Fertomid

Fertomid is a fertility agent used to stimulate ovulation in women who want to become pregnant.

Product dosage: 50mg
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Fertomid (clomiphene citrate) is a selective estrogen receptor modulator (SERM) indicated for the treatment of ovulatory dysfunction in women desiring pregnancy. As a first-line pharmacological intervention for anovulatory infertility, it works by stimulating the release of hormones necessary for ovulation to occur. Its well-established efficacy, favorable safety profile, and decades of clinical use make it a cornerstone in reproductive endocrinology protocols. This agent is particularly effective in patients with polycystic ovary syndrome (PCOS) and other functional ovulatory disorders, offering a targeted approach to restore cyclic ovarian activity.

Features

• Active ingredient: Clomiphene citrate 50 mg
• Pharmacological class: Selective estrogen receptor modulator (SERM)
• Administration: Oral tablet
• Standard packaging: Blister strips of 10 tablets
• Bioavailability: Approximately 85-90% following oral administration
• Half-life: 5-7 days
• Metabolism: Hepatic, via CYP2D6 and CYP3A4 isoenzymes
• Excretion: Primarily fecal (approximately 51%), with urinary elimination of metabolites

Benefits

• Induces mono-follicular development in approximately 60-85% of anovulatory women
• Achieves ovulation rates of up to 80% in appropriately selected patients
• Offers predictable cycle control with well-established dosing protocols
• Provides cost-effective first-line treatment compared to injectable gonadotropins
• Enables timed intercourse or intrauterine insemination cycles with minimal monitoring
• Supports development of a single dominant follicle, reducing risk of higher-order multiple gestation

Common use

Fertomid is primarily prescribed for the induction of ovulation in women with ovulatory dysfunction who wish to conceive. The most common indication is for patients with polycystic ovary syndrome (PCOS) demonstrating chronic anovulation. It is also used in cases of hypothalamic amenorrhea, though response rates may vary. Off-label applications include male infertility treatment for certain endocrine disorders and occasionally for the enhancement of ovulatory function in unexplained infertility. Clinical evaluation typically includes confirmation of anovulation through basal body temperature charts, progesterone levels, or ultrasound monitoring before initiation.

Dosage and direction

The initial recommended dose is 50 mg (one tablet) daily for 5 days, starting on day 3, 4, or 5 of the menstrual cycle. Treatment should begin following a spontaneous or progestin-induced withdrawal bleed. If ovulation does not occur at this dose, the dosage may be increased to 100 mg daily for 5 days in subsequent cycles. Doses exceeding 100 mg daily are not recommended due to decreased efficacy and increased adverse effects. Maximum recommended duration of treatment is 6 cycles. Administration should occur at approximately the same time each day, with or without food. Ultrasound monitoring of follicular development is advised, particularly during the first treatment cycle or when increasing dosage.

Precautions

Patients should undergo thorough gynecological evaluation before treatment to exclude pregnancy, ovarian cysts, and other contraindications. Liver function tests should be considered in patients with hepatic impairment. Visual symptoms should be promptly reported and may necessitate discontinuation. Ovarian hyperstimulation syndrome (OHSS) may occur, particularly in patients with polycystic ovaries; appropriate monitoring is essential. Long-term use (greater than 12 cycles) may be associated with increased risk of ovarian borderline tumors. Patients should be advised of the possibility of multiple births (approximately 8% risk, primarily twins).

Contraindications

Fertomid is contraindicated in patients with: pregnancy; liver disease or history of hepatic dysfunction; abnormal uterine bleeding of undetermined origin; ovarian cysts not related to polycystic ovarian syndrome; uncontrolled thyroid or adrenal dysfunction; organic intracranial lesions such as pituitary tumors; hypersensitivity to clomiphene citrate or any component of the formulation. It should not be used simultaneously with other fertility medications unless under specialized supervision.

Possible side effects

Common adverse reactions (≥10%) include: vasomotor flashes (10-20%); abdominal discomfort (5-15%); ovarian enlargement (5-10%); breast tenderness (2-5%). Less frequent effects (1-10%) include: visual disturbances (blurring, spots, flashes); nausea; headache; abnormal uterine bleeding. Rare but serious side effects (<1%) include: ovarian hyperstimulation syndrome (OHSS); ovarian torsion; ectopic pregnancy; allergic reactions. Most side effects are dose-dependent and reversible upon discontinuation.

Drug interaction

Significant interactions may occur with: anticoagulants (may potentiate effects); thyroxine (may alter binding); danazol (may inhibit ovulation); GnRH analogs (may alter pituitary response). Concomitant use with letrozole or other aromatase inhibitors is not recommended. Caution is advised with medications affecting CYP2D6 metabolism. Herbal supplements with estrogenic activity (soy, red clover) may interfere with mechanism of action.

Missed dose

If a dose is missed, it should be taken as soon as remembered unless it is nearly time for the next dose. Doubling of doses is not recommended. If multiple doses are missed, consultation with the prescribing physician is advised as cycle timing is critical for therapeutic efficacy. The treatment course may need to be restarted in the subsequent cycle if significant dosing errors occur.

Overdose

Symptoms of overdose may include nausea, vomiting, vasomotor symptoms, visual disturbances, and ovarian enlargement. There is no specific antidote. Treatment should be symptomatic and supportive. Gastric lavage may be considered if ingestion was recent. Medical attention should be sought immediately. Dialysis is not likely to be effective due to high protein binding.

Storage

Store at controlled room temperature (20-25°C or 68-77°F). Protect from light and moisture. Keep in original packaging until use. Do not use if tablets show signs of discoloration or deterioration. Keep out of reach of children and pets. Do not flush medications down the toilet or pour into drainage. Dispose of unused medication through take-back programs.

Disclaimer

This information is for educational purposes only and does not constitute medical advice. Fertomid is a prescription medication that should only be used under the supervision of a qualified healthcare provider. Individual response may vary. Proper diagnosis and monitoring are essential for safe and effective use. The prescriber should be familiar with current treatment guidelines and contraindications.

Reviews

Clinical studies demonstrate ovulation rates of 70-80% and pregnancy rates of 30-40% per ovulatory cycle in appropriately selected patients. Meta-analyses show cumulative pregnancy rates of approximately 70-75% after 6 cycles of treatment. Patient satisfaction surveys indicate high acceptability of oral administration compared to injectable alternatives. Specialist consensus supports Fertomid as first-line therapy for anovulatory infertility based on extensive clinical experience and evidence-based guidelines from reproductive endocrine societies.