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Selective oestrogen receptor modulator

Clomifene citrate

Brand names: Clomid

Adult dose

Dose: 50mg OD for 5 days starting day 2–5 of cycle. May increase to 100mg in subsequent cycles. Max 6 cycles
Route: PO
Frequency: OD x 5 days

Clinical pearls

  • Anovulatory infertility (esp. PCOS)
  • Limit to ≤6 cycles to minimise ovarian cancer risk
  • Pre-treatment ovulation work-up required

Contraindications

  • Pregnancy
  • Hepatic impairment
  • Ovarian cyst (other than PCOS)
  • Hormone-dependent tumour
  • Undiagnosed abnormal uterine bleeding

Side effects

  • Hot flushes
  • Mood changes
  • Visual disturbance
  • Multiple pregnancy
  • OHSS

Monitoring

  • Ultrasound + LH/progesterone to confirm ovulation

Reference: BNF; NICE CG156; https://bnf.nice.org.uk/drugs/clomifene-citrate/. Verify against your local formulary and the latest BNF before prescribing.

Related

Curated clinical cross-links plus same-class fallbacks.