Serophene (clomiphene citrate) is a first-line oral fertility medication specifically designed to induce ovulation in women with anovulatory disorders. As a selective estrogen receptor modulator (SERM), it works by stimulating the pituitary gland to increase production of follicle-stimulating hormone (FSH) and luteinizing hormone (LH), thereby promoting follicular development and maturation. This medication represents a cornerstone in reproductive endocrinology, offering a well-tolerated and effective solution for patients seeking to achieve pregnancy. Its established efficacy and decades of clinical use make it a trusted option for physicians specializing in infertility management.

Features

• Contains 50 mg clomiphene citrate per tablet
• Oral administration with high bioavailability
• Selective estrogen receptor modulator (SERM) mechanism
• Typically prescribed in 5-day treatment cycles
• White, round, scored tablets for easy splitting
• Manufactured under strict GMP standards
• Available in blister packs of 10 tablets
• Stable at room temperature storage conditions

Benefits

• Effectively induces ovulation in approximately 80% of appropriately selected patients
• Non-invasive oral administration compared to injectable alternatives
• Well-established safety profile with decades of clinical use
• Cost-effective first-line treatment option for anovulation
• Enables timed intercourse or intrauterine insemination cycles
• Minimal monitoring requirements compared to gonadotropin therapies

Common use

Serophene is primarily indicated for the treatment of ovulatory dysfunction in women desiring pregnancy. The most common applications include management of polycystic ovary syndrome (PCOS)-related anovulation, amenorrhea, and oligo-ovulation. Physicians may also prescribe Serophene for unexplained infertility as part of controlled ovarian stimulation protocols. The medication is particularly effective in patients with demonstrated endogenous estrogen production, as evidenced by progestin-induced withdrawal bleeding. Treatment is typically initiated in women under 35 years of age who have no other identifiable fertility factors, though off-label use may extend to older reproductive age groups in specific clinical scenarios.

Dosage and direction

The recommended initial dosage of Serophene is 50 mg (one tablet) daily for five days, beginning on the fifth day of the menstrual cycle (with day 1 being the first day of menstrual bleeding). If spontaneous ovulation does not occur, the dosage may be increased to 100 mg daily for five days in subsequent cycles. Treatment should not exceed 150 mg daily, and therapy beyond three cycles requires careful reevaluation. Maximum recommended duration is six cycles due to potential endometrial effects. Patients should be monitored via transvaginal ultrasound to assess follicular development and prevent ovarian hyperstimulation syndrome (OHSS). Timing of intercourse or insemination is typically recommended 5-10 days after the last dose, based on ovulation prediction methods.

Precautions

Patients should undergo comprehensive fertility evaluation before initiating Serophene therapy, including assessment of thyroid function, prolactin levels, and male factor infertility. Regular monitoring via transvaginal ultrasound is essential to monitor follicular development and prevent multiple gestation, which occurs in approximately 8% of pregnancies achieved with clomiphene citrate. Liver function tests should be performed in patients with hepatic impairment. Visual disturbances, though rare, require immediate discontinuation and ophthalmologic evaluation. Endometrial thickness should be monitored, as clomiphene may have anti-estrogenic effects on the endometrium. Patients should be advised that long-term use (beyond 12 cycles) may be associated with increased risk of borderline ovarian tumors.

Contraindications

Serophene is contraindicated in patients with known hypersensitivity to clomiphene citrate or any component of the formulation. It must not be used during pregnancy, as it may cause fetal harm. Other contraindications include liver disease of a type not previously evaluated with clomiphene citrate, abnormal uterine bleeding of undetermined origin, ovarian cysts not related to polycystic ovarian syndrome, and uncontrolled thyroid or adrenal dysfunction. The medication is also contraindicated in patients with pituitary tumors and those with organic intracranial lesions such as pituitary tumors.

Possible side effects

The most common adverse reactions include vasomotor flushes (10%), abdominal discomfort (7%), ovarian enlargement (5%), and breast tenderness (2%). Visual symptoms such as blurring, spots, or flashes (phosphenes) occur in approximately 1.5% of patients. Less frequent side effects include nausea, vomiting, nervousness, insomnia, headache, and dizziness. Multiple pregnancies occur in approximately 8% of clomiphene-induced pregnancies, with twins being most common. Ovarian hyperstimulation syndrome (OHSS) is a rare but serious complication requiring immediate medical attention. Most side effects are dose-dependent and reversible upon discontinuation of therapy.

Drug interaction

Serophene may interact with anticoagulants, potentially enhancing their effect. Concomitant use with gonadotropins may increase the risk of ovarian hyperstimulation. Thyroid medications may require dosage adjustments during clomiphene therapy. The medication may interfere with the accuracy of hormonal assays, particularly estrogen and progesterone measurements. Drugs that induce liver enzymes (such as rifampin, carbamazepine, or St. John’s Wort) may reduce clomiphene efficacy. Conversely, drugs that inhibit CYP2D6 may increase clomiphene concentrations. Physicians should review all concomitant medications, including herbal supplements, before prescribing.

Missed dose

If a dose of Serophene is missed, the patient should take it as soon as remembered unless it is almost time for the next dose. In that case, the missed dose should be skipped, and the regular dosing schedule resumed. Patients should never double the dose to make up for a missed one. Consistency in dosing is important for optimal follicular development, so patients should be advised to set reminders and take the medication at approximately the same time each day during the treatment cycle.

Overdose

There is no specific antidote for Serophene overdose. Symptoms may include nausea, vomiting, vasomotor flushes, visual disturbances, and ovarian enlargement. In case of suspected overdose, symptomatic and supportive treatment should be initiated. Gastric lavage may be considered if ingestion occurred within a short time frame. Patients should be monitored for signs of ovarian hyperstimulation syndrome, and pelvic ultrasound should be performed to assess ovarian size. Medical supervision is recommended until symptoms resolve.

Storage

Store Serophene tablets at controlled room temperature between 20°C to 25°C (68°F to 77°F), with excursions permitted between 15°C to 30°C (59°F to 86°F). Keep the medication in its original blister packaging to protect from light and moisture. Do not store in bathroom cabinets or other humid areas. Keep out of reach of children and pets. Do not use tablets that appear discolored or show signs of deterioration. Properly discard any unused medication after the treatment cycle.

Disclaimer

This information is provided for educational purposes only and does not constitute medical advice. Serophene should only be used under the supervision of a qualified healthcare provider specializing in reproductive medicine. Individual response to therapy may vary, and treatment should be tailored to specific patient circumstances. The prescribing physician should thoroughly evaluate each patient’s medical history and current health status before initiating therapy. Patients should report any unusual symptoms or side effects to their healthcare provider immediately.

Reviews

Clinical studies demonstrate that Serophene achieves ovulation rates of 70-80% in appropriately selected patients, with cumulative pregnancy rates of approximately 30-40% over three to six treatment cycles. The majority of pregnancies occur within the first three treatment cycles. Patient satisfaction surveys indicate high acceptance due to oral administration and relatively mild side effect profile compared to injectable alternatives. However, some patients report frustration with the timing requirements and the emotional challenges of cycle monitoring. Physicians consistently rate Serophene as a valuable first-line option for ovulation induction, particularly noting its predictable response and established safety profile in clinical practice spanning decades.