Clomifene citrate (Clomid)

Clomifene citrate (Clomid)

Another name:2-4-[2-Chloro-1,2-diphenylethenyl]phenoxy-N,N-diethylethanamine citrate
Synonyms:clomifene citrate; clomphid; clomid; fertyl; clomivid; fertivet; anti estrogen hormones; Cholramiphene
Structural formula: C26H28ClNO·C6H8O7
Molecular weight: 598.11
 
CAS NO: 50-41-9
Appearance: white or milky white crystalline powder
Use: the goods to anti-estrogen fertility inducer, the objects in dysfunctional uterine bleeding, polycystic ovary, menstrual disorders and drug-induced amenorrhea and other gynecologic diseases

1.background
Clomifene is a mixture of two geometric isomers, enclomifene (E-clomifene) and zuclomifene (Z-clomifene). These two isomers have been found to contribute to the mixed estrogenic and anti-estrogenic properties of clomifene.
Clomifene has been used since the 1960s. It was first used to treat cases of oligomenorrhea but was expanded to include treatment of anovulation when women undergoing treatment had higher than expected rates of pregnancy.
In April 1989, a patent was awarded to Yale University Medical researchers Dr. Florence Comite and Dr. Pamela Jensen for the use of clomiphene to predict fertility in women. A woman capable of sustaining pregnancy would develop denser bone mass while on clomiphene; the bone mass increase would be predictive of fertility, and the changes could be detected on a CT scanner.
2.Adverse events
The most common adverse drug reaction associated with the use of clomifene (>10% of people) is reversible ovarian enlargement. Less common effects (1-10% of people) include visual symptoms (blurred vision, double vision, floaters, eye sensitivity to light, scotomata), headaches, vasomotor flushes (or hot flashes), abnormal uterine bleeding and/or abdominal discomfort.Rare adverse events (<1% of people) include: high blood level of triglycerides, liver inflammation, reversible baldness and/or ovarian hyperstimulation syndrome.
Clomifene can lead to multiple ovulation, hence increasing the chance of twins (10% of births instead of ~1% in the general population) and triplets.
Some studies have suggested that clomifene citrate if used for more than a year may increase the risk of ovarian cancer. This may only be the case in those who have never been and do not become pregnant.Subsequent studies have failed to corroborate those findings. This however is disputed and some feel there is no significant increase in risk.
The incidence of fetal and neonatal abnormalities for patients on clomifene for fertility is similar to that seen in the general population. There is no data to suggest a higher rate of congenital anomalies or spontaneous abortions after using this drug
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