- Dosages used
- Clostilbegit for infertility
Clostilbegit (clomiphene) is one of the classes of selective estrogen receptor modulators (SERMs). The mechanism of action of Clostilbegit is based on a selective effect on estrogen receptors of the hypothalamic-pituitary system, due to which the receptors are blocked for estrogens and, through a feedback mechanism, the secretion of gonadotropins (follicle-stimulating and luteinizing hormones) is increased, which, acting on the follicles in the ovaries, causes stimulation of their function ( stimulation of ovulation). There are indications that blockade of estrogen receptors in the hypothalamus leads to increased production of GnRH, thereby providing a higher level of regulation of the hypothalamic-pituitary-ovarian system.
Clostilbegit has certain pharmacokinetic features: good absorption when taken orally, long (up to 7 days) half-life due to active binding to blood plasma proteins.
Clostilbegit: mechanism of action
Clostilbegit belongs to the group of non-steroidal antiestrogenic drugs that stimulate ovulation.
The mechanism of action of this drug is based on the activation of the synthesis of gonadotropic hormones in the pituitary gland: FSH (follicle-stimulating), LH (luteinizing) and prolactin. The effect of clostilbegit directly depends on its dosage: the higher it is, the more the production of gonadotropins is suppressed, and vice versa, small doses of the drug enhance the formation of tropic hormones and promote ovulation. In addition, it is worth noting that the mechanism of action of clostilbegit is influenced by the concentration of estrogen in the blood: at low levels of estrogen it causes a moderate estrogenic effect, and at elevated levels it leads to an anti-estrogenic effect. However, it does not affect progestogen and androgenic activity in any way.
Nowadays, the drug is widely used in gynecology as part of infertility therapy, because immediately after its absorption, the processes of follicle maturation are activated and accelerated. Clostilbegit is available in the form of flat grayish-white tablets. Its active ingredient is clomiphene citrate, in the amount of 50 mg per tablet. It is very quickly absorbed from the digestive tract after oral administration. The breakdown of the drug occurs in the liver, and the metabolites are completely excreted along with bile within 10-14 days.
Clostilbegit is often prescribed during IVF (in vitro fertilization) to stimulate the formation of eggs. There are cases when specialists do not wait for the follicle to rupture, but immediately puncture mature female reproductive cells for the next stage of IVF.
Release form and composition
The drug is produced by a Hungarian pharmaceutical company. Its main active ingredient is clomiphene citrate. Its content in 1 tablet is 50 mg. The medication contains many auxiliary components, among which it is worth highlighting lactose monohydrate, stearic acid, talc, potato starch and gelatin.
Clostilbegit is produced for men and women in white tablets. They may also have a slight grayish or yellowish tint. They are round and flat, in the middle they have a dividing chamfer. To distinguish the original from counterfeits, make sure that the tablet is engraved with CLO. The drug has no pronounced smell or taste. You can buy Clostilbegit at a pharmacy with a doctor's prescription. It is sold in cardboard packages or glass bottles, and the tablets themselves are stored in blisters made of aluminum foil.
Clostilbegit: indications and contraindications
The main purpose of taking clostilbegit is to stimulate ovulation, which is carried out in the following situations:
- Anovulatory cycles;
- Amenorrhea of various origins or oligomenorrhea;
- Polycystic ovary syndrome (PCOS);
- Pituitary tumors causing galactorrhea;
- Prolonged postpartum amenorrhea and galactorrhea caused by various pathological processes, for example, Chiari-Frommel syndrome;
- Androgen deficiency.
Clostilbegit is prescribed not only to women, but also to men, since this drug has a positive effect on sperm quality, especially with oligospermia (reduced number of sperm in the ejaculate).
But this medication can cause adverse reactions from other organs and systems, so it is contraindicated in cases of renal and liver failure, neoplasms of the reproductive system and pituitary gland, ovarian cysts, kidney and liver failure. It should not be used in cases of changes in the functionality of the adrenal glands and thyroid gland, hypofunction of the pituitary gland, uterine bleeding of unknown etiology, visual and metabolic disorders. It is also not recommended to use clostilbegit during pregnancy and lactation, in case of hypersensitivity to the components of the drug.
Indications for use
It is worth noting that most often the drug is prescribed to women, not men. It is used in the absence of ovulation, since the action of the drug is aimed at stimulating this process. The medicine also helps well with amenorrhea, that is, with a long absence of menstruation over several cycles. It can also be used for rare periods, the interval between which exceeds 35-40 days. The benefits of the drug for women have been proven by many studies, but not everyone knows that it can also be effectively used to treat male infertility.
As a rule, it is prescribed when oligospermia is detected, that is, when the patient has insufficient ejaculate volume. "Clostilbegit" for men, when taken for a long time, stimulates the production of sperm in sufficient quantity for conception. In addition, this drug is an anti-estrogen, so it is also used by bodybuilders who want to maintain their physical shape in good condition. However, it is not recommended to choose it without consulting a specialist, because incorrectly taking the medication can subsequently result in problems with sexual function and hormones.
Clostilbegit: method of application and dosage
Clostilbegit is produced in the form of tablets, so it is intended only for oral administration. It is advisable to take it at the same time; the treatment regimen and dosage are determined by the attending physician depending on the characteristics of the patient and the reaction of the genital organs to the drug.
If the patient is diagnosed with infertility and her menstrual cycle is regular, then clostilbegit is prescribed on the 5th day of the cycle. With amenorrhea, the day of the first dose is not of fundamental importance.
There are 2 main schemes for using clostilbegit.
As a rule, patients are initially prescribed 1 regimen: 50 mg once a day for 5 days. During therapy, it is necessary to monitor the ovarian response and conduct laboratory tests. The result of this treatment is ovulation on days 11-15 of the menstrual cycle.
If the desired effect from the first regimen does not occur, then a second regimen is prescribed: for the next cycle, the woman must immediately take 2 tablets of clostilbegit (100 mg) once a day for 5 days. If such a dosage helps achieve the desired ovulation and pregnancy, then the drug is immediately discontinued. But if the therapy does not bring results, then it is worth taking a break for 3 months and then repeating treatment according to scheme 2. The basic rule of any course is that the total dose for the entire period is no more than 750 mg.
To avoid ovarian hyperstimulation in PCOS, clostilbegit should be taken no more than 50 mg once a day. To treat complications from long-term use of oral contraceptives, in particular amenorrhea, you should start using one regimen. In most cases, patients experience results immediately after the first attempt. The therapeutic course of clostilbegit in men takes longer - approximately 6 weeks, while 50 mg of the drug must be taken 1-2 times a day.
How to take the medicine correctly?
To achieve an effective result, the instructions for men recommend taking Clostilbegit only under the supervision of a specialist. The medicine is usually taken in a course lasting 5-6 weeks. While taking the medication, regular spermograms are performed to monitor changes in the patient’s fertility level. The drug is usually taken in the morning and evening. Men should take one 50 mg tablet at a time. However, if the disease is mild, the doctor may reduce the dosage to one dose per day. You need to take the tablet with a small amount of clean water; it is not recommended to chew the medication.
If there is no visible effectiveness from taking the drug, the doctor may extend the course. However, the total dose taken over the course of a week should not exceed more than 750 mg. Before starting to take the medicine, it is recommended to undergo a full examination and also check your liver.
Clostilbegit: negative reactions
Clostilbegit is a non-steroidal drug that can cause various adverse reactions from different body systems. Most often, it leads to the development of dyspeptic symptoms (nausea, vomiting, loss of appetite, weakness, changes in stool, flatulence, and others), but can contribute to the appearance of pain in the abdominal area. Some patients complain of dizziness, headaches, depression, irritability and insomnia, and allergic reactions. Visual dysfunction cannot be ruled out: double vision, photophobia, disturbances in light perception, so you should not drive vehicles or work with precise and dangerous machinery after taking the drug.
Clostilbegit can also negatively affect the state of the hormonal system, causing disruption of the menstrual cycle, uterine bleeding, enlarged ovaries, and pain in the mammary glands.
In addition, it contributes to the development of endometriosis, the progression of uterine fibroids and increases the likelihood of multiple or ectopic pregnancy.
The literature describes cases of clostilbegit overdose, so patients are not recommended to change the treatment regimen on their own, so as not to cause abdominal pain, nausea, vomiting, lower back discomfort, visual disturbances and ovarian hyperstimulation (excessive enlargement). There is no specific therapy for such conditions; specialists take measures to eliminate unfavorable symptoms and promote rapid elimination of the drug.
Side effects of the drug Clostilbegit
Side effects that occur mainly only when the drug is used in high doses include headache, dizziness, nausea, sometimes vomiting, depression, fatigue, anxiety, insomnia, weight gain, abdominal pain, and hot flashes. Symptoms such as blurred vision disappear after stopping treatment. In some women, ovarian enlargement is possible, sometimes the ovaries can increase to 4–8 cm, so it is necessary to monitor the basal temperature and if a biphasic temperature curve appears, treatment should be stopped. With prolonged administration of the drug, hair loss may occur. In some cases, skin rashes accompanied by itching, allergic dermatitis, chest pain, painful menstruation, and difficulty urinating are noted. The likelihood of multiple pregnancies increases.
Clostilbegit: features of administration
Before you start taking clostilbegit, you should undergo a full medical examination and find out the etiology of infertility. Therapy with the drug is possible with normal test results, calm ovaries during palpation, adequate functioning of the adrenal glands and thyroid gland, and sufficient concentrations of gonadotropin in the blood and urine.
While taking clostilbegit, the ovaries may become enlarged (up to 8 cm) and cysts may appear in them. In this case, the drug is discontinued until the body is completely restored, and then its dosage is reduced and the duration of the course is reduced. But sometimes clostilbegit is replaced with analogues when such complications occur.
Throughout the entire period of treatment, the doctor monitors the condition of the vagina, the reaction of the ovaries, checks their functionality, he can detect the phenomenon of the “pupil” - an increase in the amount of cervical mucus before ovulation.
In some patients, it is difficult to determine ovulation even after stimulation with clostilbegit, and the possibility of the formation of an inferior corpus luteum cannot be ruled out. Therefore, after the desired pregnancy occurs, women are recommended to use progesterone preparations.
Clostilbegit is a popular remedy that is prescribed in many specialized institutions, including the IVF Center clinic in Smolensk. This is due to the rapid positive effect of taking it immediately after the first course of therapy.
Clostilbegit for infertility
Clostilbegit in the treatment of infertility is an inexpensive, highly effective first-line drug for the treatment of normogonadotropic anovulation. An important positive aspect of its use is the possibility of oral administration. However, the use of this drug is associated with a certain risk of complications and should be carried out only by a doctor, if possible, using ultrasound monitoring of folliculogenesis and endometrial development. In the vast majority of cases, the negative anti-estrogenic effect of Clostilbegit on endometrial thickness can be corrected by the use of estrogen drugs after the end of taking Clostilbegit in the planned fertile cycle.
"Klostilbegit" for men: reviews
Before starting treatment, many people seek to find out reviews about the drug that their doctor prescribed to them. Clostilbegit is an effective remedy that is popular among patients suffering from infertility. Among the advantages of the drug, its affordable price is noted (about 500-800 rubles per package). When using the medicine, you do not need to take into account meals and time of day, which patients also like. Thanks to it, sperm accumulate in semen, which increases the likelihood of conception. In addition, after treatment with this drug, the chance of multiple pregnancy increases. According to men, its main drawback is a sharp deterioration in sperm count after stopping use.
Thus, the drug “Clostilbegit” can be called effective for men. Reviews and results of use confirm the quality of this medicine. However, it brings one-time benefit, without completely curing oligospermia. To get rid of the disease forever, you need to choose another remedy.
