Health Tooty Fruity

A trusted product for the management of INFERTILITY in Fern ales & Males...
IMPROVES
 Enhances ovulation
Offers flexibility of dpsage
 Is well tolerated
 Sperm quantity
 Sperm morphology Sperm motility

Description: 
Clofer has oestrogenic and anti-oestrogenic properties. It may be separated into its Z & E isomers, zu clomiphene and En clomiphene. It is a white to pale yellow, odourless or almost odourless, crystalline powder. It contains 30 to 50% of the Z isomer. Absorption: Clofer is given by mouth and absorbed from gastrointestinal tract Metabolism: It is metabolized in the liver. Excertion: It is slowly excreted via the bile. Unchanged drug and metabolites are excreted in the faeces. Half Life: The biological half life is reported to be 5 days although traces are found in faeces for upto 6 weeks. Entero-hepatic re-circulation takes place.

Isomers:
The En-isomer is reported to be less well absorbed and more rapidly eliminated than the Z-isomer. This is the cause that Z-isomer is more efficient & effective. Actions: Clofer is chemically related to chlorotrainisene & has both oestrogenic and anti-oestrogenic properties, the latter residing principally in the En-isomer. It exert its therapeutic effects by stimulating the secretion of pituitary gondotrophic hormones, probably by blocking the effect of oestrogens at receptor sites in the hypothalamus & pituitary. Indications: Clofer is used in the treatment of anovulatory infertility. Therapy with Clofer will not be successful unless the women, though anovulatory, is capable of ovulation and her partner is fertile. It is ineffective in primary pituitary or ovarian failure.

Contraindications:
Clofer is contraindicated in patient with liver disease, or history of liver dysfunction, endometrial carcinoma or ovarian cysts, undiagnosed abnormal uterine bleeding and during pregrancy Side Effects: Reversible ovarian enlargement, and cyst formation, vasomotor flushes abdominal or pelvic discomfort, pain in abdomen with nausea & vomiting, breast tenderness, abnormal uterine bleeding, weight gain, headache, increased urinary flow, transient eye disturbance, blurring of vision, cataracts, allergic rashes, urticaria, reversible hair loss, dizziness, light headedness, nervous tension, fatigue, vertigo, insomnia, depression, abnormal liver function tests and multiple births, congenital disorders as neural tube defect, Down s syndrome in the newborn.

Precautions:
The cause of infertility should be investigated. The patient should be warned of the possibility of multiple births, particularly if higher doses are used. Treatment should be discontinued if visual disturbances develop and the patient warned that this might effect their ability to drive or operate machinery. The patient should be instructed to report any abdominal or pelvic pain as this may indicate the presence or enlargement of ovarian cysts. Patients with polycystic ovaries undergoing therapy with Clofer should receive the lowest doses possible to prevent any further enlargement of cyst formation. Prolonged courses of treatment are not recommended.

 Dosage & Administration:
Clofer is administered orally in tablet form. The usual dose by mouth is-50mg of Clofer daily for 5 days, starting on or about the 5th day of the menstrual cycle If ovulation does not occur, a course of 10Omg daily for 5 days may be given. Clofer is also sometimes used in conjunction with gonadotrophins and in in-vitro fertilisation programmes. Use of Clofer in the treatment of male infertility has also been investigated. Clofer 50mg daily for 25 continuous days in a month is recommended. It can be continued without breakjf the clinician so desires. How Supplied: 30 tablets in blister packs of 10's.