Clomiphene Citrate

Adults: For females: 50 mg is taken once daily for 5 days. This can begin on any day from the second to the fifth day of the menstrual cycle if bleeding is occurring, or at any time if the patient has had no recent uterine bleeding. A smaller dose or a shorter course may be needed for patients who are unusually sensitive to clomiphene, such as those with polycystic ovary syndrome. If ovulation does not occur, the dose is raised to 75-100 mg daily for 5 days, with the next course starting no sooner than 30 days after the previous one. Generally, three courses are enough to determine whether ovulation can be achieved; if it still has not occurred, the diagnosis should be reassessed. If ovulation occurs without conception, the same cycle is repeated until conception happens or for 3-4 cycles. If pregnancy has not occurred after about 6 cycles in total, continuing clomiphene therapy is not recommended. For males: 25 mg is taken once daily for up to 90 days, with a 5-day break recommended after every 25 days of treatment. Patients on haemodialysis: Haemodialysis shortens the serum half-life by 25-30%. Patients on regular haemodialysis are given a loading dose of 250 mg-1 g before dialysis. Elderly: Dosing is the same as for adults. Time to peak effect: Ovulation usually occurs 4-10 days after the last day of treatment, averaging around 7 days, though this can vary between patients and cycles. In rare cases, it may occur as late as 14 days after treatment ends.