as whether the benefits outweigh the risk. An endocrinologist or a gynecologist, who are experts in endocrine and gynecology disorders, respectively, monitor or supervise the use of Clomid after careful diagnosis. The following considerations should be noted before the use of Clomid:

  1. Presence or absence of ovarian cysts: The drug should not be utilized in patients suffering from ovarian cysts unless those who have PCOS.

  2. Pregnancy or lactation: It should not be used in pregnant women or lactating mothers.

  3. Abnormal bleeding: A doctor should evaluate patients for abnormal bleeding from the vaginal associated with neoplastic lesions before Clomid administration.

  4. Liver problems: Clomid should not be used in those with impaired or dysfunctional liver.

  5. Uterine fibrosis: Clomid use in patients suffering from uterine fibroids should proceed cautiously to prevent further fibroid enlargement.

  6. Endometriosis and Endometrial cancer: Endometrial biopsy must be carried out before Clomid therapy because ovarian dysfunction and endometriosis/ endometrial cancer increase with age.

  7. Estrogen levels: Patients should be evaluated for adequate estrogen levels since Clomid is an estrogen receptor-modulating drug.

In general, the following investigations should be carried out before, during, and after the use of Clomid:

  • Liver function tests;

  • Lipid profiles;

  • Hormonal profile;

  • Ovulatory profile;

  • Endometrial biopsy;

  • Abdominal scans.

Dosage

For ovulation stimulation in patients with infertility due to anovulation, 50 mg per day for five days is adequate. Since ovulation usually occurs five to ten days after taking Clomid, sexual intercourse should be planned to match the expected ovulation time to achieve pregnancy. The initial 50 mg per day could be increased to 100 mg per day if ovulation did not occur during the first cycle.

Before increasing the dose of Clomid, patients should, however, be evaluated to ascertain the following:

  • Whether pregnancy occurred;

  • Whether the ovaries were enlarged;

  • Whether there was a formation of ovarian cyst between the treatment cycles.

Most patients ovulate after the initial or second treatment cycles. But if no ovulation occurs after three therapy cycles, the doctor should re-evaluate the patient for pregnancy, uterine bleeding, or menstruation. Also, if no pregnancy occurs after three ovulatory responses or menstruation does not happen after the ovulatory response, a re-evaluation for other impediments to pregnancy should be done. These include:

  • Primary ovarian or pituitary failure;

  • Male factor infertility;

  • Thyroid and adrenal disorders, for which the use of Clomid is not indicated.

Clomid Interactions

Clomid interacts with some drugs, alcohol/ food, and certain pathological conditions. It has severe interactions with bexarotene and fluoro-estradiol F18, while it has moderate interactions with abrocitinib and ospemifene.

Clomid interacts with the following pathological conditions:

Hyperlipidemia, particularly hypertriglyceridemia. This condition has been observed in patients who are taking Clomid. It is, therefore, important that triglyceride levels of patients who are to receive Clomid are measured before, during, and after treatment.

Hyperpituitary  Activity. Clomid interacts with estrogen receptors in various tissues. This can stimulate and cause an uncontrollable increase in the release of pituitary hormones, which subsequently causes thyroid and adrenal dysfunction. Clomid is therefore contraindicated in patients with hyperpituitarism, intracranial lesions, and pituitary tumors.

Uncontrolled Adrenal Dysfunction. Clomid interferes with steroidogenesis and fluid hemostasis (fluid regulation).

Abnormal uterine bleeding. Clomid is contraindicated in patients with uncommon or undiagnosed uterine or genital bleeding. It is essential to evaluate patients to ensure that neoplastic lesions are not present.

Hepatic dysfunction. The liver metabolizes clomid.  Therefore, patients with hepatic impairment or recent history of liver diseases may find it difficult to excrete Clomid. This results in increased levels of the drug in the plasma and prolonged half-life in the blood in patients whose livers are compromised.

Adverse/ Side Effects of Clomid

Adverse effects can occur when using Clomid due to hypersensitivity to its active compounds, poisoning, or abuse of the drug.

Some of the reported side effects of Clomid are:

  • Vomiting

  • Stomach cramps

  • Nausea

  • Bradycardia

  • Tachycardia

  • Rapid weight gain

  • Bloating of the abdomen

  • Dyspnea

Other side effects include

  • Ovarian hyperstimulation

  • Headaches

  • Spotting

  • Breast tenderness accompanied by pains and flushing

  • Tingly sensations

  • Abdominal fullness

  • Blurred vision

Overdose, Missed Dose, and Storage

In case of a suspected overdose or if you experience any of the listed side effects or other severe conditions while taking Clomid, call 911 or the poison control center in your area.

If you miss a dose, do not take a double dose to make up. Instead, call your doctor. Only take Clomid as prescribed and directed by your doctor.

Clomid should be stored away from light, moisture and at room temperature. It shouldn’t be kept in the toilet.

It is also essential to keep Clomid and other medicines away from the reach of children, pets, and domestic animals.