Clomid online in Australia

Use

Therapeutic indications

Treatment of infertility due to anovulation and normoprolactinemic dysovulation of high functional origin:

• anovulation sterility
• sterility by dysovulation:

or "inadequate yellow body"

or short luteal phase

or polycystic ovary syndrome.

Test for both diagnostic and therapeutic purposes:

• in certain amenorrhoea of hypothalamic-pituitary origin
• in long-term amenorrhea after oral contraception (after verifying that the plasma prolactin level is normal).

Ovulation induction as part of medically assisted procreation (intrauterine insemination, IVF)

Dosage and method of administration

Dose

Treatment of infertility by anovulation and normoprolactinemic dysovulation of high functional origin.

The starting dose is 1 tablet per day (50 mg) for 5 days.

Treatment will begin 2 to 5 days after the onset of natural or progestogen-induced withdrawal bleeding, or, in the absence of a cycle, on a day arbitrarily chosen by the treating physician.

In ovulation there is no benefit in increasing the dose in subsequent cycles. Otherwise (no thermal change, plasma progesterone on day 20-26 of the cycle minus 3 ng / ml), 100 mg per day will be prescribed for 5 days during the second treatment cycle (2 tablets in a single dose daily) .

It is not recommended to increase the daily dose and duration of treatment beyond 100 mg / day, for 5 days. If, at this dose, three cycles did not allow ovulation to be obtained, the therapeutic trial will be considered to have ended. When, at a dose of 50 or 100 mg, you have ovulated without this being followed by pregnancy, you can persevere for up to a total of six treatment cycles.

Some patients with polycystic ovaries may be hypersensitive to CLOMID, even at the initial dose (50 mg / day). In this case, the dose for the following cycles can be reduced to ½ tablet per day (25 mg / day).

It is important to remind the couple of the need to have regular sexual intercourse during the supposed fertile period.

CLOMID is not indicated for women who ovulate.

Test for diagnostic and therapeutic purposes

This test is used for the diagnosis of gonadotropic insufficiency if there is a desire for pregnancy. The dose is 2 tablets / day (100 mg) for 5 consecutive days and for a single cycle.

Induction of ovulation in the context of medically assisted procreation (IVF, ...).

Some ovarian stimulation protocols use CLOMID (2 tablets per day from the 2nd to 6th day of the cycle) followed by hMG for several days to cause the maturation of various follicles.

Administration form

CLOMID is administered orally and can only be used under specialized medical supervision.

Prescription and delivery conditions

List I

Duration and special precautions for conservation

Shelf life: 3 years.

Special precautions for storage: Store away from light, moisture and excessive heat.

Preclinical safety data

Not specified

Incompatibilities

Not specified

Employment precautions

Contraindications

• Hypersensitivity to the active substance or to any of the excipients included in the Composition section.
• Recent or severe liver conditions.
• Gynecological hemorrhages of poorly specified etiology.
• "Hormone dependent" tumors.
• Organic ovarian cysts.
• Visual disturbances during treatment or during previous treatments.

Pregnancy and lactation

Animal studies have shown a teratogenic effect.

In clinical practice, there is currently insufficiently relevant data to assess a possible malformation or fetotoxic effect of this medicinal product when administered during pregnancy.

There are no indications for this medicine during pregnancy. However, in case of accidental exposure, there are no arguments to recommend termination of pregnancy.

Warnings and precautions for use

Warnings:

Before administering CLOMID:

• make sure the woman is not pregnant before taking CLOMID. If in doubt, get a sensitive and reliable pregnancy test (consult the patient before each treatment),
• Make sure the cause of infertility is not due to:

or primary ovarian failure,

or hypothalamic-pituitary insufficiency of organic origin,

• investigate and possibly adequately treat other possible causes of infertility, women and men,
• The couple should be warned of the higher probability of multiple pregnancy and its possible complications.
• Medicines used in the treatment of infertility have been reported in some studies published in the literature to increase the risk of certain tumors, benign or malignant, particularly hormone-dependent. However, all the data in the literature do not allow us to conclude with certainty about the presence or absence of an additional risk of developing certain tumors, in particular hormone-dependent tumors, in patients treated with ovulation inducers.

During treatment:

• CLOMID, alone or in combination with gonadotropins, can cause exceptionally severe, often moderate, ovarian hyperstimulation syndrome. Rare cases of severe ovarian hyperstimulation syndromes have been reported during the onset of the following symptoms: pericardial effusion, anasarca, hydrothorax, acute abdomen, kidney failure, pulmonary edema, ovarian hemorrhage, deep vein thrombosis, ovarian torsion, and acute respiratory distress. If pregnancy occurs in a woman with ovarian hyperstimulation syndrome, a rapid progression to a severe form of the syndrome may occur.
• Ovarian hyperstimulation appears a few days after the end of treatment with CLOMID.
• Particular attention will be paid when the patient complains of pelvic pain during treatment, weight gain, a general feeling of swelling. Therefore, an increase in the size of the ovaries should be sought by ultrasound. A new CLOMID therapy sequence will not resume until the ovarian volume has returned to normal. The treatment dose will then be reduced.

Ovarian hyperstimulation with CLOMID is rarely complicated.

Visual symptoms:

The patient should be warned about the risk of developing visual symptoms, such as blurred vision, persistent bright images, phosphenes, scintillating scotomas. These symptoms may appear during or after treatment with CLOMID and are generally reversible. However, cases of prolonged visual disturbances have been reported, even after discontinuing CLOMID. These visual disturbances can be irreversible, especially if the dose and / or duration of treatment are longer than recommended. In the event of visual disturbances, treatment should be definitively suspended and a complete ophthalmological examination performed. Some rare cases of posterior capsular cataract have been reported in patients taking CLOMID, without ruling out or retaining a causal relationship.

Employment precautions

• In obese patients, appropriate dietary measures are recommended throughout treatment to achieve significant weight loss. As with any treatment that induces ovulation, significant obesity should delay treatment initiation and prioritize dietary measures.
• CLOMID should only be used under specialized medical supervision.
• Follow-up should be clinical (functional signs, menotherm) and possibly biological with plasma progesterone dosing, to be performed between the 20th and 26th of the cycle.
• During a CLOMID-induced cycle, a possible progestin treatment should not be prescribed before the 20th day of the cycle, so as not to modify the cervical mucus, especially when ovulation is a little late. At the end of an anovulatory cycle, obtaining a withdrawal bleed by a progestogen sequence allows immediate consideration of a new therapeutic cure at a higher dose.
• Special monitoring is recommended in patients with uterine fibroids due to the risk of fibroid enlargement.
• Although isolated cases of birth defects have been observed after treatment with CLOMID, CLOMID has not been shown to affect the frequency of birth defects in children born to women with fertility problems. The mother's age and multiple pregnancies are risk factors for fetal or neonatal abnormalities.
• Insufficient cervical mucus due to the antiestrogenic action of CLOMID may justify combined local estrogen therapy.
• Hypertriglyceridaemia has been reported (see section 4.8 Unwanted effects). Familial or pre-existing hypertriglyceridemia, and use at higher doses and / or during a longer treatment cycle than recommended are associated with a risk of hypertriglyceridemia. Periodic monitoring of plasma triglyceride levels may be indicated in these patients.
• CLOMID can interfere with cholesterol synthesis when administered for long periods. Patients on prolonged treatment may have elevated levels of desmosterol.
• This medicine contains sucrose. It is not recommended for use in patients with fructose intolerance, glucose-galactose malabsorption syndrome, or sucrase / isomaltase deficiency.
• This medicine contains lactose. Its use is not recommended in patients with galactose intolerance, Lapp lactase deficiency, or malabsorption of glucose or galactose (rare inherited diseases).

Interaction with other medicinal products and other forms of interaction

Not specified

Caution

Undesirable effects

Reproductive system and breast disorders:

• ovarian hyperstimulation (see section 4.4).
• cervical mucus insufficiency due to the antiestrogenic action of CLOMID that may justify an associated local estrogen therapy.

There have been some reports of the development of endometriosis or worsening of pre-existing endometriosis.

• hypermenorrhea, breakthrough bleeding
• breast tenderness
• pelvic discomfort
• endometrial thickness reduction

Kidney and urinary tract disorders:

• pollakiuria

Pregnancy, puerperal and perinatal disorders:

• Moderate risk of multiple pregnancy, including both intra and ectopic pregnancies: The risk of an ectopic pregnancy increases after a CLOMID cycle.

Eye conditions:

• Vision disorders: Blurred vision sensation, persistence of bright images, phosphenes, scintillating scotomas are observed in approximately 2% of cases (frequency increasing with the total dose received).

These visual disturbances generally disappear within a few days or even weeks after treatment is stopped. However, cases of prolonged visual disturbances have been reported, even after stopping treatment. These visual disturbances can be irreversible, especially after an increase in doses and / or the duration of treatment. Its appearance during any treatment requires the immediate cessation of CLOMID and contraindicates any subsequent treatment. Some rare cases of posterior subcapsular cataracts have been reported.

Cardiac disorders:

Tachycardia, palpitations

Skin and subcutaneous tissue disorders:

• urticaria or allergic dermatitis, alopecia

Benign, malignant and unspecified tumors:

Isolated cases of occurrence or worsening of certain tumors, most often hormone-dependent, have been reported.

Nervous system disorders:

• headache, dizziness, lightheadedness, and drunkenness.
• seizures have been reported

Psychiatric disorders:

• Some cases of worsening of a pre-existing psychosis have been reported.
• Asthenodepressive disorders, nervousness, insomnia have also been reported.

Vascular disorders:

• hot flushes

Gastrointestinal disorders:

• nausea, vomiting
• abdominal discomfort (bloating, bloating)
• pancreatitis

Metabolic disorders:

Hypertriglyceridemia sometimes associated with pancreatitis has been observed in patients with familial or pre-existing hypertriglyceridemia, and / or when used at a dose and / or duration longer than recommended. Periodic monitoring of plasma triglyceride levels may be indicated in these patients.

Overdose

No cases of acute poisoning have been reported.

In case of overdose, nausea, vomiting, flushing, potentially irreversible visual disturbances, ovarian enlargement with abdominal and pelvic pain can be observed.

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