Clostilbegit, a relatively inexpensive drug, is used. Clostilbegit: instructions for use, analogues and reviews, prices in Russian pharmacies. Pharmacological action Clostilbegit

This instruction valid from 04/12/13

Registration number:

P N014432/01-18.09.2008

Trade name of the drug:

Clostilbegit ®

International Nonproprietary Name (INN):

clomiphene

Dosage form:

pills

Compound:

each tablet contains 50 mg of the active substance clomiphene citrate.
Excipients: gelatin 2 mg, magnesium stearate 2 mg, stearic acid 2 mg, talc 5 mg, potato starch 39 mg and lactose monohydrate 100 mg.

Pharmacotherapeutic group:

antiestrogenic agent

ATX Code: G03GВ02

Pharmacological properties

Pharmacodynamics

An anti-estrogen of a non-steroidal structure, the action of which is due to specific binding to estrogen receptors of the ovaries and pituitary gland. With low levels of estrogen in the body, it exhibits a moderate estrogenic effect, with high content- antiestrogenic effect. In small doses, it enhances the secretion of gonadotropins (prolactin, FSH and LH), stimulates ovulation; V large doses inhibits the secretion of gonadotropins. It does not have gestagenic or androgenic activity.

Pharmacokinetics:

When taken orally, it is well absorbed from the gastrointestinal tract. Metabolized in the liver. Subject to enterohepatic recirculation. T 1/2 - 5-7 days.
It is excreted mainly in bile.

Indications for use:

anovulatory infertility (ovulation induction);
amenorrhea (dysgonadotropic form), secondary amenorrhea, post-contraceptive amenorrhea;
Stein-Leventhal syndrome (polycystic ovary syndrome);
oligomenorrhea;
galactorrhea (due to a pituitary tumor);
Chiari-Frommel syndrome (prolonged postpartum amenorrhea-galactorrhea syndrome);
androgen deficiency;
in men: oligospermia.

Contraindications:

increased sensitivity to any ingredient of the drug;
liver and/or kidney failure;
pregnancy and lactation;
ovarian cyst (except for polycystic ovary syndrome);
tumor or hypofunction of the pituitary gland;
dysfunction thyroid gland or adrenal glands;
metrorrhagia of unknown etiology;
long-term or recently developed visual impairment;
neoplasms of the genital organs;
endometriosis;
ovarian failure due to hyperprolactinemia;
galactose intolerance, lactase deficiency or glucose malabsorption (as each tablet contains 100 mg of lactose).

Pregnancy and lactation

The use of the drug during pregnancy and breastfeeding is contraindicated.

Directions for use and dosage:

For infertility, the dose and duration of treatment depend on the sensitivity (reaction to the drug) of the ovaries. For patients with a regular menstrual cycle, it is recommended to start treatment on the 5th day of the cycle (or on the 3rd day of the cycle if ovulation is early or the duration of the follicular phase is less than 12 days). For amenorrhea, treatment can begin any day.
Regimen I. 50 mg per day for 5 days while monitoring the ovarian response using clinical and laboratory tests. Ovulation usually occurs between the 11th and 15th day of the cycle. If such treatment does not lead to ovulation, the following regimen should be used:
Scheme II. from the 5th day of the next cycle, 100 mg per day for 5 days. If ovulation is not observed at this time, the same regimen should be repeated again (100 mg per day). In case of failure, the drug should be interrupted for 3 months, and then treatment should be repeated for 3 months. If the second course is ineffective, subsequent treatment with the drug is not effective.
The total amount of the drug taken during each course should not exceed 750 mg.
In polycystic ovary syndrome, due to the tendency to hyperstimulation, treatment should begin with a dose of 50 mg per day.
In the absence of menstruation due to long-term use of contraceptives, 50 mg per day should be prescribed; A 5-day course of treatment usually achieves success on the first attempt.
Men are prescribed 50 mg 1-2 times a day for 6 weeks (systematic monitoring of spermatogram is required).

Side effect

Common side effects (> 1%), rare side effects (

From the outside digestive system:
nausea, vomiting;
rarely: gastralgia, flatulence, diarrhea, syndrome acute abdomen.
From the nervous system: headache, dizziness, drowsiness;
rarely: slowing of the speed of mental and motor reactions, increased excitability, depression, insomnia.
Sense organs: visual impairment (impaired light perception, double vision, blurred contours, photophobia, etc.).
From the outside genitourinary system: increased frequency of urination, hardening of the mammary glands, pain in the lower abdomen, dysmenorrhea, pathological uterine bleeding, increase in ovarian size (including cystic);
rarely: vaginal dryness, polyuria, menorrhagia.
Allergic reactions:
rarely - rash, urticaria, allergic dermatitis, vasomotor disorders.
Others:
rarely: increased appetite, increase or decrease in body weight, alopecia, pain in the area mammary glands, “flushes” of blood to the face.
When treated with clomiphene, the likelihood of multiple pregnancy, ectopic pregnancy, endometriosis, and the growth of existing uterine fibroids increases.
Hot flashes observed during the course of treatment cease after the end of taking the drug.
Cystic enlargement of the ovaries may also occur, especially in Stein-Leventhal syndrome. In these cases, the size of the ovaries can reach 4-8 cm. In this case, you should monitor the body temperature and stop treatment as soon as it becomes biphasic.

Overdose

Symptoms: nausea, vomiting, vasomotor phenomena, flushing of the face, visual impairment (decreased visual acuity, flashes, scotoma), enlarged ovaries and pain in the pelvic and abdominal organs.
Treatment: except elimination active substance In case of overdose, only maintenance therapy can be used. There is no data on the possibility of removing clomiphene by dialysis.

Interaction with other drugs

Compatible with gonadotropic hormone preparations.

special instructions

Before using this drug, be sure to carefully gynecological examination. The use of this drug is indicated in cases where the total level of gonadotropin in the urine is lower lower limit normal or at the normal level, palpation of the ovaries does not reveal any deviations from the norm, and the functions of the thyroid gland and adrenal glands are normal.

If the egg does not mature, it should be this drug exclude or treat all others possible reasons infertility. If ovarian enlargement or cystic transformation is detected, the use of the drug is not permitted until the ovaries return to normal sizes. In the future, the dose or duration of treatment should be reduced.

During the treatment process, constant observation by a gynecologist is necessary; ovarian function should be monitored, vaginal examinations should be performed, and the “pupil” phenomenon should be observed.

Often during the course of treatment it is difficult to determine the moment of ovulation, and insufficiency is often observed corpus luteum. Therefore, after conception, it is recommended to begin prophylactic administration of progesterone.

Increases the likelihood of developing multiple pregnancies.

Each tablet contains 100 mg of lactose, so the drug is not recommended for use in patients with galactose intolerance, lactase deficiency or glucose malabsorption.

Car driving ability
During the treatment period, care must be taken when driving vehicles and engaging in other potentially dangerous species activities that require increased concentration and speed of psychomotor reactions, since the drug can cause visual impairment.

Release form:

Tablets 50 mg. 10 tablets in a brown glass bottle with a PE cap with first opening control and an accordion shock absorber.
1 bottle along with instructions for use in a cardboard box.
10 tablets in a blister made of PVC/PVDC//aluminum foil.
1 blister along with instructions for use in a cardboard box.

Best before date:

5 years. Do not use after the expiration date stated on the packaging.

Storage conditions:

At a temperature of 15 – 25°C.
Keep out of the reach of children

Conditions for dispensing from pharmacies:

By doctor's prescription.

Company manufacturer
CJSC "EGIS Pharmaceutical Plant"
1106 Budapest, st. Keresturi, 30-38 HUNGARY

Representative office of JSC "EGIS Pharmaceutical Plant" (Hungary), Moscow
121108, Moscow, st. Ivana Franko, no. 8.

Clostilbegit is a non-steroidal anti-estrogenic drug, widely used in gynecology to stimulate ovulation in the treatment of infertility. Active substance - .

The use of the drug stimulates an increase in the level of luteinizing and follicle-stimulating hormones. The mechanism of action is associated with stimulation of the process of binding estrogen receptors to the pituitary gland and ovaries.

At low levels of estrogen in the body, Clostilbegit has a moderate estrogenic effect, and at high levels it has an antiestrogenic effect.

When used in small doses, the secretion of gonadotropins is increased, as well as ovulation is stimulated. When used in large doses, the secretion of gonadotropins is blunted.

1 tablet of Clostilbegit contains:

Clomiphene citrate – 50 mg;
Auxiliary components: gelatin – 2 mg, magnesium stearate – 2 mg, stearic acid – 2 mg, talc – 5 mg, potato starch – 39 mg, lactose monohydrate – 100 mg.

The drug does not have androgenic and progestogenic activity.

Indications for use

What does Clostilbegit help with? According to the instructions, the drug is prescribed in the following cases:

Amenorrhea (absence of menstruation), caused by a violation of the level of gonadotropin and its regulatory effect on the genitals (dysgonadotropic form of amenorrhea).
Postcontraceptive amenorrhea is the absence of menstruation after the use of oral hormonal contraceptives.
Anovulatory infertility – to induce the ovulation process.
Secondary amenorrhea due to disturbances in the level of sex hormones in a woman’s body.
Oligomenorrhea – decreased severity menstrual bleeding, as well as the duration of menstruation itself.
Galactorrhea - appearance and discharge breast milk in a woman due to the development of a hormone-producing tumor of the pituitary gland.
Stein-Leventhal syndrome - polycystic ovary syndrome (formation large quantity formations filled serous fluid, as a result of which the functional activity of the ovary is significantly impaired).
Chiari-Frommel syndrome is prolonged postpartum amenorrhea and galactorrhea (breast milk production).

Additionally, it can be used to treat androgen deficiency (insufficient levels of male sex hormones) and oligospermia (decreased number of sperm per unit volume of ejaculate) in men.

Instructions for use Clostilbegit, dosage

The drug is taken orally with a drink clean water. The dose and duration of treatment for infertility are determined individually, taking into account the reaction of the ovaries to the drug.

For women with regular menstruation, it is recommended to start therapy on the 5th day of the cycle, with early ovulation or the duration of the follicular phase less than 12 days - on the 3rd day of the cycle. If you have amenorrhea, you can start taking the drug on any day.

Regimen 1: 50 mg per day for 5 days while monitoring the ovarian response using clinical and laboratory studies. Ovulation usually occurs between days 11 and 15 of the cycle. If such treatment does not lead to ovulation, then regimen 2 should be used.
Scheme 2: from the 5th day of the next cycle, 100 mg per day is prescribed for 5 days. If ovulation is not observed at this time, then the same regimen should be repeated again (100 mg per day). In case of ongoing anovulation, the drug should be interrupted for 3 months and then treatment should be repeated for 3 months. If the second course is ineffective, subsequent treatment with the drug is also ineffective.

The maximum total dose of the drug taken during each course is 750 mg.

For post-contraceptive amenorrhea, take 50 mg daily. In most cases, a five-day course of the first described treatment regimen is successful.

For men treating oligospermia, Clostilbegit is prescribed 50 mg 1-2 times a day. The drug is taken for 6 days, systematically monitoring the spermogram.

special instructions

Before starting use, it is important to laboratory test indicators of functional activity of the liver.

A gynecological examination is required to determine the level of gonadotropin in the urine.

An increase in the size of the ovaries or suspicion of the development of polycystic disease is grounds for discontinuation of the drug.

During the use of Clostilbegit, a periodic examination by a gynecologist is required, who monitors the functional activity of the ovaries and conducts vaginal examinations.

During the treatment of infertility after conception, a prophylactic course of progesterone is recommended.

Side effects

The instructions warn about the possibility of developing the following side effects when prescribing Clostilbegit:

From the digestive system: nausea, vomiting; rarely – gastralgia, flatulence, diarrhea, acute abdominal syndrome, increased appetite.
From the central nervous system: headache, dizziness, drowsiness; rarely – slowing of mental and motor reactions, increased excitability, depression, insomnia.
From the senses: visual impairment (including impaired perception of light, double vision, blurred contours, photophobia).
From the urinary system: increased frequency of urination, polyuria.
From the reproductive system: pain in the lower abdomen, vaginal dryness.
From the outside endocrine system: hardening of the mammary glands, dysmenorrhea, pathological uterine bleeding, enlargement of the ovary (including cystic); rarely – pain in the mammary glands.
The likelihood of multiple pregnancy, ectopic pregnancy, endometriosis, and growth of existing uterine fibroids increases.
Cystic enlargement of the ovaries is possible, especially with Stein-Leventhal syndrome. In these cases, the size of the ovaries can reach 4-8 cm. In this case, you should monitor the body temperature and stop treatment as soon as it becomes biphasic.
Dermatological reactions: rarely - alopecia.
From the side of metabolism: rarely – increase or decrease in body weight.
Allergic reactions: rarely - rash, urticaria, allergic dermatitis, vasomotor disorders.
Other: sensations of a rush of blood to the face with a feeling of heat (stop after finishing taking the drug).

Contraindications

It is contraindicated to prescribe Clostilbegit in the following cases:

Intolerance to the active substance or other components of the drug;
Pregnancy;
History of uterine bleeding;
Serious liver disease;
Ovarian cyst;
Visual impairment;
Oncological processes;
Decreased pituitary gland function.

Overdose

In case of overdose, there is a risk of vasomotor reactions, vomiting, visual disturbances, nausea, pain in the pelvic organs and abdomen, as well as the risk of ovarian enlargement.

Held symptomatic treatment, removal of the drug from the body is practiced (gastric lavage, taking sorbents).

Analogues of Clostilbegit, price in pharmacies

If necessary, you can replace Clostilbegit with an analogue active substance- these are drugs:

Clomiphene citrate,
Serophene,
Serpafar.

When choosing analogues, it is important to understand that the instructions for use of Clostilbegit, price and reviews of the drugs similar action do not apply. It is important to consult a doctor and not change the drug yourself.

Price in Russian pharmacies: Clostilbegit 50 mg 10 tablets - from 581 to 723 rubles, according to 704 pharmacies.

Store out of the reach of children at a temperature of +15°...+25°C. Shelf life – 5 years.

Dispensing conditions from pharmacies are by prescription.

When a doctor prescribes Clostilbegit when planning a pregnancy, the likelihood of conception increases already in the first month of using the drug. How does he work? What category of patients can it be recommended for? Why doesn't it always help you get pregnant?

Causes of disturbance and absence of ovulation

The natural process of ovulation can be disrupted for a number of reasons. Ovulation is the release of an egg that is mature and ready for fertilization from the ovary. The egg grows and matures in the follicle, the follicle ruptures, releasing it. This process normally “starts” in every healthy woman during the fertile period monthly, with the onset of the first day menstrual cycle.

The work of the ovaries and the uninterrupted maturation of follicles in them is regulated by the hypothalamic-pituitary system of the brain, and usually the work of follicle-stimulating hormone is aimed at maturing one growing dominant follicle. On average, the cycle is 26-30 days, and ovulation occurs in the middle (13th - 15th day). On what day the egg is released in a particular patient can be determined exactly using special ovulation tests.

Problems with ovulation or complete absence(anovulation) are common cause female infertility. Failures may be caused by:

hormonal “restructuring” during puberty, the process can be delayed up to 2 years from the day of the first menstruation;
restoration of the body in postpartum period and during lactation;
postmenopausal;
treatment hormonal drugs or the use of hormonal contraceptives;
pathologies of the endocrine system;
underweight or obesity;
head injuries, tumor processes in the brain;
some diseases of the genitourinary system;
polycystic ovary syndrome, etc.

Typically, ovulation disorders are accompanied by symptoms such as constant irregular cycle, abundant and painful menstruation or, on the contrary, their absence. Preliminary diagnostics can be done at home. To do this you need to keep a regular schedule. basal temperature. Only a specialist can make an accurate diagnosis after a detailed examination.

Pharmacological action and indications for use

Stimulation of ovulation with Clostilbegit should be under the supervision of the attending physician, since the dosage has a direct impact on the effectiveness of therapy. This is an anti-estrogenic drug, the active ingredient of which is clomiphene; it selectively blocks the binding of the hormone estradiol to the receptors of the hypothalamus and ovaries.

Due to stimulation with Clostilbegit, negative feedback is inhibited and the production of gonadotropins (prolactin, follicle-stimulating and luteinizing hormones) is activated. At high content in female body estrogen "Clostilbegit" exhibits a fairly pronounced anti-estrogenic effect, and at low levels - a moderate estrogenic effect. Thus, in small doses the drug activates the secretion of gonadotropins, and in large doses it stops.

The effectiveness of Clostilbegit in planning pregnancy is quite high, but this treatment is not suitable for all forms of infertility. Indications for use are:

amenorrhea (including post-contraceptive or secondary);
pathological late ovulation;
androgen deficiency;
anovulatory infertility;
Stein-Leventhal and Chiari-Frommel syndromes;
polycystic ovary syndrome.

However, it is contraindicated to stimulate with Clostilbegit in case of ovarian cysts, oncological processes, endometriosis, dysfunction of the adrenal glands and the pituitary gland.

Only those patients whose infertility is caused by ovulation disorders can get pregnant after Clostilbegit; for other reasons it turns out to be useless!

If anovulation is a symptom of other causes of infertility, stimulation of ovulation with Clostilbegit can also be used. But before stimulation it is necessary to eliminate these causes and go through necessary treatment. Due to the antiestrogenic effect, Clostilbegit is not recommended for women with endometrial growth problems.

Release form of the drug

"Klostilbegit" is produced in the form of round and flat tablets without a pronounced odor of a grayish-white hue. Tablets are packaged in dark glass containers of 10 pieces. Each tablet contains 50 mg of active ingredient (clomiphene citrate).

On average, according to 2017 data, the cost of the drug is about 600 – 700 rubles. Available with a prescription, self-medication with Clostilbegit is unacceptable!

Reception scheme

How is ovulation stimulated with Clostilbegit? Despite the fact that instructions for use of the drug are included in each package, the stimulation regimen is prescribed by the attending physician individually, taking into account the reactivity of the patient’s ovaries.

As a rule, Clostilbegit can be prescribed 50 mg daily for 5 days from the 5th day of the cycle with continuous monitoring of the effect of the dosage on the body (ultrasound control, in some cases blood tests for hormones). If ovulation does not occur the first time, then therapy is re-prescribed for 5 days from the 5th day of the subsequent cycle, but at a dose of 100 mg. In case of failure, if the drug did not help, the follicle has not matured, and ovulation has not occurred, treatment at a dosage of 100 mg can be repeated for the third cycle.

If there is no effect, after a three-month break, a three-month therapeutic course of 100 mg per day is repeated. After the second unsuccessful course, it is not worth continuing therapy. In this case, the total dose of the drug for one menstrual cycle cannot exceed 750 mg.

Overweight women are prescribed a dose of 100 mg immediately, and then increase it if necessary.

Male infertility and Clostilbegit

Often the cause of infertility in a couple is oligospermia in the man. This diagnosis means that the number of motile sperm in the seminal fluid is reduced. In this case, the pathology can only be detected in a laboratory, since outwardly it does not make itself felt, without in any way affecting the sexual activity of a man and without causing him discomfort. "Clostilbegit" for men is prescribed for normalization hormonal levels and treatment of oligospermia at a dose of 50 -100 mg per day for a course of 6 weeks with regular monitoring spermograms.

Those men who have been helped by this drug note that when taking Clostilbegit, sexual function did not decrease.

Is he dangerous?

Taking Clostilbegit may be accompanied by side effects such as dizziness and headaches, nausea and occasional vomiting, anxiety, insomnia, weight gain, hair loss, etc. Basically, negative reviews about the drug arise against the background of its long-term use.

“Clostilbegit” should not be taken for more than six courses in a lifetime, as this is fraught with symptoms early exhaustion ovaries.

When stimulated by the drug, more than one follicle can mature, which leads to multiple pregnancies.

Many girls who have been prescribed this drug doubt whether it is worth the risk reproductive health, taking it? This needs to be decided with the attending physician, who will weigh the pros and cons.

“Klostilbegit” – very effective drug, which gives many women a chance to experience the joy of motherhood. However, treatment should begin only as prescribed by a specialist and take place under his close supervision.

By the way, keyword"specialist" here. You must be completely sure that your doctor has followed all the rules associated with the use of the drug:

Before ovulation is stimulated, you should be given tests and ultrasound monitoring to make sure that there really is no ovulation. The prescription of the drug should not be based only on the basal temperature chart!
The doctor must make sure that the fallopian tubes passable.
Before prescribing the drug, you need to examine your husband, in particular, you need fresh spermogram results.
Ultrasound monitoring during stimulation should be performed every cycle, starting from the very first cycle.

Doctor's answers

Obstetrician-gynecologist Elena Artemyeva answers the site’s questions.

Outdated drug?

— There is an opinion that Clostilbegit is an outdated drug, and many doctors no longer use it to stimulate ovulation, replacing it with others, more modern drugs. Is it so?

- This is wrong. Clomiphene citrate (“Clostilbegit”) is still widely used in gynecology when it is necessary to stimulate ovulation. Ovulation induction is successful if the diagnosis is correct and the cause of anovulation is determined.

Does it always help?

— Does this drug always help?

- In polycystic ovary syndrome, ovarian resistance to clomiphene citrate is common. Simply put, the ovaries do not respond to treatment with the drug. Insensitivity ranges from 20 to 60%, which is quite a lot. Therefore, a special rating scale was developed that takes into account the patient’s height, weight, ovarian volume and some hormonal indicators. An experienced doctor will definitely analyze this data before prescribing Clostilbegit.

It is important to take into account that during treatment with Clostilbegit, the thickness of the endometrium decreases. If you have a thin endometrium, doctors usually stimulate ovulation with other drugs.

Interaction

— Is the drug used alone or together with other medications?

— Clomiphene citrate is often used in combination with other drugs. For example, hormonal hormones are sometimes prescribed oral contraceptives a short course (two to three months) and only then Clomiphene citrate. Sometimes a combination of Clostilbegit and Metformin is used.

To make stimulation more effective, it can be supplemented with therapy with gonadotropic hormones, for example, the drug “Proginova”. Proginov contains synthetic estrogen. “Proginova” and “Klostilbegit” are prescribed according to a special scheme:

on the fifth day of the cycle – 5 days of “Klostilbegit”;
when the ultrasound shows that the follicle is mature (has grown to 20 mm), an hCG injection is given to stimulate the formation of the corpus luteum;
Normally, after the hCG injection was given, ovulation occurs approximately 2 days later, and Proginova is prescribed to prevent ovarian aging.

Therapy can also be successfully supplemented with the drug Duphaston. Synthetic dydrogesterone, which Duphaston contains, is an analogue of natural progesterone that effectively helps fertilization and maintain pregnancy.

Duphaston is taken in the second cyclic phase and helps prepare the endometrium for pregnancy, improves the process of egg implantation and reduces the risk of miscarriage. Duphaston is also safe during pregnancy, while Clostilbegit is potentially dangerous to the fetus and cannot be taken if conception has occurred.

The simultaneous use of the drugs Proginova, Clostilbegit and Duphaston is prescribed quite often. But, of course, this should be decided by your attending physician. He also makes the decision to cancel treatment.

What if it didn’t help?

— What to do if Klostilbegit did not help?

- Then they stimulate ovulation with other drugs. These are hormonal drugs “Menotropin”, “Follitropin” and others. This effective medicines, but they are more likely to cause side effects than Clomiphene citrate. Therefore, if your gynecologist is sure that Clostibegit will help you, they usually start with it.

Instructions for use of the drug "Clostilbegit" (click to enlarge)

Clostilbegit is a stimulator of gonadotropin production.

Release form and composition

Dosage form Clostilbegita - tablets (round, flat, white, grayish-white or yellowish-white), 10 pcs. in blisters or dark glass bottles, 1 blister or 1 bottle in a cardboard pack.

The active ingredient of the drug is clomiphene citrate: 1 tablet – 50 mg.

Auxiliary components: stearic acid, magnesium stearate, talc, lactose monohydrate, gelatin, potato starch.

Indications for use

For women:

Induction of ovulation in anovulatory infertility;
Androgen deficiency;
Oligomenorrhea;
Secondary amenorrhea;
Dysgonadotropic form of amenorrhea;
Post-contraceptive amenorrhea;
Prolonged postpartum amenorrhea-galactorrhea syndrome (Chiari-Frommel syndrome);
Galactorrhea that developed against the background of a pituitary tumor;
Polycystic ovary syndrome (Stein-Leventhal syndrome).

For men:

Oligospermia.

Contraindications

Ovarian cyst (except polycystic ovary syndrome);
Metrorrhagia of unknown etiology;
Endometriosis;
Insufficiency of ovarian function as a result of hyperprolactinemia;
Tumors of the genital organs;
Hypofunction or tumor of the pituitary gland;
Adrenal dysfunction;
Liver/renal failure;
Visual impairment;
Thyroid dysfunction;
Lactase deficiency, galactose intolerance, glucose malabsorption;
Pregnancy;
Lactation;
Hypersensitivity to clomiphene or excipients.

Directions for use and dosage

Clostilbegit should be taken orally.

The dose and duration of treatment for infertility are determined individually, taking into account the reaction of the ovaries to the drug.

Scheme I: 50 mg of clomiphene citrate (1 tablet of Clostilbegit) for 5 days. With the help of laboratory and clinical trials control the reaction of the ovaries. Ovulation usually occurs between days 11 and 15 of the cycle. If there is no effect, the following regimen is prescribed.

Scheme II: 100 mg (2 tablets) per day for 5 days. If there is no ovulation at this time, the second scheme is repeated. If anovulation continues, the use of Clostilbegit is interrupted for 3 months, after which treatment is carried out for 3 months. If this course is ineffective, further treatment is not advisable.

The maximum permissible total dose for each course is 750 mg.

Initial daily dose for polycystic ovary syndrome – 50 mg.

For post-contraceptive amenorrhea, the drug is taken 50 mg once a day daily. When using scheme I, as a rule, one 5-day course is sufficient.

For the treatment of oligospermia, men are prescribed 50 mg 1-2 times a day. The drug is taken for 6 days, systematically monitoring the spermogram.

Side effects

Digestive system: nausea and vomiting; rarely - increased appetite, diarrhea, flatulence, gastralgia, acute abdominal syndrome;
Reproductive system: vaginal dryness, pain in the lower abdomen;
Central nervous system: headache, dizziness and drowsiness; rarely – increased excitability, insomnia, depression, slowed mental and motor reactions;
Urinary system: polyuria, increased urination;
Allergic reactions: rarely - rash, vasomotor disorders, urticaria, allergic dermatitis;
Dermatological reactions: rarely - alopecia;
Endocrine system: dysmenorrhea, enlarged ovary (including cystic), hardening of the mammary glands, pathological uterine bleeding; rarely – pain in the mammary glands;
Other: flushing of the face with a feeling of heat (stops after discontinuation of the drug).
Metabolism: rarely – decrease or increase in body weight;
Sense organs: visual impairment (including blurred contours, double vision, photophobia, impaired light perception);

When treated with Clostilbegit, the likelihood of multiple and ectopic pregnancy, growth of existing uterine fibroids, and endometriosis increases.

When taken too high dose possible sensations of a rush of blood to the face, vasomotor reactions, visual disturbances (flares, scotoma, decreased visual acuity), nausea, vomiting, pain in the pelvic organs and abdomen, enlarged ovaries. Treatment of overdose involves measures aimed at removing clomiphene from the body and maintenance therapy.

special instructions

Before prescribing Clostilbegit, a thorough gynecological examination should be performed. Treatment can be started only if the total content of gonadotropin in the urine is within the normal range or less than its lower limit, the condition of the ovaries upon palpation is normal, and the functions of the thyroid gland, adrenal glands and liver are normal. In the absence of ovulation, before starting treatment, it is necessary to exclude or cure all other forms of infertility.

During therapeutic courses with Clostilbegit, constant observation by a gynecologist, vaginal examinations, monitoring of ovarian function, monitoring of the pupil phenomenon (opening of the cervical canal that occurs during ovulation) are required. During treatment, it is not always possible to determine the moment of ovulation; insufficiency of the corpus luteum is often observed, therefore, after conception, preventive treatment with progesterone is recommended. Rating: 4.7 - 3 votes

To stimulate ovulation, in particular tubal infertility and. Besides, side effect Clostilbegitis is a change in pH and thickening of the cervical (cervical) mucus, which interferes with the advancement of sperm. That is why pregnancy, when stimulated by Clostilbegit, occurs, as a rule, not directly in cycles with Clomiphene, but in the interval between courses or after several courses of taking the drug, when viscosity and pH are restored. Reviews of the drug Clomiphene or Clostilbegit fully confirm this.

For polycystic ovary syndrome, clostilbegit is one of the main drugs that help restore ovulation. However, by restoring ovulation, clomiphene may slightly increase the viscosity of cervical mucus. In most cases, this additional action is not critical, and pregnancy occurs. The additional administration of duphaston during ovulation further worsens the permeability of the cervix for sperm.

Under no circumstances start taking Clomiphene without a doctor’s prescription and do not increase the dosage on your own! Firstly, the dose of the drug determines whether it will stimulate ovulation or suppress it, and secondly, hyperstimulation threatens the formation of cysts and your possible pregnancy will be postponed indefinitely. It is also not recommended to carry out more than 6 courses of ovarian stimulation in a lifetime. The price of an unskilled approach to stimulation is your health. The effect of the drug lasts for several years, and the supply of eggs in the female body is limited and after hyperstimulation, ovarian hyperfunction occurs, which threatens ovarian depletion and early menopause. Hyperfunction of the ovaries is deliberately achieved during stimulation during the IVF process and this is the main side effect long-awaited pregnancy, lasting for many years.

At correct selection dosage of Clostilbegit during stimulation (IVF does not count), the consequences are minimized and, as a rule, the second and subsequent pregnancies occur without problems, and early menopause is not threatened.

They write that Clostilbegit and Clomiphene have a pronounced anti-estrogenic effect, but this is not so. Whether the effect is estrogenic or antiestrogenic depends entirely on the dosage, and if the dosage is selected correctly, the drug will not adversely affect the growth of the endometrium.

Support for the second phase of the menstrual cycle after stimulation with Clomiphene is usually carried out with Duphaston or Utrozhestan. In order to prevent the development of insufficiency of corpus luteum function after treatment with Clostilbegit, it is recommended to carry out prophylactic treatment with progesterone Duphaston or Utrozhestan after conception. Clostilbegit is used only with constant supervision by a gynecologist.

After taking the drug, you need to check and, if necessary, restore liver function, otherwise severe toxicosis and late gestosis during pregnancy may occur.