Patients taking Clomiphene should be specially warned about such visual side effects as spots, flashes (scintillating scotomata) and blurring which may happen during Clomiphene citrate therapy.

The occurrence of visual events increases with the total dose or with the duration of the treatment with this medication. They usually disappear after several days when the treatment with Clomiphene is stopped.

Patients using this medication should be careful while driving a car or making other dangerous activities which demand special alertness.

These side effects are considered to occur because of the concentration and extension of after images. Visual activity has not been impaired in most patients; study participants who took 200 mg of Clomiphene developed visual blurring after a week of treatment. The side effect proceeds to severe diminution of visual activity by the 10^th day. The visual activity comes back to normal on the 3^rd day after the therapy ends.

Some patients during clinical studies developed phosphenes and scotomata in long-term use of Clomid which vanish on the 22^nd day after the treatment is stopped.

The etiology of these visual side effects is not yet recognized, so it is recommended to stop the treatment in patients with ophthalmological events.

Clomiphene citrate is manufactured by Par pharmaceutical companies, INC.

Clomiphene citrate is available with a prescription under the brand name Clomid in the form of tablets in the dosage of 50 mg. Clomid tablets are round, white tablets with “Par 701” imprint on one side, the other side is plain. Clomid tablets are supplied in cartons of 10 and cartons of 30.

Your doctor and pharmacist has additional information about Clomiphene, if you have any questions ask your doctor.

The medication should be stored in closed containers at controlled room temperature from 15 to 30º C. Clomid tablets should be protected from heat, light and humidity. Keep away from children and pets.

During Clomid animal studies animal fetotoxicity was evaluated. Animal studies involved pregnant rats, mice, rabbits and rhesus monkeys. Clomiphene citrate was administered to pregnant rats in the doses of 1 to 2 mg/kg per day. The result was weak, edematous fetuses and hydramnion. The fetuses had wavy ribs and other bone changes.

The increase in the doses to 8 mg/kg per day to the pregnant rats resulted in resorption and dead fetuses. The further enlargement of the dose in 40mg/kg per day led to dystocia, delayed parturition and maternal deaths.

Single doses of 50mg/kg led to fetal cataracts, the largest tested dose administration of 200 mg/kg caused cleft palate.

The studies have shown that clomiphene injections of 2mg/kg to pregnant rats and mice caused metaplastic alterations of reproductive tract.

Newborn rats and mice were also injected clomiphene of 2 mg/kg in their first days of life. This resulted in uterine and vaginal mucosa metaplastic changes. The newborn animals had early vaginal opening and anovulatory ovaries.

The results of this study were practically the same with other estrogens studies. They have demonstrated abnormal reproductive behavior and changes in the reproductive organs.

The pregnant rabbits tested received oral doses of 20 to 40 mg/kg per day during the pregnancy period. The results were temporary bone changes in fetuses.

In rhesus monkeys that were administered oral doses of 1.5 to 4.5 mg/kg per day during pregnancy period no abnormal offspring was registered.

Clomid is indicated to treat ovulatory failure in women who want pregnancy when their partner is potent and fertile (when men can ejaculate and produce sperm). Clomiphene is usually taken in 5 day cycles in dose of 50 mg per day. The second or third courses of therapy may be given. The dose in the second and third courses is increased to 100mg per day.

According to the results of clinical trials Clomid  starts ovulation in 80% of patients. The trials have demonstrated that about 40% to 45% of women using Clomid get pregnant within six cycles of use.

Clomid is not recommended to use more than six cycles. In case six cycles usage shows no result and pregnancy is not achieved, your doctor may recommend other alternative treatment methods.

Clinical studies of clomiphene citrate involved 7578  participants. Patients were indicated to receive the drug due to their ovulation impediments and ovulatory dysfunctions.

The clinical trials demonstrated successful therapy in more than 30 % of the women (2635 patients got pregnant during the clinical trial period). Spontaneous abortions reported 483 women.

1697 women had single births, the incidence of multiple pregnancies was 7.98% (165 multiple births) including 6.9%- twin, 05.% – triplet, 0.3% -quadruplet, 0.1% quintuplet. The ratio of the monozygotic to dizygotic twins was about 1:5.

The overall survival percent of babies from multiple pregnancies was 73%.

Never take any prescription drug without first consulting your doctor. The following cases should be discussed with your doctor before you start taking Clomid:

• if you might be pregnant;
• in case you have a thyroid problem or another endocrine disorder;
• if you have undiagnosed vaginal bleeding;
• if you have endometriosis or endometrial carcinoma;
• in case you suffer from uterine fibroids;
• if you have liver disease;
• if you have been diagnosed to have ovarian cysts or ovarian enlargement not due to polycystic ovarian syndrome;
• in case you suffer from  other serious or chronic medical disorders.

In the above mentioned cases taking Clomid may be forbidden for you may or you may require a lower dose. Your doctor will monitor your condition if you have any of the conditions listed above.

Do not take the drug if you are pregnant. Clomid belongs to the pregnancy category X.  It is known if Clomid may cause birth defects.

It is not known if the drug may pass into breast milk. If you are breast – feeding a baby, consult your doctor before taking Clomid.

According to the results of clinical trials, Clomiphene citrate in recommended doses is generally well tolerated. Side effects are usually of mild character and disappear after the treatment is stopped.

The following side effects were reported in less than 1 % of the tested women:

·        Acute abdomen;

·        Appetite increase;

·        Constipation;

·        Dermatitis or rash;

·        Depression;

·        Diarrhea;

·        Dizziness;

·        Fatigue;

·        Hair loss;

·        Insomnia;

·        Light-headedness;

·        Fatigue;

·        Increased urinary;

·        Vaginal dryness;

·        Weight gain or loss.

Other side effects may include:

• ovarian enlargement presenting as abdominal or pelvic pain, tenderness, pressure, or swelling;
• flushing;
• nausea, vomiting;
• breast tenderness or discomfort;
• blurred vision or other visual disturbances;
• headache;
• abnormal uterine bleeding.

Inform your doctor if you have allergic reactions to any component of the drug. If you experience any of the following conditions, stop taking Clomid and seek emergency medical attention immediately: difficulty breathing, swelling of lips, tongue, or face, hives.

The syndrome of ovarian hyperstimulation (OHSS) is one of the reported conditions in patients taking Clomid.  The OHSS includes swelling of the hands or legs, abdominal pain and swelling, shortness of breath, weight gain, and nausea or vomiting. This syndrome can have a fatal character. Inform your doctor at once if you experience any of the side effects of this syndrome.

Clomid common side effects are hot flashes; breast tenderness, mood swings, and nausea, still they aren’t so bad in comparison with other fertility drugs. When your doctor decides to stop the treatment, the side effects will disappear.

Clomid increases the likelihood of multiple births.  There is a 10% chance of having twins when taking Clomid.

Having triplets or multiples of more are less than 1% of the time. Still this side effect may worry some women greatly. Multiple births may carry additional risk both for the mother and for the fetuses.

The other side effect of the drug is the ability of  Clomid to  decrease the quality of the cervical mucus. And sperm has to make its way to the egg with more difficulty. Taking Clomid may increase the chance of making uterus thinner and this may cause problems for implantation.

Side effects other than those mentioned here may also appear. Inform  your doctor about any side effect especially if it is unusual or bothersome.

Before using this drug consult your doctor. Your doctor will give you all the necessary directions on how to use this drug.  Follow all the directions to have a good result for your health and avoid possible side effects.

The most common recommended dose of Clomid is 50 mg, used during five days, on days 3 through 7 of your cycle, or days 5 through 9 of your cycle. The day one of your cycle is thought to be the first day of real menstrual bleeding.

According to the clinical trials ovulation and pregnancy rates are similar whether the drug is started on day two, three, four, or five.  Follow your doctor directions even if you have a different schedule to follow than other patients.

Sometimes the starting dose of 50 mg doesn’t work, and then your doctor can increase the dose for a successive result. The other way you can  have another try at 50 mg.

Remember that more amount of the drug especially at or above 150 mg can increase the risks of side effects. Do not exceed the recommended dose on your own.

The drug is indicated when the problems with ovulation occur. Still if you have got problems of different character such as blocked fallopian tubes, stimulating the ovulation process is meaningless due to the fact that the egg and sperm cannot simply meet.

In case there is a problem with menstrual cycles (irregular cycles, or cycles without ovulation) the drug may be administered.

When a woman has endocrine disorders such as Polycystic ovary syndrome (PCOS) the drug is often used. The main commonly associated with PCOS conditions are obesity, irregular menstruations, amenorrhea, acne, cycles without ovulation and great amount of androgenic hormones. The infertility in women is also related to PCOS. This condition is characterized by inability of a woman to carry a pregnancy to full term.

Clomid is used to treat the infertility of unexplained character. The drug is also a way for people who cannot afford more expensive invasive fertility treatments such as in vitro fertilisation – (IVF).  Clomid is not used in IVF; it is more commonly used during intrauterine insemination (IUI) when sperm is placed into female’s uterus artificially with the purpose to impregnate a woman.