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Fertomid (Clomiphene) Buyer and Patient Handbook in South Africa

Fertomid (Clomiphene) is a short-acting oral medication used to stimulate ovulation in women who have difficulty becoming pregnant. It belongs to the selective estrogen receptor modulator (SERM) class and is supplied as 25 mg, 50 mg and 100 mg tablets.

What is Fertomid?

Fertomid is a clomiphene citrate tablet indicated for the treatment of anovulation or oligo-ovulation in women with infertility. It is approved by the South African Health Products Regulatory Authority (SAHPRA) and aligns with FDA and EMA standards. The medication is available in a round, film-coated tablet form that is swallowed whole with water.

Who Should Use Fertomid?

• Women diagnosed with ovulatory dysfunction (e.g., Polycystic Ovary Syndrome).
• Women under the care of a qualified fertility specialist.
• Women aged 18-39 years who are otherwise healthy and have normal uterine anatomy.
• Those who have not responded to lifestyle changes alone.

How Does It Work?

Fertomid works by binding to estrogen receptors in the hypothalamus, tricking the brain into sensing low estrogen levels. This prompts the pituitary gland to release more follicle-stimulating hormone (FSH) and luteinising hormone (LH), which stimulate the ovaries to mature follicles. The result is a higher chance of a mature egg being released during the menstrual cycle. Abuse potential is low, but the drug should only be used under professional supervision because of the risk of multiple pregnancies.

Why Choose Fertomid?

Choosing Fertomid offers the reliability of a well-studied brand formulation with consistent tablet strength and proven bio-equivalence to generic clomiphene. For patients seeking cost-effective options, generic clomiphene citrate tablets provide the same active ingredient at a lower price, though the brand may be preferred for its established safety record. Off-label uses (e.g., male hypogonadism) should only be considered after thorough discussion with a healthcare professional.

Dosage, Administration, Lifestyle and Dietary Recommendations

Recommended Dosage

• Starting dose: 50 mg once daily for 5 days, beginning on cycle day 2-5.
• Adjustment: May increase to 100 mg daily if ovulation does not occur after 2-3 cycles.
• Maximum: 150 mg per cycle (e.g., 50 mg for 3 days).

How to Take

1. Take the tablet with a full glass of water.
2. Preferably take in the morning to minimise nausea.
3. Do not crush or split the tablet unless instructed.

Missed Dose

• If a dose is missed, take it as soon as you remember provided it is at least 12 hours before the next scheduled dose.
• Skip the missed dose if it is closer than 12 hours to the next dose, and continue the regular schedule.

Overdose

• Call emergency services (112) immediately if you suspect an overdose.
• Symptoms may include severe nausea, vomiting, visual disturbances, or abdominal Pain.

Special Populations

• Elderly: Not routinely used; limited data.
• Children: Not indicated.
• Renal/hepatic impairment: No dose adjustment needed for mild-moderate dysfunction; severe disease warrants specialist review.

Lifestyle & Diet

• Avoid grapefruit juice while on Fertomid, as it may increase blood levels.
• Maintain a balanced diet with adequate protein and complex carbohydrates.
• Moderate exercise is encouraged; avoid excessive endurance training which can impair ovulation.
• Limit caffeine to ≤200 mg per day (≈2 cups coffee).

Precautions and Warnings

• Do not use if you are pregnant or breastfeeding.
• Perform a baseline ultrasound to rule out ovarian cysts before starting treatment.
• Watch for signs of ovarian hyperstimulation syndrome (OHSS): rapid weight gain, abdominal pain, shortness of breath.
• Use effective contraception if you wish to avoid pregnancy during treatment cycles not aimed at conception.

Drug Interactions

Potential Side Effects

Common Side Effects

• Nausea
• Hot Flashes
• Breast tenderness
• Mood swings

Less Common Side Effects

• Headache
• Visual disturbances (blurred vision)
• Abdominal discomfort

Serious Side Effects

• Ovarian hyperstimulation syndrome - seek immediate medical attention.
• Severe allergic reaction (rash, swelling, difficulty breathing) - call emergency services.

Who Should Avoid This Medication?

• Known hypersensitivity to clomiphene or any tablet excipients.
• Existing ovarian cysts larger than 3 cm.
• Uncontrolled thyroid disease.
• History of multiple gestations (e.g., twins, triplets) where further risk is undesirable.

Storage Instructions

• Store at 15-30 °C in a dry place.
• Keep the bottle tightly closed, away from moisture and heat.
• Keep out of reach of children.

Fertomid Alternatives

Frequently Asked Questions

How long does it take to see an effect?

Most women ovulate within 5-10 days after completing the 5-day dosing schedule.

Can I drink alcohol while taking Fertomid?

Occasional moderate alcohol (≤1 drink per day) does not affect efficacy, but heavy drinking may impair ovulation.

What if I don’t get pregnant after the first cycle?

Your doctor may increase the dose or extend treatment to up to 3 cycles before evaluating alternative options.

Is Fertomid safe for women with polycystic ovary syndrome (PCOS)?

Yes, it is commonly prescribed for PCOS-related anovulation, but monitoring for OHSS is essential.

Can I take Fertomid with my birth control pill?

Using combined oral contraceptives concurrently can reduce Fertomid’s ovulation-stimulating effect; discuss timing with your clinician.

What should I do if I experience visual disturbances?

Stop the medication and contact a healthcare professional promptly; visual symptoms can indicate OHSS.

Does Fertomid increase the chance of twins?

It raises the likelihood of multiple ovulations, so the risk of twins is higher than natural conception, though still low.

How should I schedule my fertility monitoring?

Baseline ultrasound on day 2-5, followed by a mid-cycle scan (around day 12-14) to confirm follicle development.

Glossary

• Selective Estrogen Receptor Modulator (SERM): A drug that blocks or activates estrogen receptors in different tissues.
• Follicle-Stimulating Hormone (FSH): Hormone that promotes growth of ovarian follicles.
• Ovarian Hyperstimulation Syndrome (OHSS): Excessive ovarian response causing swelling and fluid shifts.

Disclaimer

This handbook provides general information about Fertomid (clomiphene) and is not a substitute for professional medical advice. All off-label uses, dosage adjustments, and treatment decisions must be discussed with a qualified healthcare provider. Our online pharmacy service offers convenient access to approved medicines; however, the responsibility for safe use rests with the patient and their clinician. Always read the patient information leaflet and consult a doctor if you have concerns.