Clinical Information
The usual starting dose is 50 mg (one 50 mg tablet or two 25 mg tablets) by mouth once daily for 5 days, beginning on day 3, 4, or 5 of your menstrual period as directed by your doctor. If you do not ovulate, your doctor may increase the dose to 100 mg daily for another 5-day cycle. Do not take more than 100 mg in any 24-hour period and do not use the medicine for more than 6 cycles in total. Take each dose at the same time each day with or without food. If you miss a dose and remember within 12 hours, take it right away; if more than 12 hours have passed, skip that dose and take the next one at the regular time. Do not double up doses.
Clomiphene blocks estrogen receptors in the hypothalamus, a part of the brain that controls hormone release. This block tricks the body into thinking estrogen levels are low, causing the pituitary gland to release more follicle-stimulating hormone (FSH) and luteinizing hormone (LH). Higher FSH and LH help the ovaries mature and release an egg. Ovulation usually occurs 5-10 days after the last tablet in a cycle. Because the effect lasts only one cycle, treatment is repeated each month until pregnancy occurs or the doctor stops therapy.
Do not use if you are already pregnant (can harm an unborn baby). Do not use if you have liver disease or a history of liver problems. Do not use if you have uncontrolled thyroid or adrenal gland disorders. Do not use if you have abnormal vaginal bleeding of unknown cause. Do not use if you have an ovarian cyst not related to polycystic ovary syndrome. Do not use if you are allergic to clomiphene or any ingredient in the tablet. Not recommended for children or post-menopausal women.
May decrease the effect of estrogen-containing medicines such as birth-control pills or hormone replacement therapy. Using with drugs that affect hormone levels, such as letrozole or gonadotropins (hCG injections), may raise the chance of ovarian overstimulation—your doctor will adjust doses if both are needed. Alcohol can worsen dizziness or blurred vision caused by clomiphene; limit or avoid drinking. Tell your doctor if you take seizure medicines (e.g., phenytoin), rifampin, or herbal supplements like black cohosh, as they may change hormone levels and alter treatment response.
Very common (more than 1 in 10): hot flashes. Common (1–10 in 100): abdominal bloating or discomfort, breast tenderness, nausea, headache, mood swings, thick cervical mucus. Uncommon (1–10 in 1,000): visual disturbances (blurred vision, spots, flashes) that usually stop after treatment; ovarian enlargement or cysts causing pelvic pain. Rare but serious: ovarian hyperstimulation syndrome (severe pelvic pain, rapid weight gain, shortness of breath), severe visual changes that do not go away, blood clots. Multiple pregnancy (twins or more) occurs in about 7–10% of successful pregnancies with clomiphene. Contact your doctor right away if you have severe abdominal pain, swelling, trouble breathing, or vision problems.
Store tablets at room temperature 68-77°F (20-25°C). Keep in the original, tightly closed bottle. Protect from moisture, heat, and direct sunlight. Do not store in the bathroom. Keep out of reach of children. Dispose of unused or expired tablets through a pharmacy take-back program or mix with coffee grounds or cat litter in a sealed bag before placing in household trash.
Frequently Asked Questions
Q:When should I start taking my first dose each cycle?
A:Most doctors tell you to start on day 3, 4, or 5 of your menstrual period. Count day 1 as the first day you have full bleeding. Follow your doctor’s exact instructions for your cycle.
Q:How will I know if the medicine is working?
A:You should ovulate about 5–10 days after the last pill. Your doctor may ask you to track basal body temperature, use ovulation test kits, or have blood tests and ultrasounds to confirm ovulation.
Q:What should I do if I feel dizzy or have blurred vision?
A:Stop driving or operating machines right away and call your doctor. Most vision changes are temporary, but you may need to stop the medicine if they persist.
Q:Can I use clomiphene for more than six months?
A:No. FDA guidelines recommend no more than six treatment cycles because longer use has not been shown to increase pregnancy rates and may raise risks.
Q:Does clomiphene increase the chance of twins?
A:Yes. About 7–10% of pregnancies with clomiphene result in twins, compared with about 1–2% naturally. Triplets or higher multiples are rare but possible.
Q:Should I stop my birth-control pills before starting clomiphene?
A:Yes. Birth-control pills prevent ovulation and will block clomiphene from working. Your doctor will tell you when to stop them and when to begin your first clomiphene cycle.
Q:Can I drink alcohol while taking this medicine?
A:It’s best to limit or avoid alcohol. Alcohol can make side effects like dizziness or stomach upset worse and may affect hormone levels.
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