Precautions for the use of Clomid.
What Precautions Should Be Taken with Clomid?
Before purchasing and using Clomid, the potential side effects of Clomid should be weighed against its need and against the potential adverse events associated with other fertility therapies. Fertility treatments, in general, can produce mood swings and fluctuating emotions for the woman taking them. Patients taking Clomid should be prepared for intense feelings and up-and-down moods during the monthly drug cycles. They should also be able to devote a large amount of time to going to the doctor’s office for monitoring and testing.
There is a 10% chance of conceiving twins while taking Clomid, and a smaller than 10% but greater than normal chance of having triplets (0.3-0.55). Multiple births can make for more difficult pregnancies, challenging deliveries, and increased risk of fetal problems.
Clomid can cause birth defects if taken while pregnant. Therefore Clomid should be discontinued if pregnancy is determined or if there is suspicion of pregnancy. Clomid is a Pregnancy Category X drug, meaning it is in the most dangerous category of drugs to take during pregnancy. Sometimes after taking a cycle of Clomid, a woman will not get her normal menstrual period about two weeks later. This can be due to two primary reasons: 1) she did not ovulate; or 2) she is pregnant. It is important to determine the cause for missing a period after Clomid therapy, as with a missed period due to pregnancy, it is imperative to discontinue use of Clomid.
Pregnancy, the presence of ovarian cysts, or a hypersensitivity (allergy) to Clomid are all contraindications to begin taking Clomid.
Because it can make all of these conditions worse, Clomid is rarely given to women with the following conditions: liver disease, kidney disease depression, thrombophlebitis (blood clots), enlarged ovaries, ovarian cysts, endometriosis, fibroid tumors, and unusual vaginal bleeding.
Clomid can cause vision changes and dizziness. Women who take Clomid are advised not to drive, operate heavy machinery, or engage in other potentially dangerous activities until they see how they react to Clomid.
Clomid only has one major drug interaction; Clomid should not be taken with bexarotene (Targretin), as it increases risk of pancreatitis. This interaction is considered a non-issue by most prescribers, as bexarotene is an anti-cancer drug that cannot be taken during pregnancy or if a patient may become pregnant.
Clomid is not recommended for women who cannot conceive due to blocked fallopian tubes or for women who do not ovulate due to primary pituitary or ovarian failure. For a woman to receive Clomid her estrogen levels and pituitary gland function must be normal, and her partner must be clinically diagnosed as fertile.
In overweight patients with polycystic ovary syndrome (PCOS), before attempting Clomid therapy, an attempt should be made to lower body mass index (BMI) by using exercise and diet. In some cases, achieving a healthier weight can induce ovulation. Also, medication to regulate insulin metabolism may be recommended prior to starting Clomid therapy. Insulin regulators may still be needed during the time Clomid is taken for maximum efficacy.
Women taking Clomid should be cautioned that it is considered a fertility drug in that it stimulates ovulation. There is no guarantee, however, of pregnancy with Clomid therapy, as there are a multitude of factors that enter into conception.
Some studies have shown higher miscarriage rates for women who become pregnant while on Clomid. Analysis of all studies of Clomid have determined that there is no greater risk of miscarriage with Clomid than without it. The higher rates of miscarriage in some studies have been attributed to advanced maternal age in the women studied and the higher rates of polycystic ovary syndrome (PCOS) that frequently led women to receive Clomid in the first place.
Clomid is sometimes abused by male body builders to reverse the effects of steroid use, like gynecomastia. It is considered an illegal drug in the sporting world.
What Are the Symptoms of Clomid Overdose?
Symptoms of a Clomid overdose include abdominal pain, nausea, vomiting, flushing, and vision changes (blurring, floaters, spots, or flashes).
What Are the Side Effects of Clomid?
The side effects of Clomid include swelling of the ovaries, abdominal pain or tenderness, breast tenderness, insomnia, vision changes (blurring, floaters, spots, or flashes), headache, nausea, vomiting, irritability, fatigue, depression, weight gain, hot flashes, bloating, spotting, and vaginal dryness. Rarely, ovarian cysts can be a side effect of Clomid.
Even more rarely, OHSS (ovarian hyperstimulation syndrome) can result from taking Clomid. This occurs when there is an over-response to the drug, causing the ovaries to produce too many eggs. When this happens, the ovaries swell and leak fluid into the abdominal cavity. Symptoms of OHSS include weight gain, bloating or feelings of bloating, pelvic pain, dizziness, nausea, vomiting, and shortness of breath.
Ovarian cysts, OHSS, and severe vision changes are the greatest reasons for physician recommendation to discontinue Clomid therapy.
Women taking Clomid concomitantly with metformin (see Precautions, below) have a higher than normal rate of gastrointestinal side effects.
An allergic reaction to Clomid is characterized by itching, hives, rash, difficulty breathing, and difficulty swallowing. Patients experiencing these symptoms should seek medical care immediately and should discontinue use of Clomid until a doctor has been seen.
Clomid has a half-life of five days, meaning at five days, approximately half of the drug remains in the body. Therefore, side effects may remain for several days even after discontinuation of the drug or completion of a cycle.
What Is the History of Clomid?
Clomid has been used as a fertility drug since the 1960s. It was approved by the FDA in 1967, at first to treat oligomenorrhea (irregular menstrual periods). It was discovered as an incidental finding that women who took Clomid had an unexpectedly high pregnancy rate. After this discovery, Clomid began being prescribed for anovulation. Its easy route of oral administration make it a popular fertility drug, in comparison with many injectable medications.