An accurate examination of the pelvis should be made before treatment and repeated before each successive treatment cycle. Prolifen should not be administered in the presence of ovarian cysts due to the danger of a further increase in the size of the ovaries. Special attention must be given to patients in the later stage of reproductive life due to the major incidence of anovulatory disorders and the increased tendency for the onset of endometrial carcinoma.
Similar attention should be given to patients with abnormal hemorrhages before treatment. In particular it is necessary to ensure that there are no occult neoplastic lesions. In both categories of patients it is necessary to perform a biopsy of the endometrium.
Prolifen therapy must always be preceded by a clinical examination of hepatic functions. To reduce to a minimum risk of abnormal ovarian swelling, it is important to use the minimum dose of Prolifen that gives a positive result. Some patients with a polycystic ovarian syndrome may have an exaggerated response to normal Prolifen dosage. In this case the doses and cycle duration should be reduced. Finally, it should be remembered that the maximum swelling of the ovary, whether this is physiological or abnormal, only occurs after several days of suspension of the recommended Prolifen doses.
Prolifen (Clomiphene Citrate) is a very potent drug that must only be administered under direct and constant medical control. Do not exceed the dose or the treatment duration prescribed by the physician.