Last update Feb. 19, 2019

Clomifene Citrate

Likely Compatibility

Fairly safe. Mild or unlikely adverse effects. Compatible under certain circumstances. Follow-up recommended. Read Commentary.

Synthetic ovulation stimulant. It inhibits hypothalamic estrogen receptors, which in turn stimulates the release of FSH, estradiol and LH. It has initially anti-estrogenic and then estrogenic effects.
Indicated to induce ovulation in infertility treatment and polycystic ovary syndrome (Hossein 2016, AEMPS 2016, Sanofi 2012, López 2004, Sheehan 2004, Kousta 1997).
Increased risk of multiple pregnancy.
Administered orally, a daily dose for 5 days, maximum 3 menstrual cycles.

Since the last update, we have not found published data on its excretion in breast milk.

Its high volume of distribution makes the transfer to milk in significant quantities unlikely, but its long half-life could facilitate it.

Adverse effects are infrequent and temporary at usual doses; they occur in high doses and for prolonged periods such as those used in research studies (AEMPS 2016, Sanofi 2012).

Studies on the effects on prolactin and milk production are scarce, out of date and contradictory, for while for some authors clomiphene decreases prolactin plasma levels, inhibiting breastfeeding when administered during the first week postpartum (Weinstein 1976, Kalir 1975), for others it has no effect on prolactin nor does it inhibit breastfeeding (Canales 1977).

In any case, when breastfeeding is well established, prolactin levels do not correlate with milk production. This would be the case in an infertility treatment.

It is not advisable to take it during the first weeks of the postpartum period due to the risk of decreased milk production.

In infertility treatment, the possible anovulatory effect of frequent on demand breastfeeding should be taken into account.


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Alternatives

Suggestions made at e-lactancia are done by APILAM team of health professionals, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it. The pharmaceutical industry contraindicates breastfeeding, mistakenly and without scientific reasons, in most of the drug data sheets.

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Other names

Clomifene Citrate is also known as


Clomifene Citrate in other languages or writings:

Group

Clomifene Citrate belongs to this group or family:

Tradenames

Main tradenames from several countries containing Clomifene Citrate in its composition:

Pharmacokinetics

Variable Value Unit
Oral Bioavail. > 90 %
Molecular weight 406 daltons
VD 57 l/Kg
pKa 9.31 -
Tmax 6 hours
120 - 168 hours

References

  1. Hossein-Rashidi B, Khandzad B, Shahrokh-Tehraninejad E, Bagheri M, Gorginzadeh M. Recombinant FSH Compared to Clomiphene Citrate as the First-Line in Ovulation Induction in Polycystic Ovary Syndrome Using Newly Designed Pens: A Randomized Controlled Trial. J Family Reprod Health. 2016 Abstract
  2. AEMPS. Clomifeno. Ficha técnica. 2016 Full text (in our servers)
  3. Sanofi. Clomiphene. Drug Summary. 2012 Full text (in our servers)
  4. López E, Gunby J, Daya S, Parrilla JJ, Abad L, Balasch J. Ovulation induction in women with polycystic ovary syndrome: randomized trial of clomiphene citrate versus low-dose recombinant FSH as first line therapy. Reprod Biomed Online. 2004 Abstract
  5. Sheehan MT. Polycystic ovarian syndrome: diagnosis and management. Clin Med Res. 2004 Abstract
  6. WHO / UNICEF. BREASTFEEDING AND MATERNAL MEDICATION Recommendations for Drugs in the Eleventh WHO Model List of Essential Drugs. Department of Child and Adolescent Health and Development (WHO/UNICEF) 2002 Abstract Full text (link to original source) Full text (in our servers)
  7. Kousta E, White DM, Franks S. Modern use of clomiphene citrate in induction of ovulation. Hum Reprod Update. 1997 Abstract
  8. Canales ES, Lasso P, Soria J, Zárate A. Effect of clomiphene on prolactin secretion and lactation in puerperal women. Br J Obstet Gynaecol. 1977 Abstract
  9. Weinstein D, Ben-David M, Polishuk WZ. Serum prolactin and the suppression of lactation. Br J Obstet Gynaecol. 1976 Abstract
  10. Kalir R, David MP, Kraicer PF. Clomiphene citrate in suppression of puerperal lactation. Am J Obstet Gynecol. 1975 Abstract

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